How To Test For Male Breast Cancer

Overview Of Male Breast Cancer

The etiology, diagnosis, and treatment of breast cancer in males is similar to that in females. Unlike breast cancer in females, however, breast cancer in men is rare. Although its frequency has increased in recent decadesparticularly in the urban United States, Canada, and the United Kingdombreast cancer in males accounts for less than 1% of breast cancers. In the United States, males are expected to account for only 2650 of the estimated 284,200 cases of breast cancer predicted to occur in 2021.

Unfortunately, this rarity has largely precluded prospective randomized clinical trials. It may also contribute to the infrequency of early diagnosis. Men tend to be diagnosed with breast cancer at an older age than women and with a more advanced stage of disease, and they have proportionately higher mortality, although outcomes for male and female patients with breast cancer are similar when survival is adjusted for age at diagnosis and stage of disease.

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For more information, see the following:

For patient education information, see Male Breast Cancer.

Men With Breast Cancer Usually Have Lumps That Can Be Felt

Lumps and other signs may be caused by male breast cancer or by other conditions. Check with your doctor if you have any of the following:

• A lump or thickening in or near the breast or in the underarm area.
• A change in the size or shape of the breast.
• A dimple or puckering in the skin of the breast.
• A nipple turned inward into the breast.
• Fluid from the nipple, especially if it’s bloody.
• Scaly, red, or swollen skin on the breast, nipple, or areola .
• Dimples in the breast that look like the skin of an orange, called peau dorange.

Personal Stories From Men With Breast Cancer

While 144 men are diagnosed with breast cancer every year, it can be isolating being diagnosed with what is considered a ‘women’s cancer’. It may help to read stories from other men with breast cancer to know you are not alone. Read stories from men with breast cancer, or connect with other men in a similar situation on BCNA’s online network.

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Causes Of Breast Cancer In Men

Some factors that can increase the risk of breast cancer in men include:

• increasing age

• family history of breast cancer in first-degree relatives who have had BRCA2 breast cancer or several relatives who have had colon, prostate or ovarian cancer

• high levels of oestrogen

• some testicular disorders

• Klinefelter’s syndrome – a rare condition where men have two X chromosomes and one Y chromosome .

Lifestyle factors that slightly increase the risk of breast cancer in men and women include:

• drinking alcohol
• lack of physical activity.

Which Men Are More Likely To Get Breast Cancer

It’s rare for a man under age 35 to get breast cancer. Your chance of getting breast cancer goes up with age. Most breast cancers in men happen between ages 60 and 70.

Other things that raise the odds for male breast cancer include:

• Breast cancer in a close female relative
• History of radiation exposure of the chest
• Enlarged breasts because of drug or hormone treatments, some infections, or poisons
• Severe liver disease, called cirrhosis
• Diseases of the testicles such as mumps orchitis, a testicular injury, or an undescended testicle
• Obesity

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Male Breast Cancer: What Men Should Know

Breast cancer is typically thought of as a woman’s disease. But men develop the disease, too. And, due to a lack of awareness about male breast cancer, it’s often found at later stages, when the disease is more difficult to treat.We recently discussed male breast cancer with Sharon Giordano, M.D., chair of Health Services Research and associate professor of Breast Medical Oncology at MD Anderson. Dr. Giordano sees more male breast cancer patients than any other doctor in the world.Here’s what she had to say.How common is male breast cancer? Male breast cancer represents approximately 1% of all cases of breast cancer. In the United States, 2,190 new cases of male breast cancer were expected to be diagnosed in 2012, as compared to 229,060 cases in women. What causes male breast cancer? The cause of male breast cancer is not known. Risk factors include a family history of breast cancer, prior radiation exposure and Klinefelter syndrome, which is the presence of an extra X chromosome in a man.BRCA1 and BRCA2 mutations also are a risk factor for breast cancer in men. In particular, BRCA2 mutations are linked to male breast cancer. Men with a BRCA2 mutation may have close to a 10% lifetime risk of developing breast cancer.

Why Do Men Get Breast Cancer

Men can get cancer of the breast because they have a small amount of breast tissue which can then become cancerous. Certain things can make the condition more likely, such as:

• Age. Breast cancer in men tends to develop in older men, usually between the ages of 60 and 70.
• Family history. Some breast cancers are caused by a flawed gene. The main gene which can cause men to be more at risk of breast cancer is the BRCA2 gene. If two or more of your close family have developed breast cancer, particularly if they had it under the age of 50, you may also be at risk of breast cancer. If a close family member developed breast cancer under the age of 40, a flawed gene might have been the cause. It may be possible for family members to have blood tests to check for this gene if their family history is strong.
• High oestrogen levels. Oestrogen is a female hormone and conditions in men which raise their oestrogen levels can make them more likely to develop breast cancer. Examples of conditions which raise oestrogen levels include Klinefelter’s syndrome and cirrhosis of the liver. Being very overweight can also result in higher oestrogen levels.
• Exposure to radiation in the past. Previous exposure to radiation can increase the risk of cancer.

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When To Seek Care

Having one or more symptoms does not mean you have breast cancer. Symptoms of breast cancer can be similar to those of other conditions.

Male breast cancer is rare, making up only about 1 percent of all cases. That said, its easier to treat breast cancer before it spreads, so see your doctor if you have:

• a lump or hard mass on your chest or underarm
• nipple inversion or discharge
• dimpling or puckering of the skin

A large retrospective study published in 2019 concluded there is a potential benefit to screening men at high risk of developing breast cancer. If you think you may be at high risk of breast cancer, it might be worth discussing with your doctor or a genetic specialist.

Most breast lumps are caused by something other than cancer but may still require treatment.

If Cancer Is Found Tests Are Done To Study The Cancer Cells

• How quickly the cancer may grow.
• How likely it is that the cancer will spread through the body.
• How well certain treatments might work.
• How likely the cancer is to recur .

Tests include the following:

• Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
• HER2 test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.

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Can Breast Cancer In Men Be Prevented

Because breast cancer in men is so rare, breast screening programmes do not include men. Men with a very strong family history of breast cancer may be advised to have tests for the flawed gene which may put them at risk. For example, if a close male relative has breast cancer, or if the BRCA2 gene has been found in close family members. However, even if you are found to have this gene, it does not mean you will necessarily develop breast cancer. You may, however, be advised to have regular check-ups. There is no standard guidance to follow as breast cancer in men is so unusual.

The cause of cancer for most people is not known, so the best way to avoid problems is to keep your weight within a healthy range and to report any changes in your breasts to your doctor as soon as possible.

Many Men Are Too Embarrassed To Talk About Lumps In Their Chest

Another reason men get diagnosed later than women may be due to social stigma concerning breast cancer. Men are often very embarrassed to bring up breast lumps with their doctors or talk about breast cancer with their families, Dr. OHea says. They fear that a breast cancer diagnosis will make them seem less manly which couldnt be further from the truth.

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Information Booklet For Men

If you would like to know more about breast cancer in men, read BCNA’s Men get breast cancer too booklet. It provides information specifically for men, including treatments, coping strategies and common challenges that men face after a diagnosis. The booklet also mentions other resources and counselling services that are available to you. The booklet was developed with input from men who have been diagnosed with breast cancer as well as their family members, health professionals and researchers.

What Is The Outlook For Men With Breast Cancer

The prognosis for men who have breast cancer depends on the tumors size and if it has spread. These are reflected in the cancer stage. In general, a higher stage indicates a worse prognosis. Early diagnosis can improve the outlook significantly. But because men dont get regular breast cancer screenings like women, the first sign of cancer is usually a lump. By that time, the cancer has often spread to the lymph nodes or other areas of the body.

Healthcare providers measure cancer outlook by the five-year survival rate. Overall, the survival rate for male breast cancer is 84%. The survival rate for men with breast cancer that has not spread beyond the original tumor is 97%. For men with cancer that has spread to other parts of the body, the survival rate is about 22%.

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How To Do A Breast Self

Can I Prevent Male Breast Cancer

You may not be able to prevent breast cancer. But you can lower your risk of developing the disease by maintaining a healthy weight, avoiding excess alcohol and getting plenty of exercise.

If you have a family history of breast cancer, talk to your doctor. You may consider genetic testing to see if you have the BRCA1 or BRCA2 genetic mutation. These gene changes increase your risk of breast cancer. People with these gene changes should visit their healthcare provider regularly and get frequent cancer screenings.

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How To Get Brca Genetic Testing

Genetic counseling is recommended for those who are interested in being tested for breast cancer gene mutations. You can talk to a doctor about getting a referral to a genetic counselor, who can help determine whether genetic testing would make sense based on family history and risk factors. Since many genetic tests only look for one specific gene mutation, the counselor can often help determine which mutations to test for.

The genetic test itself simply involves taking a small sample of blood or saliva, which is sent to a lab for analysis. Results can take several weeks or months.

Genetic testing results are not always clear-cut:

• A test result can be positive, meaning that the patient does carry the gene mutation.
• A negative test result indicates that they do not have that particular known gene mutation. It does not, however, rule out the possibility of having mutations in other genes. It also does not rule out the possibility of developing breast cancer. Most breast cancer cases are not hereditary, so everyone should still have an early detection plan.
• Genetic test results can also be uncertain or ambiguous. An ambiguous test result means that a mutation has been found on the gene, but it is not yet known whether that particular mutation has any effect on the chances of developing breast cancer.
• Someone is either negative or positive. Over time, a person cannot go from being negative to being positive or vice versa for the specific gene mutations they were tested for.

Diagnosing Male Breast Cancer

Diagnosis male breast cancer starts with providing a complete personal and family medical history, describing your symptoms and being examined by your doctor.

After that, you may have screening with one of a few possible technologies, including a diagnostic mammogram, a breast ultrasound, a magnetic resonance imaging scan and/or possibly a test to study your nipple discharge.

Your doctor may also test your blood chemistry to look for unusual amounts of a substance that might suggest disease.

If your diagnostic tests show you may have cancer, the next step is a biopsy. A variety of different biopsies can involve removing cells through a needle, including fine-needle aspiration or core needle biopsy, or removing the whole lump or part of the suspicious area through surgery.

If cancer is found, additional tests will help your doctor know how quickly it may grow, how likely it is to spread or recur and what treatments may be the most appropriate.

Those would include:

• An estrogen and progesterone receptor test that measure the amount of these receptors in the cancer
• A HER2 test to measure the presence and level of HER2 protein

Men tend to be diagnosed with breast cancers that are hormone receptor-positive and HER2-negative.

The spread of cancer from breast to lymph nodes and other parts of the body in men appears to be similar to what women experience.

The stage of breast cancer is determined by your care team based on:

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Men Most Commonly Find Their Cancer Through A Lump

Just over half of women diagnosed with breast cancer reported finding their cancer through a lump or other physical sign, according to a study published in the Journal of Womens Health. However, that number is nearly 100 per cent for men, Dr. OHea says. Most commonly, men report feeling a hard or painful lump under or around their nipple or from discharge from the nipple. Men dont get routine mammograms so noticing that something looks or feels weird is really the only way they find it, he explains.

Men Have Breast Tissue

We tend to think of breasts as a female thing, but men do have some breast tissue in their pectoral area and behind their nipples, Dr. OHea says. They dont have as much estrogen as women so the tissue doesnt develop the way it does in women. But it can develop breast cancer in the same way as female breast cancer, he explains. What people often call man boobs are not breast tissue but rather fatty deposits that accumulate in the chest area. Having larger man boobs does not increase your risk of getting breast cancer, he adds.

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What Can I Do To Reduce My Risk

If several members of your family have had breast or ovarian cancer, or one of your family members has a known BRCA1 or BRCA2 mutation, share this information with your doctor. Your doctor may refer you for genetic counseling. In men, mutations in the BRCA1 and BRCA2 genes can increase the risk of breast cancer, high-grade prostate cancer, and pancreatic cancer.

If genetic testing shows that you have a BRCA1 or BRCA2 gene mutation, your doctor will explain what you should do to find cancer early, if you get it.

All men can lower their risk by keeping a healthy weight and exercising regularly.

How Is Male Breast Cancer Treated

Treatment for men with breast cancer is the same as that for women. The treatment offered to you will depend on different factors such as the type of tumour, the stage of the disease and your general health.

The main treatments used are surgery, chemotherapy, radiotherapy, hormone therapy and targeted therapies. Read more about treating breast cancer.

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