Breast Cancer Can Strike Men, Too

Breast cancer in men is rare – but it does occur. Each year in the United States approximately 2,000 cases of male breast cancer are diagnosed and about 500 men die from the disease, according to the National Cancer Institute. Although breast cancer can strike men at any age, statistics show it is usually diagnosed among men ages 60 to 70, which is five to 10 years later than in women.

“Breast cancer in men is typically detected at a later age and stage than in women because men – and their doctors – don’t believe they’re at risk for the disease,” said Robert DerHagopian, M.D., surgeon with the Breast Clinic at Miami Cancer Institute.

Know the Risk Factors

A number of factors can increase a man’s risk of getting breast cancer, says the American Cancer Society. These include:

Growing older: Just as is the case for women, the risk of breast cancer in men increases with age.

High estrogen levels: Breast cell growth, both normal and abnormal, is stimulated by the presence of estrogen. Increased estrogen levels in men can be caused by:

•    Hormonal medicines.
•    Obesity, which increases the production of estrogen.
•    Gynecomastia – the presence of excess breast tissue.
•    Certain testicular conditions.
•    Liver disease, which usually leads to lower levels of androgens (male hormones) and higher levels of estrogen (female hormones).
•    Klinefelter’s syndrome – a genetic disorder that results in lower levels of androgens and higher levels of estrogen.

Chest radiation exposure: Men who have had radiation therapy to the chest before age 30 to treat such conditions as Hodgkin’s disease may be at increased risk of developing breast cancer.

Family history of breast cancer or genetic alterations: Men with a first-degree relative – mother, father, brother, sister, child – with breast cancer are at slightly higher risk to develop breast cancer. Men who have a BRCA mutation – the same tumor suppressor gene that actress Angelina Jolie has – also are at a greater risk for the disease.

While their lifetime chance of developing breast cancer is still a low 5 to 6 percent, men with a BRCA2 mutation have a 100 times increased risk for developing breast cancer and also may be at increased risk of developing prostate cancer, according to scientists with the Food and Drug Administration (FDA).

Get Genetic Counseling

All men with breast cancer should be referred for genetic counseling, Dr. DerHagopian advises. Discovering the presence of a BRCA mutation can be a lifesaving step for a man and his family members.

“Other family members may want to consider genetic counseling to learn more about their potential risks and whether genetic testing for BRCA mutations might be appropriate for them,” Dr. DerHagopian said. “Additionally, it’s important that people inform their healthcare provider if any man in their family has had breast cancer.”

Watch for Signs and Symptoms

The most common symptom of breast cancer in men is a lump, usually located directly under the nipple, says Dr. DerHagopian. According to the John W. Nick Foundation, an organization dedicated to male breast cancer awareness, some men may have the following additional symptoms:

•    Inverted nipple
•    Itchy, scaly sore or rash on the nipple
•    Breast swelling
•    Dimpling, puckering or redness of the breast skin
•    Nipple discharge

“Although most breast lumps in men are benign, men who discover a lump or have any symptoms should see their physician to be evaluated,” advised Dr. Derhagopian.

Consider the Treatment Options

Breast cancer in men is often treated the same way as breast cancer in women and is dependent on the stage of the cancer. Treatment options include:

Surgery may be performed to remove the tumor. A modified radical mastectomy is usually performed in the treatment of male breast cancer, says Dr. DerHagopian.

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. It’s often given after surgery to kill any cancer cells that may be left.

Hormone therapy removes hormones or blocks their action and stops cancer cells from growing. Tamoxifen is a commonly used drug, says Dr. DerHagopian, however, it can have negative side effects for men.

Chemotherapy uses drugs to kill cancer cells or stop them from dividing. For men with larger tumors, positive lymph nodes or cancer that has spread, chemotherapy is often recommended in addition to surgery or hormonal treatment, Dr. DerHagopian says.

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.

Because breast cancer in men accounts for only 1 percent of all breast cancer cases, there have been few clinical trials on treatment of the disease, say researchers with the FDA. But that is changing, and men now are permitted by the National Cancer Institute to take part in state-of-the-art therapy and clinical trials.

“The number of men in breast cancer trials will still be small because male breast cancer is a rare condition,” said Dr. DerHagopian. “But as more men take part in these studies, the valuable findings will help men facing this disease in the future.”