Male breast cancer is rare and affects 2.7 out of 100,000 African American men
Male breast cancer is rare and affects 2.7 out of 100,000 African American men

Male breast cancer is rare and affects 2.7 out of 100,000 African American men and 1.9 out of 100,000 Caucasian men in the United States.

The African American men with breast cancer typically have a lower chance of recovery. It is more common in older men but can occur at any age. Male breast cancer must be differentiated from the following conditions:

  • Gynecomastia (noncancerous enlargement of the male breast)
  • Pseudogynecomastia (lipomastia), which is fat deposition in breasts

Men retain small amounts of breast tissue from birth where the cancer originates. Breast cancer may feel like

  • Small lump near the nipples
  • Knots in the armpits
  • New changes at the nipple and skin covering the breast tissue, such as redness, scaliness, puckering, discharge from the nipple or inverted nipple
  • Blood discharge from nipples
  • Pain around the nipple area or the pecs (muscle underlying breasts)
  • Weight loss

Male breast cancer typically begins unilaterally. The cancer can spread to the other breast, surrounding tissues, lymph nodes and other parts of the body (metastasis). Male breast cancer is highly curable if diagnosed and treated early.

What causes male breast cancer?

The exact causes of male breast cancer are unknown. Everyone, including men, is born with a small amount of breast tissue that contains milk-producing glands (lobules), ducts that carry milk to the nipples and fat. During puberty, women develop more breast tissue whereas men don’t. Based on research, it is believed that male breast cancer occurs when some of the breast cells divide more rapidly than healthy cells and form a tumor. The tumor can spread (metastasize) to nearby tissue, lymph nodes and other distant parts of the body.

The causes of male breast cancer include

  • Inherited genes can increase breast cancer risk: Inherited mutations in one of the several genes, especially in the BRCA2 gene, increases the risk of breast and prostate cancers. Those with a family history of cancer should consult a doctor and genetic counselor.
  • Factors that increase the risk of male breast cancer include
    • Older age. The risk of breast cancer increases for men older than 60 years of age.
    • Exposure to estrogen. Taking estrogen-related drugs as hormone therapy for prostate cancer can increase the risk of male breast cancer.
    • Family history of breast cancer. If a close family member has breast cancer, there is a higher chance of developing the disease.
    • Klinefelter syndrome. This is a genetic syndrome. It occurs when boys are born with more than one copy of the X chromosome. Klinefelter syndrome is associated with abnormal development of the testicles, lower levels of certain male hormones (androgens) and more female hormones (estrogens).
    • Liver diseaseLiver cirrhosis can reduce male hormones and increase female hormones, increasing the risk of male breast cancer.
    • Obesity. Obesity is associated with higher levels of estrogen. This may increase the risk of male breast cancer.
    • Testicular disease or surgery. Orchitis (inflammation of testes) or surgical removal of the testes (orchiectomy) can increase the risk of male breast cancer.

QUESTION

A lump in the breast is almost always cancer. See Answer

What are the types of male breast cancer?

Types of breast cancer diagnosed in men include

  • Ductal carcinoma (cancer that begins in the milk ducts). Most of the cases of male breast cancer are ductal carcinomas.
  • Lobular carcinoma (cancer that begins in the milk-producing glands). This is rare because men only have a few lobules in their breast tissue.
  • Other rare types of cancer. This includes Paget disease of the nipple and inflammatory breast cancer.

How is male breast cancer treated?

Treatment depends on the stage of cancer and the patient’s overall health. Treatment options for male breast cancer include

  • Surgery: This is the most preferred treatment. In the early stages, surgery can be curative. Surgical procedures involve removing all the breast tissue (mastectomy) with or without the surrounding lymph nodes.
  • Radiation therapy: This uses high-energy beams to kill cancer cells.
  • Hormone therapy: Most male breast tumors are hormone-sensitive (rely on hormones to grow). Hormone-sensitive male breast cancer can improve with hormone therapy medications, such as tamoxifen.
  • Chemotherapy: Chemotherapy uses medications that may be taken intravenously or as pills to kill cancer cells. Chemotherapy is often advised after surgery to kill cancer cells that might have metastasized. It is a good option for men with advanced breast cancer.

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Medically Reviewed on 5/14/2021
References
Jana BRP. Breast Cancer in Men Overview of Male Breast Cancer. Medscape. https://emedicine.medscape.com/article/1954174-overview

Breastcancer.org. Male Breast Cancer. https://www.breastcancer.org/symptoms/types/male_bc