Male breast carcinomas, though relatively rare, are serious neoplasias affecting the breast tissue in both men and people assigned male at birth. Though less common compared to women, it needs prompt diagnosis and proper management to curb it from spreading. Being aware of some distinctive characteristics of male breast cancer, its symptoms, causes, and treatment options are important for at-risk individuals and the providers trying to deliver comprehensive cancer care.
What Is Male Breast Cancer?
Male breast cancer is a type of tumour that develops in the breast tissues inside men's and AMAB individuals' chests. Unlike female breast tissue, male breast tissue cannot manufacture milk; however, it consists of some fatty tissue, ducts, and cells that may become malignant. The malignant cells begin to grow without bounds and develop a tumour. If left on time and not treated appropriately, it may metastasize to other body parts.
This is a rare disease when compared to its incidence in females. It is a mere less than 1% of the total number of breast cancers. While this may be a very rare case, recognition of risk, symptoms, and options of treatment can make all the difference in managing the disease and improving the results.
Types of Male Breast Cancer
Male breast cancers are mostly those beginning in the ducts—small tubes that transport fluids through the tissue to the nipple. The types of male breast cancer are also:
- Invasive ductal carcinoma: This is the most common type that comprises as much as 90% of all male breast cancer. During IDC, cancer starts in the breast ducts and then invades surrounding breast tissue, with the potential to spread to other body parts.
- Ductal Carcinoma in Situ: This is a non-invasive form of cancer limited to the breast ducts. Since DCIS has not spread into the surrounding breast tissues, if left untreated, it may progress into an invasive disease over time.
- Invasive Lobular Carcinoma: ILC begins in the lobule glands that make milk in female breasts, though men likewise have these in smaller amounts. As in IDC, the cells of ILC can invade beyond the breast tissue.
Rarer forms are inflammatory breast cancer and Paget's disease of the breast, which affect the skin of the breast and nipple, respectively. Symptoms and treatment methods may differ in these uncommon types.
How Common Is Male Breast Cancer?
While male breast cancer is a relatively rare disease, it increases in incidence with age. It is estimated that more than half of all men diagnosed with the condition are over the age of 60 years. As far as racial incidence is concerned, there are indeed those who report higher records, though studies continue to understand why this should be the case.
Symptoms of Male Breast Cancer to Watch For
Most of the diagnostic symptoms in male breast cancer are either overlooked or mistaken for benign maladies. In general, early signs and symptoms of male breast cancer may include the following:
- Lumps in the Breast or Chest Area: One might feel a firm lump in the chest, more often than not painless, particularly behind the nipple or inside the armpit.
- Skin Changes: Dimples or an orange-skin texture may appear on the skin over the area of the lump. This condition often indicates that the problem is located deeper in the tissue.
- Changes in the Nipple: A nipple turned inward into the breast, pain in the nipple, and discharge from the possibly blood-stained may be symptoms of cancer.
- Tenderness or Pain: Although not often mentioned, there are reports of chest pain and tenderness from some men.
If any such symptoms appear, a healthcare provider should be consulted for further evaluation. The key to effective treatment greatly lies in early detection.
Causes and Risk Factors for Male Breast Cancer
The reason behind male breast cancer is not known exactly, but typically it involves DNA mutation in the breast cells that acts as the direct cause for the uncontrollable growth and division of cells faster than normal. Anybody can get breast cancer, though certain variables may increase a man's chances of developing it:
- Age: The risk of cancer increases with age factor. Many people are diagnosed above the age of 60 years.
- Family History and Genetics: The risk is higher if there is any medical history within the family, especially with first-degree relatives. Besides, genetic alterations notably raise the possibility of having this kind of cancer; the most common are the BRCA1 and BRCA2 genes. Other genetic disorders include Cowden syndrome due to the PTEN gene and Li-Fraumeni syndrome associated with the TP53 gene.
- High Levels of Estrogen: The etiological elements leading to high levels of estrogen generally promote the growth and development of breast cancer cells. These elements include obesity, liver cirrhosis, and genetic conditions such as Klinefelter syndrome.
- Hormone Medications: Any person taking estrogen hormones, which are also employed in gender-affirming hormone therapy, is at increased risk for breast cancer.
- Testicular Conditions: Conditions such as orchitis-inflammatory of the testicles, undescended testicles, or having had testicular surgery can increase the risk.
- Radiation Exposure: Radiation therapy to the chest, especially at a young age may heighten the risk of developing the disease in later life.
How Male Breast Cancer is Diagnosed
The diagnosis of male breast cancer is the same as for female breast cancer. A healthcare provider examines the patient thoroughly, examines his symptoms and family history, and then recommends the following tests:
Physical Examination: A breast examination may show lumps or other abnormalities in the chest.
Imaging Studies: This will include commonly utilized imaging modalities like mammograms and ultrasounds. A mammogram is an X-ray of the breast, while an ultrasound uses sound waves to create detailed pictures of the tissues of the breast.
Biopsy: A biopsy may be conducted to confirm the presence of cancer by taking a small tissue sample from the suspicious area. The specimen is then taken to the laboratory for analysis, where the cancerous cells are diagnosed and the type of breast cancer identified.
Laboratory tests may also determine the presence of various receptors on the cancer cells, such as estrogen receptor, progesterone receptor, and HER2/neu receptor. The presence of these markers helps health professionals decide on the right treatment modality.
Staging of Male Breast Cancer
Actual staging after diagnosis is necessary to measure the severity and spread of cancer. Stages in male breast cancer range from 0 to IV, with higher stages referring to a more progressive development of cancer. In diagnosing the various stages, doctors tend to lean on several imaging tests such as a PET scan, CT scan, or bone scan to identify areas where cancer may have spread. The stages include:
- Stage 0: The cancerous cells are confined only within the ducts and have not invaded other tissues.
- Stage I: A small tumour is present, and cancer hasn't invaded the lymph nodes.
- Stage II: Cancer has invaded nearby lymph nodes or a larger tumour is present.
- Stage III: Cancer has invaded multiple lymph nodes and possibly the chest wall or skin.
- Stage IV: Cancer has metastasized to other body parts such as bones, lungs, liver, or the brain.
Treatment Options for Male Breast Cancer
Treatment of male breast cancer depends upon the type, stage, and tumour characteristics. Common treatments include:
- Surgery: Surgical removal of the tumour is usually the first treatment. Because men have such a small amount of breast tissue, removal of the tumour requires removing the entire breast, a procedure called a mastectomy. Sometimes lymph nodes are also removed.
- Radiation Therapy: Radiation, with high-energy rays, targets the cancer cells in an attempt to kill remaining cancer cells post-surgery. It is given very often after a lumpectomy.
- Chemotherapy: Chemotherapy uses drugs in order to try to destroy the cancer cells of the body. It is given either before surgery to reduce a tumour in size or after surgery to destroy remaining cancer cells.
- Hormone Therapy: Some male breast cancers are hormone-sensitive; therefore, treatments such as Tamoxifen can be utilized to either reduce estrogen levels or block estrogen receptors on cancer cells to lower the capacity for growth of these cells.
- Targeted Therapy: This treatment focuses on certain proteins or genetic mutations in cancer cells and aids in halting their growth.
Prevention of Male Breast Cancer
There are no sure ways of preventing male breast cancer, but it is encouraged that men with a family history or known genetic mutations of the disease discuss screening options with a healthcare provider. By doing routine examinations and imaging tests, cancer may be found early, when it is more curable.
Genetic testing is possible for people with a strong family history because it can be informative about the presence of mutations in the BRCA1 and BRCA2 genes, among others. Indeed, awareness of this genetic information can provide one with the ability to follow up and lower related risks through early detection and other preventive ways.
Prognosis and Outlook for Patients with Male Breast Cancer
Prognosis in the case of male breast cancer is highly dependent upon a variety of factors, including stage of diagnosis, tumour size, and dissemination. Generally speaking, early-stage male breast cancers have an excellent survival rate, though the prognosis does worsen as the cancer continues to progress.
For example, the five-year survival rate is about 95% for cancer that has not spread beyond the breast, while it substantially reduces for metastatic ones. Early diagnosis and treatment remain the cornerstone of improving survival rates with a maintained quality of life.
Living with Male Breast Cancer
Living with a diagnosis of male breast cancer is challenging, both physically and emotionally. Support systems for patients should be available, including psychological counselling and support groups, with which to better cope with the emotional effects of the disease. Men can return to full lives following a diagnosis of male breast cancer by following treatment recommendations and regular check-ups.
Men should consult the doctor as soon as they find any change in their chest or are at high risk for this malignancy. The diagnosis and intervention early mean everything in the management and prognosis of male breast cancer.
