Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Some men
are notorious foot-draggers, especially when it comes to scheduling doctor
visits. That's unfortunate. Routine preventive care can find
cancer in men and
other diseases in the early stages, when there are more options for treatment
and better chances of a cure. Some men, though, would never go to the doctor
except for the women in their life. According to Leonard Lichtenfeld, MD, deputy
chief medical officer for the national office of the American Cancer Society,
women are often the ones who push men to get screened for cancer.
Experts say that men could benefit greatly by being alert to certain cancer
symptoms that indicate a trip to the doctor's office sooner rather than later.
Some of those cancer symptoms in men are specific. They involve certain body
parts and may even point directly to the possibility of cancer. Other symptoms
are more vague. For instance, pain that affects many body parts could have
dozens of explanations and may not be cancer. But that doesn't mean you can rule
out cancer without seeing a doctor.
Cancer Symptom in Men No. 1: Breast Mass
If you're like most men, you've
probably never considered the possibility of having
breast cancer. Although it's
not common, it is possible. "Any new mass in the breast area of a man needs to
be checked out by a physician," Lichtenfeld says.
In addition, the American Cancer Society identifies several other worrisome
signs involving the breast that men as well as women should take note of. They
include:
When you consult your physician about any of
these signs, expect him to take a careful history and do a physical exam. Then,
depending on the findings, the doctor may order a mammogram, a
biopsy, or other
tests.
Men possess a small amount of nonfunctioning breast
tissue (breast tissue that cannot produce milk) that is concentrated in the area
directly behind the nipple on the chest wall. Like breast cancer in women, cancer of the male breast is the uncontrolled growth of the
abnormal cells of this breast tissue.
Breast tissue in both young boys and girls consists of tubular structures
known as ducts. At puberty, a girl's
ovaries produce female hormones (estrogen) that cause
the ducts to grow and milk glands (lobules) to develop at the ends of the ducts.
The amount of fat and connective tissue in the breast also increases
as girls reach puberty. On the other hand, male hormones (such as testosterone)
secreted by the testes suppress the
growth of breast tissue and the development
of lobules. The male breast, therefore, is made up of predominantly small,
undeveloped ducts and a small amount of fat and connective tissue.
How common is male breast cancer?
Male breast cancer is a rare condition, accounting for only about 1% of all breast cancers. The American Cancer Society estimates that in 2010, about 1,970 new cases of breast cancer in men would be diagnosed and that breast cancer would cause approximately 390 deaths in men (in comparison, almost 40,000 women die of breast cancer each year). Breast cancer is 100 times more common in women than in men. Most cases of male breast cancer are detected in men between the ages of 60 and 70, although the condition can develop in men of any age. A man's lifetime risk of developing breast cancer is about 1/10 of 1%, or one in 1,000.
What are causes and risk factors of male breast cancer?
As with cancer of the female breast, the cause of cancer of the male breast
has not been fully characterized, but both environmental influences and genetic
(inherited) factors likely play a role in its development. The following risk
factors for the development of male breast cancer have been identified.
Radiation exposure
Exposure to ionizing radiation has been associated with
an increased risk of developing male breast cancer. Men who have previously
undergone radiation therapy to treat malignancies in the chest area (for example,
Hodgkin's lymphoma)
have an increased risk for the development of breast cancer.
Hyperestrogenism (high levels of estrogen)
Men normally produce small amounts of the female hormone
estrogen, but
certain conditions result in abnormally high levels of estrogen in men. The term
gynecomastia refers to the condition in which the male breasts become abnormally
enlarged in response to elevated levels of estrogen. High levels of estrogens also can
increase the risk for development of male breast cancer. The majority of breast
cancers in men are estrogen receptor-positive (meaning that they grow in
response to stimulation with estrogen). Two conditions in which men have abnormally high levels of estrogen that are commonly associated with breast enlargement are Klinefelter's
syndrome and cirrhosis of the liver. Obesity is also associated with elevated estrogen levels and breast enlargement in men.
Klinefelter's syndrome is an
inherited condition affecting about one in 1,000 men. A normal man has two sex
chromosomes (X and Y). He inherited the female X chromosome from his mother and the male Y chromosome from his
father. Men with Klinefelter's syndrome have inherited an extra female X chromosome, resulting
in an abnormal sex chromosome makeup of XXY rather than the normal male XY. Affected Klinefelter's patients produce high levels of estrogen and develop
enlarged breasts, sparse facial and body hair, small testes, and the inability
to produce sperm. Some studies have shown an increase in the risk of developing breast cancer in men with this condition. Their risk for development of breast cancer is markedly
increased, up to 50 times that of normal men.
Cirrhosis (scarring) of the liver can result from chronic alcohol abuse,
chronic viral hepatitis, or
rare genetic conditions that result in accumulation of toxic substances within
the liver. The liver produces important binding proteins that affect the
transport and delivery of male and female hormones via the bloodstream. With
cirrhosis, liver function is compromised, and the levels of male and female
hormones in the bloodstream are altered. Men with cirrhosis of the liver have
higher blood levels of estrogen and have an increased risk of
developing breast cancer.
Familial predisposition
Epidemiologic studies have shown that men who have
several female relatives with breast cancer also have an increased risk for
development of the disease. In particular, men who have inherited mutations in
the breast cancer-associated BRCA-2 gene have a dramatically increased (about
eightyfold) risk for developing
breast cancer, with a lifetime risk of
about 5%-10% for development of breast cancer. BRCA-2 is a gene on chromosome 13 that
normally functions in suppression of cell growth. Mutations in this gene lead to
an increased risk for development of breast, ovarian, and prostate cancers.
About 15% of breast cancers in men are thought to be attributable to BRCA-2
mutation. The role of the BRCA-1 gene, which has been associated with inherited breast cancers in women, is not as clearly defined for male breast cancers.
Finasteride use
Finasteride (Propecia, Proscar), a drug that has been used to treat benign prostatic hyperplasia and to prevent prostate cancer, may be associated with an increased risk for male breast cancer. During clinical trials for the drug, no increased risk was shown. However, over 50 cases of male breast cancer have been reported worldwide in men taking the drug. Further studies are needed to clarify whether a causal relationship between the drug and the disease actually exists.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependant on the type of hepatitis.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Gynecomastia, an enlargement of the gland tissue in the male breast is the caused by an imbalance of hormones. Certain medical conditions may also lead to gynecomastia such as cirrhosis, malnutrition, disorders of the male sex organs, kidney failure, thyroid disorders, and medications. Gynecomastia is generally treated with medication, and if necessary surgery.
Klinefelter syndrome, also referred to as XXY condition, is a genetic disease. Klinefelter syndrome affects mostly males. Symptoms include decreased testosterone levels, development of breasts, wider hips, and infertility. Some men with Klinefelter syndrome have no symptoms. Treatment includes educational, therapeutic, and medical therapy.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Lymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Lifestyle changes, a healthy antioxidant-rich diet, exercise, and weight reduction can help reduce a woman's risk of developing breast cancer. It's important to be aware of how risk factors such as family history, lifestyle factors, breast conditions, radiation therapy, and hormonal factors may influence your chances of developing breast cancer. Mammography and breast self-examinations are crucial steps in breast cancer prevention.
Men's health is an important component to a happy lifestyle and healthy relationships. Eating healthy, exercise, managing stress, and knowing when to have medical tests for a particular age is key to disease prevention in men.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
A breast biopsy is a procedure in which part or all of a suspicious breast growth is removed and examined, usually for the presence of
cancer. The growth sample is suctioned out through a needle or cut out using a surgical procedure. The sample is then examined and evaluated under a microscope by a pathologist to identify non-cancerous (benign) or cancerous (malignant) tissue.
Words used to refer to the abnormal area or growth before and after diagnosis may include lump, mass, lesion, and tumor.
What is the purpose of a breast biopsy?
The basic aim of a breast biopsy is to determine whether or not a worrisome lump is cancer and, if it is cancer, what type it is. When no cancer is detected, the diagnosis of a benign or harmless lump is reassuring.
What specialties of physicians and practitioners do breast biopsies?
Many physicians and healthcare practitioners can be invol...
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