When most people picture someone with breast cancer, they often think about women; many are shocked to find out that men can also get breast cancer. While male breast cancer represents less than 1% of all breast cancer cases,1 it is still a disease that men should be aware of. September is Men’s Cancer Awareness Month and for today’s blog we will be discussing male breast cancer to bring awareness to this disease.
What is Breast Cancer
Cancer occurs when healthy cells in a person’s body form into a mass of cells, otherwise known as a tumor. Cancerous tumors can become larger and spread to other parts of the body while benign tumors can become larger, but don’t spread to other body parts. When it comes to breast cancer, tumors grow in the breast tissue.
Breast Cancer in Men
Since breast cancer indicates tumors in breast tissue, men can also get breast cancer as they have breast tissue. Male breast cancer is very rare in men but the studies that have been conducted on this disease have identified some risk factors. These risk factors are having a family history of breast cancer, higher than normal estrogen levels, various lifestyle factors, exposure to radiation and being older.2
Men with breast cancer show many of the same symptoms that women with breast cancer show. These include:2
- A lump in the breasts (usually painless to the touch)
- Nipple discharge
- Swollen and/or sore breasts
- Nipple retraction or an inverted nipple
- Rash on or near the nipple
- Lumps under the arm
- Redness of the nipple or of skin near the breasts
If you notice anything unusual or any changes with your chest area, be sure to speak to your doctor or family physician as soon as possible.
Types and Subtypes of Male Breast Cancer
Most men are diagnosed with late stage breast cancer. Since male breast cancer is very rare and there is very little awareness about it, men may delay visiting their doctor until it is too late. When it comes to the types of breast cancer that men are diagnosed with, some are more typical than others.
There are two main types of breast cancer, ductal carcinoma and lobular carcinoma. Both these types may be invasive or in situ. Ductal carcinoma is when the cancer begins growing in the milk ducts. Ductal carcinoma in situ occurs when the cancer remains in the milk ducts while invasive ductal carcinoma occurs when the cancer spreads past the milk ducts. Of the two types, invasive ductal carcinoma is more common in men that are diagnosed with breast cancer.3 Lobular carcinoma is when the cancer begins growing in the lobules. Lobular carcinoma in situ occurs when the cancer remains in the lobules while invasive lobular carcinoma occurs when the cancer spreads past the lobules. As a whole, lobular carcinoma is less common in men that are diagnosed with breast cancer.3
Breast cancer also has subtypes based on proteins and genes. These subtypes are based on being positive or negative for the proteins, estrogen and/or progesterone; being positive or negative for a gene called HER2; or being negative for estrogen, progesterone and HER2. Breast cancer tumors can have estrogen receptors (ER) or progesterone receptors (PR) depending on the protein that causes their growth. When breast cancer tumors have estrogen receptors, it is referred to as ER positive; when these tumors have progesterone receptors, it is referred to as PR positive. When breast cancers do not have these receptors then the cancer subtype can be ER negative or PR negative. Some breast cancer tumors need a gene called HER2 to grow, these cancers are HER2 positive when there have too many HER2 receptors. Cancers that do not have too many HER2 receptors are HER2 negative. When a breast cancer tumor does not express ER, PR and HER2, it is referred to as triple negative. Of all the subtypes of breast cancer, men are more commonly diagnosed as ER positive or PR positive. Younger men are more commonly diagnosed as triple negative.3
Testing, Diagnosing and Treating Male Breast Cancer
As with testing for breast cancer in women, tests to detect male breast cancer include the following:2
- Biopsy of breast tissue
- Mammogram (not routinely given to men)
If a man is diagnosed with breast cancer, there are various ways that his cancer can be treated.3 While these are the same treatment procedures for women with breast cancer, some procedures are less common for men. Men with breast cancer can get two types of surgery, a lumpectomy or a mastectomy. For a lumpectomy, doctors remove the tumor and the surrounding healthy breast tissue while in a mastectomy, the entire breast is removed. Because men have such little breast tissue, a mastectomy is more common surgery path to treat male breast cancer than a lumpectomy. Other treatment options for male breast cancer include chemotherapy, hormonal therapy, radiation and targeted therapy.
Facts and Figures About Male Breast Cancer
In Canada, approximately 200 men are diagnosed with breast cancer annually1
A breast cancer diagnosis for men younger than 25 is very rare; older men between 60 and 70 years old are more likely to be diagnosed with breast cancer4
Men and women with the same breast cancer stage at diagnosis have similar survival rates5
A study conducted in the US found that Black men had higher rates of breast cancer than White men6