Men do have breast tissues but in the rudimentary form. After puberty, the female breast grows under the influence of the female sex hormone, i.e., estrogen; however, testosterone, the male sex hormone, keeps a check over the breast growth in males.
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breast cancer in Men, Is it Possible?
Yes, the minimal breast tissue in males can also develop cancer. The breast tissue consists of a milk-producing gland called lobules. It forms a significant proportion of female breast tissue and milk carrying pathways (ducts) along with the nipple and areola complex. However, in males, the lobules are poorly developed1Khattab, A. (2020, June 29). 'Male Breast Cancer' Source
The male breast tissues consist of only ducts and nipple-areola complex. Breast cancer in males develops when one or few cells of ducts or nipple-areola complex undergo uncontrolled proliferation i.e., they divide rapidly, forming a tumor mass that presents as a lump which can spread to different parts of the body.
How does breast cancer look like in Men?
Male breast cancer usually presents as:-
During the initial stage, cancer remains undiagnosed. It is not until the stage III or IV of male breast cancer, the symptoms as mentioned above develop and comes to the patient’s knowledge2Fentiman, I. (2009). 'Male breast cancer: A review' Source
Why is breast cancer diagnosed during the later stages in males?
Since the volume of breast tissues in males is less than in females, breast cancer tends to spread faster in males than females. More than 40 % of breast cancer cases in males are diagnosed during stage 3 or 43Yalaza, M., İnan, A., & Bozer, M. (2016, January 01). 'Male breast cancer' Source
How common is breast cancer in men?
Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer cases worldwide4International Agency for Research on Cancer. GLOBOCAN 2012. Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012
Males are usually affected by other common cancers like head and neck cancer, followed by lung, prostate, and gastrointestinal tract cancer.
The reason for the low incidence rate of male breast cancer is firstly due to the presence of relatively less amount of breast tissue in males as compared to females and secondly, due to the male sex hormone, testosterone, which inhibits the growth of breast tissue in males and hence prevents males from breast cancer
Are you at risk of developing male breast cancer?
The risk factors are classified as genetic, environmental, and occupational for better understanding:-
Genetic factors that may put you at risk of developing male breast cancer include BRCA2 mutation, positive family history of breast cancer, specific genetic sexual dysfunctions like Klinefelter syndrome, Cowden syndrome, testicular agenesis syndrome, etc.
Quick Note - What is BRCA gene?
BRCA 1 & BRCA 2 are tumor suppressor genes present in the human body. These genes tend to repair the genetic material, i.e., DNA damage, and play a significant role in preventing cancer. However, mutation in such genes leads to cancer. Mutation in the BRCA2 gene is associated explicitly with male breast cancer
What are the chances of developing male breast cancer if other members of the family have breast cancer?
Positive Family history of male breast cancer can increase breast cancer risk in men, particularly if other men in the family have had breast cancer
Genetic counseling should be considered for at ‘risk male breast cancer patients,’ particularly if there is a family history of breast cancer.
Quick Note - Genetic Counselling
Genetic Counselling sessions help in identifying an individual, the risks of suffering from a genetic disorder. Family history and personal details are collected and analyzed and thereby a genetic test is proposed.
Hormonal Factors and Pre Existing Medical Conditions
Estrogen to Androgen Ratio
Breast cancer in males is usually caused by an alteration in estrogen to androgen ratios
Estrogen is a female sex hormone that stimulates ductal development in breasts. Androgens (mainly testosterone) is a male sex hormone that checks estrogen action in the human.
Medical Conditions that can lead to Breast Cancer in Men
How does obesity cause cancer in men?
Obesity is also a risk factor for male breast cancer. The fat cells in the body convert male hormones (androgens) into female hormones (estrogens), resulting in increased estrogen levels in the body. This leads to hormonal imbalance, which triggers the development of breast cancer
Occupational risk, such as working in an environment with a high temperature, exhaust fumes, radiation exposure, etc. increases the risk of developing breast cancer in men6A;, L. M. (1990). 'Risk factors for male breast cancer: A Franco-Swiss case-control study.' Source
What's Gynecomastia and Klinefelter syndrome and Do these Cause Breast Cancer in Men?
Gynecomastia is a benign enlargement of breast tissue in men which is quite common in adolescent & early adulthood. It usually involves both breasts. It occurs due to hormonal imbalance during puberty. The breast enlargement is generally mild and painless; however, some patients complain of pain & low self-esteem. There are many reasons attributed to this medical condition like liver diseases, medication, and specific syndromes like Klinefelter.
Does Gynecomastia cause breast cancer in men?
No, Gynecomastia does not increase a man’s risk of developing breast cancer. It’s a benign disease.7Niewoehner, C. B., & Schorer, A. E. (2008, March 29). 'Gynaecomastia and breast cancer in men' Source
It is a genetic condition in which the affected male is born with one extra copy of X chromosome. This leads to various physical and biochemical changes in the body, resulting in the development of feminine characters like enlarged breasts, low muscle mass, reduced facial hair and body hair, small penis, etc.
Does Klinefelter syndrome cause breast cancer in men?
What are the treatment options for male breast cancer?
The treatment of male breast cancer is similar to that of female breast cancer: surgery chemotherapy, radiation therapy, hormonal therapy, and targeted therapy; however, the treatment has to be individualized based on the age, stage, and pathological features of the disease.
What is the evidence for treatment for breast cancer?
There is a lack of awareness among the public and researchers that breast cancer can affect men too. Hence there is limited evidence for breast cancer in males. No randomized trials have focused on men with breast cancer, and all the evidence for treatment and outcomes are extrapolated from studies of treatment for women with breast cancer.
Why do males with breast cancer usually undergo extensive surgery - Mastectomy?
Women with early diagnosed breast cancer often undergo breast-conserving therapy (i.e., lumpectomy and whole-breast irradiation), but most men with breast cancer undergo mastectomy i.e., complete removal of all breast tissue and axillary lymph nodes9YScott-Conner, C., Jochimsen, P., Menck, H., & Winchester, D. (2005, December 01). '). An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients' Source.
Even with an early-stage diagnosis, breast conservation is not common in men because of the limited number of breast tissues.
Not to ignore the fact, that most men get diagnosed with breast cancer in the advanced-stage disease and therefore the breast conservation surgery is not possible
Frequently Asked Questions - Male Breast Cancer
Is a lump Formation in the breast, in men, an Indication of breast cancer?
Besides breast cancer, the reasons that may cause a lump in the male breast includes10Önder, Ö, Azizova, A., Durhan, G., Elibol, F. D., Akpınar, M. G., & Demirkazık, F. (2020, February 18). 'Imaging findings and classification of the common and uncommon male breast diseases' Source11Yuan, W., Li, A. F., Chou, Y., Hsu, H., & Chen, Y. (2018, March 20). 'Clinical and ultrasonographic features of male breast tumors: A retrospective analysis' Source
These medical conditions can be present as a breast lump and /or as nipple discharge (symptoms of breast cancer). It is always better to consult your physician incase you discover a lump in your breast region to rule out the possibility of breast cancer.
Does smoking tobacco or drinking alcohol cause breast cancer in men?
Male breast cancer is a relatively less common cancer, and its etiology is poorly understood. Although tobacco and alcohol exposures are known carcinogens for various other cancers, their direct association with male breast cancer, however, is unknown12Cook, M. B., Guénel, P., Gapstur, S. M., Van den Brandt, P. A., Michels, K. B., Casagrande, J. T., . . . Brinton, L. A. (2015, March). 'Tobacco and alcohol in relation to male breast cancer: An analysis of the male breast cancer pooling project consortium.' Source.
Is breast cancer in men more serious than in females?
In general, the survival rate in men with breast cancer is lesser than female breast cancer patients. Numerous studies have been done to evaluate the reasons, which are as follows13SS;, A. W. (2004). 'Is male breast cancer similar or different than female breast cancer?' Source:-
At an older age (both men and women), the outcomes are similar in both male and female breast cancer
Do patients with male breast cancer have an increased risk of other cancers?
A multicenter international study that pooled data from 13 cancer registries found that 12.5% of 3409 male breast cancer patients developed second instance of cancer (cancer of the small intestine, rectum, pancreas, skin (non-melanoma), prostate, and lymphatics/blood), during their lifetime14Hemminki, K., Scélo, G., Boffetta, P., Mellemkjaer, L., Tracey, E., Andersen, A., . . . Brennan, P. (2005, April 11). 'Second primary malignancies in patients with male breast cancer.' Source,15Hemminki, K., Scélo, G., Boffetta, P., Mellemkjaer, L., Tracey, E., Andersen, A., . . . Brennan, P. (2005, April 11). 'Incidence of prostate cancer in male breast cancer patients: A risk factor for prostate cancer screening' Source.
- 1Khattab, A. (2020, June 29).
Male Breast Cancer
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK526036/
- 2Niewoehner, C. B., & Schorer, A. E. (2008, March 29).
Gynaecomastia and breast cancer in men
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276281
- 3Önder, Ö, Azizova, A., Durhan, G., Elibol, F. D., Akpınar, M. G., & Demirkazık, F. (2020, February 18).
Imaging findings and classification of the common and uncommon male breast diseases
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028902
- 4Yuan, W., Li, A. F., Chou, Y., Hsu, H., & Chen, Y. (2018, March 20).
Clinical and ultrasonographic features of male breast tumors: A retrospective analysis.
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860767
- 5Fentiman, I. (2009).
Male breast cancer: A review.
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223984/
- 6Yalaza, M., İnan, A., & Bozer, M. (2016, January 01).
Male Breast Cancer
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351429
- 7A;, L. M. (1990).
Risk factors for male breast cancer: A Franco-Swiss case-control study
Retrieved October 22, 2020, from https://pubmed.ncbi.nlm.nih.gov/2323842/
- 8Cook, M. B., Guénel, P., Gapstur, S. M., Van den Brandt, P. A., Michels, K. B., Casagrande, J. T., . . . Brinton, L. A. (2015, March).
Tobacco and alcohol in relation to male breast cancer: An analysis of the male breast cancer pooling project consortium
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355041/
- 9SS;, A. W. (2004).
Is male breast cancer similar or different than female breast cancer?
Retrieved October 22, 2020, from https://pubmed.ncbi.nlm.nih.gov/14997057/
- 10Hemminki, K., Scélo, G., Boffetta, P., Mellemkjaer, L., Tracey, E., Andersen, A., . . . Brennan, P. (2005, April 11). Second primary malignancies in patients with male breast cancer
Retrieved October 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361970/
- 11JS;, L. U. (2005).
Incidence of prostate cancer in male breast cancer patients: A risk factor for prostate cancer screening
Retrieved October 22, 2020, from https://pubmed.ncbi.nlm.nih.gov/18504455/
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