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OVERVIEW

What is male breast cancer?

Breast cancer is a form of cancer that occurs in your breast(s). Men can get breast cancer, but it is more common in women. Because of this, men often don’t know they have breast cancer until it is advanced.

There are several types and levels of male breast cancer. Types vary based on the location of cancer cells and what they look like. Breast cancer can begin in your lining, ducts, or lobules. It also can occur in your nipple or areola (the circular area around your nipple). This is known as Paget’s disease of the nipple.

Breast cancer can be invasive. This means it has or could spread within the breast and nearby tissue. Metastatic spread means that the cancer can also travel through your lymphatic system to other tissue, organs, or bones. If your cancer hasn’t spread, it is pre-invasive or “in situ.” Sometimes it is called non-invasive, but this can change if the cancer isn’t treated.

Cancer grades and stages depend on the cancer cells’ size, makeup, and features. The higher the grade is (1–3), the more abnormal the cells are. It also indicates how slow or fast your cancer cells grow. The higher the stage is (I–IV) the more advanced your cancer is. It also indicates the chance that your cancer will spread. Your grade and stage affect your treatment and outlook.

Infiltrating ductal carcinoma (IDC) is the most common form of male breast cancer. This starts in your breast ducts but is likely to spread to other areas.

SYMPTOMS

Symptoms of male breast cancer

Men should be aware of the shape, size, and feel of their breasts. This can help you detect signs of breast cancer early. Symptoms include:

• A lump, or mass, in your breast tissue (This can feel round, like a marble, or flat, like a button. The lump could be sore or painless.)
• Changes in the shape or size of your breast
• A dimple in the skin of your breast
• An inverted nipple
• Pain in your nipple, breast, or surrounding area, such as lymph nodes under your arm
• Red, rough, or itchy skin on your nipple or areola
• Nipple discharge

If you have breast cancer that has spread to your lymph nodes, you could find other lumps. These could be on the side of your breast, under your arm, or by your collarbone.

CAUSES

What causes male breast cancer?

All people have cells in their bodies that grow and divide. Cancer happens when some of those cells change and grow out of control. These abnormal cells can form a mass, or tumor. Tumors can be benign (noncancerous) or malignant (cancerous).

Boys and girls have similar amounts of breast tissue when young. At puberty, girls produce increased amounts of estrogen. This female hormone causes breast tissue to grow. At the same time, boys’ estrogen levels decrease, so little breast tissue grows.

Men often find they have breast cancer at a late stage. That’s because men have less breast tissue than women, and because many men aren’t aware of male breast cancer. Most, but not all, cases of male breast cancer include higher than normal estrogen levels.

DIAGNOSIS

How is male breast cancer diagnosed?

Early detection and treatment will lead to better outcomes. Contact your healthcare provider right away if you find a lump or notice symptoms.

Your healthcare provider may perform a physical exam and review your history. If your healthcare provider thinks you may have breast cancer, they may order more tests.

• A diagnostic mammogram takes an X-ray of your breasts. Each breast is placed between two plates and flattened to see the tissue. Mammograms can be awkward and you may be sore for a moment. Your healthcare provider will review the X-ray for anything abnormal.
• An ultrasound gets a picture of your breast(s) using sound waves. The test is performed by moving a wand over the surface of your breast. The wand is attached to a machine that will create pictures of your breast(s). Your healthcare provider will look at the picture for anything abnormal.
• A magnetic resonance imaging (MRI) test gets a picture of your breast(s) using magnetic energy and radio waves. For the test, you lay on a table and a large machine surrounds you. The test is painless but can take about an hour. Your healthcare provider will look for anything abnormal on the picture.

If your healthcare provider sees anything unusual on the tests, they will likely say you need a biopsy. During a biopsy, a sample of the tissue is removed. In some cases, they might need to remove the entire mass or lump. A biopsy is the only way to know if a mass is cancer or not. Biopsies determine the size, type, and grade of the cancer.

Cancerous cells also will be tested for certain hormones and genes. If your cells are receptive to estrogen and/or progesterone, you are hormone positive. This accounts for most cases of male breast cancer. Positive hormone receptors can suggest better outcomes. If your cells contain high levels of HER2, you are HER2-positive. This form of cancer cells tends to be more aggressive

Breast cancer can spread (metastasize) by way of your lymphatic system. If your cancer is invasive, you might need more testing.

PREVENTION

Can male breast cancer be prevented or avoided?

Men cannot prevent or avoid breast cancer. Men should talk to their healthcare provider if they are at high risk for breast cancer. Their healthcare provider might suggest genetic testing or a mammogram.

Factors that can increase the risk of male breast cancer include:

• According to the Canadian Cancer Society, most men diagnosed with breast cancer are over the age of 60.
• A family history of breast cancer and/or mutations of the BRCA gene.
• High levels of estrogen. This could be a result of genes, certain medicines, or hormone treatments. Men who are overweight or alcoholic also might have more estrogen.
• Radiation exposure to the chest area.
• This is a benign condition in which a man’s breasts are larger than normal. In turn, they have more breast tissue and are at risk of breast cancer.
• Klinefelter syndrome. Men who have this genetic disorder have two or more X chromosomes, along with a Y chromosome. (Normally, men only have one X and one Y chromosome.) Klinefelter syndrome is a birth defect. Men who have it can have enlarged breasts, as well as other traits.

TREATMENT

All factors of male breast cancer play a role in your treatment. This includes size, location, type, grade, and stage. The size of the mass doesn’t change the outlook, but it can affect treatment options. Other aspects include your age, general health, and personal lifestyle choices. Talk to your healthcare provider in detail about the risks and side effects of each treatment.

Treatment can include one or more of the following:

• Surgery: A mastectomy is the most common surgery for male breast cancer. It removes all or part of the breast tissue, nipple, areola, and surrounding lymph nodes. Surgery occurs in the hospital (inpatient) and requires anesthesia.
• Radiation therapy: Radiation is often used after surgery. It can destroy remaining cancer cells and help prevent it from spreading. It also can reduce the risk of cancer returning. Radiation is usually done as an outpatient at a hospital.
• Chemotherapy: This treatment form is powerful and affects your whole body. The medicine is meant to kill all fast-growing cells, which include cancer cells—and normal cells. Hair is fast growing and that’s why people who receive chemotherapy often lose their hair. You can get chemotherapy in pill or intravenous (IV) form, or both. Your healthcare provider may prescribe other medicines to treat side effects.
• Hormonal therapy: This is an option if your cancer cells test positive for estrogen and/or progesterone receptors. It can help prevent cancer cells from growing and spreading.
• Targeted therapy: Certain forms of chemotherapy target cell defects. Herceptin medicine is a type that treats HER2-positive cancer cells. It marks and kills just the cancer cells and not normal cells. It helps prevent cancer cells from growing and spreading. Targeted therapy often has fewer side effects.

Living with male breast cancer

The process to diagnose and treat cancer can be long and frustrating. Most treatments are invasive and cause side effects. Medicines help counter these, but effects can be long lasting. You likely will need to make changes to your lifestyle.

After treatment, your cancer may subside. Remission can be brief or permanent. Cancer survivors usually require ongoing care. This can include testing and treatment to monitor and manage their health.

Living with cancer is emotional. You might consider joining a support group.

Having a male family member with breast cancer is a trigger for genetic testing and counseling. After receiving your diagnosis, a healthcare provider can help you determine if members of your family should be tested for mutations in the BRCA gene. Abnormalities in the BRCA gene cause forms of breast and ovarian cancer.

FOR MORE INFORMATION

Canadian Cancer Society

https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/breast-cancer-in-men