Male breast cancer
Although breast cancer is rare in men, it does occur: an estimated 1,400 cases will be
diagnosed in American men this year.
This is cancer that can develop in the small amount of breast tissue that men have
behind their nipples. Breast cancer occurs much more commonly in women and only 1% of
breast cancers occur in men.
What causes male breast cancer?
The cause of male breast cancer is not completely understood, but some men seem to be
at higher than average risk of developing the disease.
This rare cancer most commonly occurs in men over the age of 60. It is more common in
men who have had several close members of their family (male or female) who have had
breast cancer, a close relative diagnosed with breast cancer in both breasts or a relative
diagnosed with breast cancer under the age of 40. Having several members of the family
with cancer of the ovary or colon may also increase a man's risk of developing breast
cancer.
There are special clinics for people who are concerned that they may have an increased
risk of developing cancer because of their family history. These are known as family
cancer genetic clinics. Your GP (family doctor) can refer you to one of these clinics if
they think you may be at an increased risk of developing male breast cancer. CancerBACUP
has a section on Genetics and cancer.
In rare circumstances men with high oestrogen levels or men who have been exposed to
repeated doses of radiation (particularly at a young age) may be at an increased risk of
developing breast cancer. In a rare genetic condition where a man is born with an extra
female chromosome called Klinefelter's syndrome his risk of developing breast cancer is
increased.
Male breast cancer symptoms
The most common symptom is a lump in the breast. There are however other signs that may
occur, such as a change in the size or shape of the breast, an ulcer on the skin, fluid
coming out of the nipple (discharge) or turning in of the nipple (inversion). Another
possible symptom is a rash on the nipple or surrounding area.
How is Male breast cancer diagnosed?
Your doctor will do a physical examination of the affected breast. Tests will be needed
to confirm the diagnosis and to find out if the cancer has spread. You may have some, or
all, of the tests described below:
Ultrasound scan. A scan using sound waves is used to see whether a
lump is solid or contains fluid. A small amount of clear gel is applied to the breast
area. Then a small microphone is moved across the area and a picture appears on a monitor
screen.
Needle aspiration. A thin needle is inserted into the breast in the
area of the lump and some cells are drawn out. This may be done at the same time as the
ultrasound so that the doctor can be sure the cells are from the affected area of the
breast. The cells are examined in the laboratory to see if any are cancerous (malignant).
Needle biopsy. A small piece of tissue is taken from the breast with a
needle and sent for examination under a microscope to check for cancer cells. An injection
of local anaesthetic is given to numb the area before the biopsy is taken.
Blood tests. These are done to check your general health before any
operation.
Mammogram (breast x-ray). Mammograms may be used to look for changes
in the breast, but are not usually used, as ultrasound is more helpful for diagnosing male
breast cancer.
Treatment of Male breast cancer
As male breast cancer is so rare, there have been very few studies looking at the
treatments for this condition. It behaves in a similar way to female breast cancer, and so
is usually treated in much the same way. As with female breast cancer, a combination of
treatments is often used. CancerBACUP can send you detailed information on any of the
treatments mentioned below:
Surgery for Male breast cancer
For most men surgery is the first choice of treatment, however men cannot usually have
just the lump removed (lumpectomy). This is because the amount of breast tissue is small,
and because the tumour is often near or under the nipple. Most men having surgery need to
have a mastectomy (removal of all of the breast tissue and the nipple). Some or all of the
lymph nodes under the arm are likely to be removed as well.
Hormonal therapy for Male breast cancer
The majority of breast cancers need the hormone oestrogen to grow. Oestrogen is the
female sex hormone, but men have a small amount circulating in their bloodstream. Hormonal
therapy is very effective in reducing the amount of oestrogen in the body and is used to
try and prevent the cancer returning following surgery. It may also be used to shrink down
the cancer if it returns after initial surgery.
Tamoxifen. Tamoxifen is the hormonal therapy that is commonly used to
treat breast cancer. It reduces or stops cells making use of the oestrogen that is
circulating in the body. Men usually have similar side effects to women who take tamoxifen
(such as loss of libido or hot flushes), however they may also experience a decrease in
erections. CancerBACUP's section on Tamoxifen discusses this drug in more detail.
Aromatase inhibitors such as letrozole, anastrozole, and exemestane.
In men, oestrogen is made by the conversion of the male sex hormones (androgens). This
conversion is carried out by the enzyme aromatase. Aromatase inhibitors are drugs that
work by blocking aromatase and so blocking the formation of oestrogen. CancerBACUP has
information about the individual aromatase inhibitor drugs. If aromatase inhibitors are
used, they usually need to be given with drugs such as goserelin (Zoladex) that decrease
the production of androgens.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells.
Chemotherapy may be used after surgery if your doctors feel that there is a high risk of
cancer cells having escaped from the breast to other parts of the body before the cancer
was removed. Chemotherapy is usually given if there are cancer cells found in the lymph
nodes under the arm, or if the cancer has spread beyond the breast. The chemotherapy drugs
used in male breast cancer are the same as the ones used in female breast cancer.
CancerBACUP's section on chemotherapy
explains more about this treatment and you can also have factsheets on particular
chemotherapy drugs. Your doctor will discuss with you if chemotherapy is necessary in your
situation.
Male Breast cancer picture |