Signs and Symptoms of Breast Cancer in Men
Breast cancer in men is rare, affecting about 2,600 men in the United States every year. Less than 1% of breast cancers occur in men. Male breast cancer can occur at any age, however, it is more common in older men over the age of 60. Men can also carry gene mutations (eg BRCA) that increase their risk of developing breast cancer and other types of cancer.
Male breast cancer grows in a man’s breast tissue. Male breasts can’t produce milk but they do have fatty tissue, duct, and breast cells. The cancer develops when abnormal cells grow uncontrollably in breast tissue which forms a tumor. The tumor can also spread to other parts of the body, known as “metastatic disease”.
Causes and Risk Factors
Risk factors for male breast cancer include:
- Being over the age of 50.
- Having certain genetic mutations (BRCA1 and BRCA2).
- A family history of breast cancer.
- Taking estrogen therapy.
- Having radiation therapy that targets the chest.
- Having Klinefelter syndrome is a rare genetic condition that causes a man to have an additional X chromosome.
- Testicle injuries or surgery.
- Being overweight or obese.
- Having liver disease, especially cirrhosis.
What Are the Types of Male Breast Cancer?
- Invasive ductal carcinoma
- Invasive lobular carcinoma
- Ductal carcinoma in situ (DCIS)
- Inflammatory breast cancer
- Paget’s disease of the nipple
What Are the Most Common Signs of Breast Cancer in Men?
Men don’t typically get regular mammogram scans like women, therefore, a physical sign of breast cancer will usually be the first thing a man or a partner notices:
- A lump or swelling, which is often (but not always) painless
- Skin dimpling or puckering
- Nipple retraction (turning inward)
- Redness or scaling of the nipple or breast skin
- Discharge from the nipple
If you notice any of these signs or something else that concerns you, it is very important that you schedule an appointment with your doctor as soon as possible.
Treatment Options
Treatment for breast cancer in men depends on the type of cancer and how advanced it is. Treatment usually beings with surgery to remove the tumor and, in many cases, all the breast tissue (mastectomy) and some of the axillary (armpit) lymph nodes.
It is important to discuss all of your options with your doctor and ask questions such as:
- What treatments are appropriate for me? What do you recommend?
- How long will treatment last?
- What risks or side effects should I expect?
- What should I do to prepare for treatment?
- How much experience do you have treating this type of cancer?
- Should I get a second opinion?
- How soon do I need to start treatment?
Know All Your Options
If you are a man or woman who has been diagnosed with breast cancer, or you are considering surgery to decrease your risk of breast cancer – Breast Advocate® is for you. Breast Advocate® is a free app that provides ALL your surgical options along with evidence-based recommendations, personalized for you.
Download the latest version of the Breast Advocate® app here.
3 New Genetic Mutations Linked to Male Breast Cancer
Our genes determine everything about our bodies. They play a key role in our health and can determine our likelihood of developing diseases. Some genetic mutations significantly increase the risk of developing breast cancer. The most common mutations associated with breast cancer involve the BRCA1 and BRCA2 genes. About 10% of male breast cancers are caused by mutations in the BRCA2 gene. Other examples of mutations that increase the risk of male breast cancer include those found in PTEN, PALB2, CHEK2 and NBN genes.
In addition to these well-recognized gene mutations, other very minor changes to our DNA code (known as single-nucleotide polymorphisms, or SNPs) also influence our risk of developing cancer. Unfortunately, these types of changes in our genetic code are much more common than BRCA gene mutations.
Although most genetic research associated with breast cancer risk is derived from studies in women, newly published findings bring insight on the genetic risks of developing breast cancer in men. A UK study, published in the Journal of the National Cancer Institute looked at the genotypes of 1,380 men diagnosed with breast cancer.
Results revealed that 3 new SNPs were significantly associated with an increased risk of male breast cancer. One of these SNPs is located on chromosome 6 (rs9371545), and two are located on chromosome 11 (rs554219 and rs78540526). These SNPs increase the risk of developing breast cancer in men by about 47%, 45%, and 61% respectively. Consistent with the predominance of ER-positive tumors in men, genetic correlation was strongest between male breast cancer and ER-positive female breast cancer. Although these genetic mutations are also linked to an increased breast cancer risk in women, the 3 new SNP variants have a greater impact on men.
Improved Decision-Making
While there is still a lot of research still needed, these findings can aid in the development of better risk assessment for men. For those choosing to undergo genetic testing, test results can help quantify individual risk and help guide treatment decision-making around risk-reducing options.
“This study, which shows more of a similarity between the genetic causes of the disease in men and women than previously thought, is a major step forward,” shared Dr Simon Vincent, director of research services at Breast Cancer Now. “Our knowledge of breast cancer in men is limited, because male breast cancer is rare which makes it difficult to collect enough tissue or blood samples to research and understand the disease. We now look forward to further research into the shared genetic causes of male breast cancer which could lead to developing risk reducing treatments and interventions to help prevent more cases among those at increased risk in the future.”
Free App for Breast Cancer Treatment and Breast Reconstruction Decision-Making
A leader in breast cancer treatment education and shared decision-making, Breast Advocate® is excited to announce the release of our updated free app for breast cancer surgery and breast reconstruction. Thank you to our users for providing the valuable feedback that has helped make our app even better!
The latest updates greatly improve user experience and navigation, and give the innovative breast cancer app a fresh new look. Users can now customize the content they see on their dashboard via a personal feed, and easily find specific content using our optimized search engine.
Co-created by breast cancer specialists and patient advocates, the Breast Advocate® app provides anyone with breast cancer, a history of breast cancer, or at high risk for developing the disease a much needed voice in their treatment decision-making.
Should you have a lumpectomy or mastectomy? Should you have prophylactic surgery? Should you go flat or have breast reconstruction? If you want reconstruction, what type is best for you? Should you have gene testing? Our breast cancer app can help with these questions and much more.
The groundbreaking Breast Advocate® Wizard walks users through a detailed questionnaire to better understand their personal situation, preferences and goals. Our proprietary software combines evidence-based treatment options with the user’s preferences to create customized recommendations that are in line with the user’s specific needs. Breast Advocate® empowers users with the knowledge they need to fully discuss their treatment plan with their medical team and ensure they make the best decisions for them.
Users also have access to the latest expert opinions, published studies, helpful resources, and a community ready to provide support.
Download the latest version of the Breast Advocate app here.
FDA Calls For Men To Be Included In Breast Cancer Clinical Trials
Although breast cancer in men is not often publicized in the media, it is very important to know that men are at risk of the disease too. It is estimated that about 2,600 men will be diagnosed and 500 will die of breast cancer each year. However, because men contribute less than 1% of all cases, they are typically not included in clinical trials for treatment.
Since men have not historically been included in clinical trials, it is very possible they are not receiving optimal care. The drugs and treatment options they are prescribed have only been tested and approved for women.
The Food and Drug Administration (FDA) is calling for this to change. In their recent draft guidance, the FDA recommends the inclusion of men in breast cancer clinical trials to help improve the clinical management of the disease in male breast cancer. The FDA also states that if researchers propose to exclude male patients from a breast cancer trial, “scientific rationale should be included.” Furthermore, the FDA will not consider “low expected accrual rates of male patients with breast cancer” as sufficient rationale for excluding male patients moving forward.
The move seems to be working already… Following the FDA’s announcement, some breast cancer drug studies have extended eligible enrollment criteria to men.
Breast Advocate Founder Presents at Male Breast Cancer Coalition’s Annual Conference
According to the American Cancer Society, about 2,670 new cases of invasive male breast cancer will be diagnosed in 2019 and about 500 men will die because of this diagnosis.
Male breast cancer is rarely discussed in breast cancer awareness campaigns. The Male Breast Cancer Coalition (MBCC) aims to change this. Their mission is to build awareness of male breast cancer through the wisdom and experiences of survivors through speaking arrangements, social media and their annual conference.
This year, Breast Advocate founder, Dr. Minas Chrysopoulo, was honored to join the MBCC at their annual conference last weekend to discuss male breast reconstruction options. “Like women, men can experience the same concerns about their appearance following breast cancer surgery, most commonly a mastectomy,” shares Dr. Chrysopoulo. “Knowing there are reconstructive options is a great relief to some male breast cancer patients.”
Male breast reconstruction can include several different procedures…
Fat grafting is the most commonly performed method of reconstruction in male breast cancer patients. The procedure is performed by removing fat (using liposuction) from one area of the body, purifying it, and re-injecting it into the chest to fill in chest contour deformities.
A small breast implant can be used to reconstruct a male breast after a mastectomy. Since the aesthetics of the male breast are usually much different to that of woman, a custom implant is often the best choice for the best symmetry.
Some patients can have extensive chest wall deformity following breast cancer treatment, especially if part of the pectoral muscle is removed because of tumor involvement. In these situations, an autologous flap (reconstruction using the patient’s own tissue) may be a good option. Flap options include a Latissimus Dorsi (or “lat”) flap which uses (part or all) of the back muscle below the shoulder blade along with a segment of overlying fat and skin, or the DIEP flap which uses skin and fat from the lower abdomen.
Nipple reconstruction can be performed on its own or in conjunction with any other reconstructive procedure. If desired, the reconstructed nipple and areola can later be tattooed for a more natural appearance.
- Scar Revision Surgery
Scar revision can improve the appearance of breast surgery scars after mastectomy or lumpectomy and can be used in conjunction with fat grafting to improve chest contour defects. Releasing tethered scars can also help reduce discomfort.
- Tattooing
Various forms of tattooing can be performed along with other reconstructive procedures. These include:
- A nipple-areola tattoo (2D or 3D), either alone or in conjunction with nipple reconstruction
- An ornamental tattoo covering the surgical site
Male breast reconstruction (regardless of the procedure) is usually performed after completion of all breast cancer treatment. In select cases, it can be performed at the same time as the mastectomy.
