Breast cancer: are men the forgotten victims?

SHAFAQNA (Shia International News Association)

In recognition of Breast Cancer Awareness Month this October, cancer charities and organizations around the globe will be “thinking pink.” On October 24th, Breast Cancer Campaign will have their “Wear it Pink” event, in which people all over the US will wear pink clothing to raise awareness of the disease that will be diagnosed in more than 230,000 women this year. But in this flurry of feminine pink, it can be easy to forget that men can get breast cancer, too.

In fact, it is estimated that 2,360 new cases of breast cancer will be diagnosed in men in the US this year, and around 430 men will die from the disease.

Admittedly, breast cancer in men is rare. A man’s lifetime risk of the disease is 1 in 1,000, while a woman’s is 1 in 8. But according to a 2012 study that assessed more than 13,000 male breast cancers from the US National Cancer Data Base, men with breast cancer are less likely to survive the disease than women.

The researchers found that at diagnosis, men were likely to have much larger breast tumors, and the cancer was more likely to have already spread to other areas of the body.

“This may be attributed to the fact that awareness of breast cancer is so much greater among women than men,” commented study leader Dr. Jon Greif. “Guidelines call for regular screening, both clinical and mammographic, in women, leading to earlier detection.”

And it seems Dr. Grief is not wrong. A 2010 study by Eileen Thomas, of the University of Colorado Denver, found that 80% of men surveyed were not aware that men could even develop breast cancer, and the majority could not identify any symptoms of male breast cancer other than a lump in the breast.

In this spotlight feature, we look at the signs of male breast cancer, the diagnostic and treatment options for the disease, and why there is such lack of awareness of male breast cancer among the general public.

‘Most people don’t think of men as having breasts’

“Many people don’t know that men can get breast cancer because they don’t think of men as having breasts,” Jackie Harris, clinical nurse specialist at UK charity Breast Cancer Care, told Medical News Today. “In fact, both men and women have breast tissue, although men have much smaller amounts than women.”

Until puberty, both young girls and boys have small amounts of breast tissue consisting of lobules (glands than can produce milk), ducts (small tubes that carry milk from the lobules to the nipple) and stroma (fatty and connective tissue).

When girls reach puberty, high levels of the female hormone estrogen cause substantial growth in lobules, ducts and stroma, producing full breasts. Because boys and men have low levels of estrogen, they are very unlikely to form fully grown breasts.

However, what breast tissue a man has still contains ducts, and cells in these ducts – like all cells in the body – can become cancerous. The cancerous cells can then enter the lymphatic vessels of the breast and grow in the lymph nodes situated above and below the collarbone and under the breast bone. Once in the lymph nodes, it is likely the cancer cells have entered the bloodstream and spread to other areas of the body.

Although most male breast cancer cases begin in the ducts – known as ductal carcinoma – it can also develop in the breast lobules (lobular carcinoma), but this only accounts for around 2% of all male breast cancers.

The risk factors for male breast cancer

Exactly what causes breast cancer in men is unclear. But many of the factors that increase the risk of breast cancer among women are the same for men.

As men age, their risk of breast cancer increases, with the average age of diagnosis being 68 years. Men who have a family history of breast cancer are also at increased risk of developing the disease.

One of the most well-known risk factors for breast cancer among women is inherited BRCA1 and BRCA2 gene mutations. Men who inherit these mutations are also at much higher risk of breast cancer. Those who have a BRCA1 mutation have a 1 in 100 lifetime risk of the disease, while a BRCA1 mutation poses a 6 in 100 lifetime risk.

Past research has suggested that men with Klinefelter syndrome – a congenital condition in which an additional X chromosome is present – are also at higher risk of breast cancer.

Other factors that increase the risk of breast cancer in women, such as smoking, obesity, radiation exposure and high alcohol consumption, can also increase men’s breast cancer risk.

‘It is vital for everyone to be breast aware’

Women are encouraged to frequently check their breasts for any abnormalities, such as lumps, discharge from the nipple or changes in appearance or texture. And although many men may not be aware of it, they should do the same.

The most common signs of breast cancer in men are lumps or swelling in the breast or lymph node areas, dimpling or puckering of the skin, nipple retraction, nipple discharge and scaling or redness of the nipple or surrounding skin.

It is important to note that such signs do not always indicate breast cancer; they could be caused by a condition called gynecomastia – a benign enlargement of breast tissue. But Harris told MNT that if men spot any of these changes, they should visit their clinician immediately to determine the cause:

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