Male Breast Cancer (cont.)
How is male breast cancer diagnosed?
Diagnosis of breast cancer requires identifying cancer cells in tissue
specimens obtained by biopsy. Since men have
little breast tissue, cancers in male breasts are easily palpable (located by
feel) and, therefore, are easily accessible to biopsy. Fine needle aspiration or needle biopsy of a suspicious
mass can usually establish a diagnosis. A needle is inserted into the mass and
tissue from the suspicious area is withdrawn. Microscopic examination of the
tissue by a pathologist establishes the diagnosis.
Other techniques that may be used to diagnose breast
cancer in men include incisional (removing a portion of the suspicious tissue)
or excisional (removing
the mass in its entirety) biopsy of a breast mass. If nipple discharge is
present, microscopic examination of a smear of the discharge can sometimes
establish the diagnosis.
Imaging studies such as X-rays, CAT scans (CT scans),
magnetic resonance imaging (MRI), ultrasound, and bone scans may
be performed to evaluate the presence and extent of metastatic disease once the
initial diagnosis of breast cancer has been made.
What is staging of male breast cancer?
Staging is carried out to determine the extent to which
a cancer has spread within the body. Staging of breast cancer in men is carried
out identically to the staging of breast cancer in women. The American Joint
Committee on Cancer (AJCC) TNM system takes into account the tumor size, lymph node involvement by
cancer, and presence of metastasis:
- T: tumor size and extent
of local spread
- N: extent of tumor
involvement of lymph nodes in the axillary (underarm) region. Since the nipple
area is rich in lymphatic vessels, male breast cancer commonly spreads via the
lymphatic channels to the axillary lymph nodes (When the tumor has spread to
the lymph nodes, doctors sometimes use the term "lymph node-positive" cancer).
- M: presence
of distant metastases (spread to other parts of the body through the bloodstream
or lymphatic vessels)
Stage 0
Stage 0 refers to intraductal carcinoma, in which the cancer cells have not
spread beyond the boundaries of the ducts themselves.
Stage I
In Stage I breast cancer, the tumor is 2 cm or less in greatest diameter and
has not spread to the lymph nodes or to other sites in the body.
Stage II
Stage II cancers are divided into two groups. Stage IIA cancer is either less
than 2 cm in diameter with spread to the axillary lymph nodes, or the tumor is
between 2-5 cm but has not spread to the axillary lymph nodes. Stage IIB
tumors are either larger than 5 cm without spread to the lymph nodes or are
between 2-5 cm in size and have spread to the axillary lymph nodes.
Stage III
Stage III is
considered to be locally advanced cancer. Stage IIIA means the tumor is smaller
than 5 cm but has spread to the axillary lymph nodes, and the axillary lymph
nodes are attached to each other or to other structures; or the tumor is greater
than 5 cm in diameter with spread to the axillary lymph nodes, which may be
attached to each other or to other structures. Stage IIIB tumors have spread to
surrounding tissues such as skin, chest wall, and ribs, or to the lymph nodes
inside the chest wall.
Stage IV
Stage IV cancer refers to metastatic cancer, meaning it
has spread to other parts of the body. With breast cancer, metastases (sites of
tumor elsewhere in the body) are most often found in the bones, lungs, liver, or
brain. Stage IV cancer is also diagnosed when the tumor can be found in the
lymph nodes of the neck.
Next: How is male breast cancer treated? »
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