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Male breast cancer
is rare, accounting for less than 1% of all cases of breast cancer. The
average age of men who are found to have breast cancer is between 60 and
70 years of age, although men of all ages can develop breast cancer.
This section is devoted
to educating men of all ages about breast cancer.
Male Breast Cancer Overview
The types of breast cancer found in men are similar to those seen in women.
The most common type of breast cancer is infiltrating ductal cancer (cancer
that has spread beyond the cells lining ducts in the breast). Intraductal
cancer (abnormal cells found in the lining of a duct; also called ductal
carcinoma in situ), inflammatory cancer (a rare cancer in which the breast
looks as if it is inflamed because of its red appearance and warmth),
and Paget's disease of the nipple (the tumor has grown from ducts beneath
the nipple onto the surface of the nipple) have also been seen in men.
Lobular cancer in situ (abnormal cells found in the one of the lobes or
sections of the breast) has not been seen in men.
Risk Factors
Risk factors for male breast cancer appear to include exposure to radiation,
the administration of estrogen (a hormone), and diseases associated with
hyperestrogenism (producing too much estrogen), such as cirrhosis (liver
disease) or Klinefelter's syndrome (a genetic disorder). Male breast cancer
tends to run in families, with the risk of breast cancer increasing in
men who have multiple female relatives who have had breast cancer. Men
who have the BRCA2 genetic alteration appear to have a higher risk of
developing breast cancer.
Survival Stats
Overall survival for men who have breast cancer is similar to that of
women with breast cancer. Breast cancer in men, however, is frequently
diagnosed at a later stage, affecting the likelihood of survival.
Treatment Options
Four main types of treatment options are available to men with breast
cancer, such as:
- Surgery
(taking out the cancer in an operation)
- Radiation Therapy
(using high-dose x-rays to kill cancer cells)
- Chemotherapy
(using drugs to kill cancer cells)
- Hormone Therapy
(using drugs that change the way hormones work or taking out organs
that make hormones, such as the testicles)
Surgery for men with breast cancer is usually a modified radical
mastectomy (removal of the breast, the lining over the chest muscles,
and sometimes part of the chest wall muscles).
In addition, some
of the lymph nodes (small organs that fight infection and disease) under
the arm may also be removed and sent to a laboratory to be examined under
a microscope by a doctor of pathology to see if the lymph nodes contain
any microscopic cancer cells.
Radiation therapy
is the use of high-energy x-rays to kill cancer cells and shrink tumors.
Radiation will usually be given by a machine outside the body (external
radiation therapy).
Chemotherapy
is the use of drugs to kill cancer cells. Chemotherapy may be taken by
mouth or it may be put into the body by inserting a needle into a vein
or muscle. Chemotherapy is called a systemic treatment because the drugs
enter the bloodstream, travel through the body, and can kill cancer cells
outside the breast area.
Hormone therapy
may be given if tests show that the breast cancer cells have estrogen
receptors or progesterone receptors (certain proteins in cancer tissue).
Hormone therapy is used to change the way hormones in the body help cancers
grow. This may be done by using drugs that change the way hormones work
or by surgery to take out organs that make hormones, such as the testicles.
Hormone therapy with tamoxifen is often given to patients with early stages
of breast cancer.
Initial Surgical
Management
Most men diagnosed with breast cancer will receive a modified radical
mastectomy followed by removal of some of the lymph nodes located under
the arm.
Adjuvant Therapy
Even if the doctor removes all the cancer that can be seen at the time
of the operation, the patient may be given radiation therapy, chemotherapy,
and/or hormone therapy after surgery to try to kill any cancer cells that
may be left.
Therapy given after
an operation when there are no cancer cells that can be seen is called
adjuvant therapy. If cancer is found in the lymph nodes, treatment consisting
of chemotherapy plus tamoxifen (to block the effect of estrogen) and other
hormone therapy appears to increase survival in men as it does in women.
The patient's response
to hormone therapy depends on the presence of hormone receptors in the
tumor. The majority of breast cancers in men have these receptors. Hormone
therapy is usually recommended for male breast cancer patients, but
it can have many side effects, such as hot flashes and impotence (the
inability to have an erection adequate for sexual intercourse).
Locally Recurrent
Disease
For locally recurrent disease (cancer that has come back in a limited
area after treatment), treatment is usually surgery and radiation therapy
combined with chemotherapy.
Distant Metastases
For distant metastases (cancer that has spread to other parts of the body),
hormone therapy, chemotherapy, or a combination of both have shown some
success. Hormone therapy may include:
- Orchiectomy (removal
of the testicles to decrease hormone production)
- Luteinizing hormone-releasing
hormone with or without total androgen blockade (to decrease the production
of sex hormones)
- Tamoxifen for cancer
that is estrogen-receptor positive
- Progesterone (a
female hormone)
- Aminoglutethimide
(reduces the production of estrogen)
- Hormone therapies
may be used in sequence (one after the other).
Standard chemotherapy
regimens may be used if hormone therapy does not work.
Men usually respond
to therapy no differently than women who have breast cancer.
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