 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Breast cancer is generally thought of as a disease that affects women; but like women, men have breast tissue that can develop cancer. Breast cancer is about 100 times more common among women than men, but men should still be aware that breast cancer can affect them. Before puberty, both boys and girls have a small amount of breast tissue consisting of a few ducts, or tubes, under the nipple and areola (the dark area around the nipple). Male breast cancer occurs when these ducts develop cancer. During puberty, a girl’s ovaries produce hormones causing breast ducts to grow. During male puberty, hormones produced by the testicles prevent breast tissue from growing any further. But the tissue is there nonetheless, and like all cells of the body, the cells of a man’s breast ducts can go through cancerous changes. Gynecomastia is the most common breast disorder among males. Gynecomastia is an increase in the amount of a man’s breast tissue, and not a tumor. A man with gynecomastia will have a button-like or disk-like growth under his nipple and areola which can be felt or seen. It is common among teenage boys or older men, both of whom experience changes in hormone balance. There are different types of male breast cancer, depending on how far the cancer has progressed. Ductal carcinoma in situ (DCIS) is when cancer cells fill only the ducts of the breast and do not spread to the breast’s fatty tissue. Almost 100% of patients diagnosed at this stage may be cured, but only about 5% of cases of male breast cancer are found at this early stage. Diagnosis of DCIS is more common among women because it can be detected by mammography, but mammography is not recommended for men. Sometimes at this stage, DCIS causes a man to develop a breast discharge, calling attention to the cancer. More commonly (80%-90% of cases), male breast cancer is in the form of infiltrating (or invasive) ductal carcinoma (IDC). After beginning in a breast duct, this stage of cancer spreads through the duct wall and invades the breast’s fatty tissue. Changes in the breast are then noticeable, and cancer is most often diagnosed at this stage. Men may also develop Paget’s disease of the nipple, in which the cancer starts in the ducts and spreads to the skin of the nipple. With this disease, there is usually a history of crusting, scaly, red tissue on the nipple, itching, oozing, burning, or bleeding. Paget’s disease can result from either DCIS or IDC.
Detection and Prevention of Male Breast Cancer Detecting male breast cancer is often different than detecting female breast cancer. Mammography is used as a diagnostic test for both male and female breast cancer, but it is not used as a screening test for men. However, the American Cancer Society recommends a yearly cancer-related health checkup for all men and women over 40. Many cases of male breast cancers could have been detected earlier by health care professionals. It is important to see a physician if you have any of the following symptoms:
These symptoms can be caused by other conditions, gynecomastica being the most common; however, it is important to see a health care provider to find out. It is easier for men to feel masses in their breasts than for women because of the obvious size difference. Also, since men have so little breast tissue, male breast cancers don’t need to grow very far before they can be detected on the skin covering the breast or the muscles underneath it. So male breast cancers are usually smaller than female breast cancers when they are detected, but often they have spread more quickly beyond the breast. Also, some men ignore breast lumps because they are unaware of male breast cancer as a possible cause or out of embarrassment. This attitude can delay diagnosis and reduce the likelihood for successful treatment. A physician may use medical history, a clinical breast exam, mammograms, nipple discharge examinations, and/or biopsy to diagnose male breast cancer. A biopsy is the removal of tissue samples for examination, and it is the only way a doctor can tell if an abnormality is cancerous. There are different types of biopsies that are used depending on the patient’s situation. Staging is a way that doctors determine how far the cancer has spread and what types of treatments will be used. Male breast cancer is staged according to the size of the tumor and how far the cancer has spread beyond the breast. Risk factors
Estrogen treatments and Klinefelter’s syndrome, a congenital condition, can also put men at an increased risk because they affect sex hormones. There is no known way to prevent male breast cancer. Early detection and prompt treatment are the best strategy for reducing breast cancer deaths among men.
Treatment of Male Breast Cancer Male breast cancer treatment can be local or systemic. Local treatments are used to remove, destroy, or control cancer in a specific area. Surgery and radiation therapy are both local treatments. Systemic treatment involves receiving anti-cancer drugs that reach all parts of the body through the bloodstream. Chemotherapy and hormone therapy are both systemic therapies. Systemic therapy is often used to kill hidden cells or tumors that may occur if the cancer spreads beyond the primary site. Adjuvant therapy is systemic therapy given after surgery to prevent reoccurring cancer. Surgery With female breast cancer, breast conservation is often an option. Breast conservation consists of a lupectomy, the removal of only the lump and some surrounding tissue in the breast. Partial or segmental mastectomy or quadrantectomy, which remove up to one quarter of the breast, are also performed for women with breast cancer. However, since men have significantly less breast tissue than women, breast conservation is rarely an option. A mastectomy is usually performed, and it is often necessary to remove the nipple and areola in order to reach and surgically treat the cancer. Radiation Therapy Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be used to shrink a tumor before surgery or to destroy remaining cancer cells after surgery. Side effects of radiation therapy include fatigue, sunburn-like skin changes, and swelling of the arm if the therapy involves axillary lymph nodes (located under the arm). Chemotherapy Chemotherapy uses anticancer drugs that can be injected into a vein or muscle, or taken orally. Often, patients receive a combination of anticancer drugs for treatment. Chemotherapy is given in cycles of treatment and recovery. The average chemotherapy treatment lasts for six months, varying from four to nine months. Most patients receive chemotherapy in an outpatient part of the hospital, at the doctor’s office, or at home. Chemotherapy is often used to prevent cancer recurrence. It can produce side affects including nausea, vomiting, loss or increase of appetite, temporary loss of hair, mouth sores, increased chance of infection, and fatigue. Hormone Therapy Hormone therapy is used to treat potentially cancer-causing hormone imbalances. Antiestrogen drugs are known to be effective in shrinking male breast tumors. The antiestrogen drug tamoxifen (Nolvadex) is the most often used hormone therapy for men and women, and is taken daily in pill form. Hormone treatments can produce side affects including loss of sexual desire, weight gain, hot flashes, and mood swings. Sentinel lymph node biopsy is a new technique used in breast cancer treatment. With this treatment, dye or a radioactive substance is injected near the tumor site. Doctors then observe, through surgery or scanning, to which lymph node(s) this material flows first. These nodes are the sentinel lymph nodes, where the cancer is most likely to spread from the primary tumor. The doctor then removes the node(s) to check for cancer cells. Patients should discuss and ask questions about their condition and treatment with their cancer care team. Some questions you might ask:
|
