Breast Cancer Men

Causes

Cancer occurs when cells in the body divide without control or order. Over time these cells form a growth or tumor. The term cancer refers to growths that can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body. The lymph nodes most commonly linked with breast cancer are in the armpit, above the collarbone, and in the chest.

It is not clear what causes these problems in the cells. It is probably a mix of genetics and environment.

Cancer Cell Growth

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Risk Factors

Breast cancer is more common in men 65 years of age and over. Other things that may raise the risk of having breast cancer include:

• Family history of breast cancer
• Genetic mutations, such as BRCA1, BRCA2, and others
• Exposure to radiation, especially in the chest
• Exposure to higher levels of estrogen, which may happen with:
  • Klinefelter syndrome
  • Liver diseases
  • Alcohol use disorder
  • Testicular disorders, such as an undescended testicle or mumps orchitis
  • Obesity
  • Gynecomastia—breast tissue growth in men that is not due to excess fat in the chest
  • Prostate cancer treatment
  • Some jobs where a person spends a lot of time around high heat or gas fumes

Symptoms

Breast cancer may not have symptoms as it first forms. As the cancer grows it can cause:

• One or more lumps in the breast, which may or may not hurt
• One or more lumps in lymph nodes near the breast, under the arm, or collarbone that may or may not hurt
• Changes in the skin or nipple, such as dimpling, puckering, or nipple retraction
• Redness, irritation, or ulceration of the skin in the breast area
• Clear or bloody discharge from the nipple

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. This includes checking the breast and blood tests.

Diagnosis is confirmed with a biopsy. A tissue sample will be removed and checked for cancer cells.

Imaging tests can help with diagnosis and seeing if the cancer has spread. These may include:

• Mammogram
• Ultrasound
• Chest x-ray
• Bone scan
• MRI scan
• PET scan

The physical exam and test results will help the doctor figure out the type and stage of cancer. Staging is used to guide the treatment plan. Breast cancer in men is staged from 1 to 4. Stage 1 is a cancer that has stayed in one place. Stage 4 means it has spread to other parts of the body. Cancer cells may also be graded by how fast they might grow and spread.

Treatment

The goal of treatment is to rid the body of the cancer. How this is done depends on the cancer's stage and type.

A mix of therapies can be most helpful. For example, radiation may be used before surgery to shrink the tumor, or after to make sure all the cancer has been removed.

Treatment options include:

Surgery

The goal of surgery is to remove the tumors and any affected tissue. This can be done with:

• Modified radical mastectomy—Removal of the whole breast, the lymph nodes under the arm and the lining over the chest muscles. This is the most common procedure.
• Radical mastectomy—Removal of the whole breast, the lymph nodes under the arm, and the chest wall muscles under the breast. This is only done when the tumor is large and growing into the chest muscles.
• Axillary lymph node dissection—Removal of the lymph nodes under the arm. This is done to see if cancer cells have entered the lymphatic system.
• Sentinel node biopsy—A small amount of blue dye and/or a radioactive tracer is placed where the tumor was. Lymph nodes that pick up the substance are removed. The rest of the lymph nodes should be taken out if any sentinel nodes have cancer.

Radiation Therapy

This uses radiation to kill cancer cells and shrink tumors. It can be:

• External—Radiation aimed at the breast or area of spread from a source outside the body.
• Internal—Radioactive materials are put in the breast or area of spread in or near the cancer cells.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be given as a pill, injection, or IV. The drugs enter the blood and travel through the body killing mostly cancer cells. Some healthy cells are killed as well. This can help lead to a person having side effects.

Medicines

The following therapies may be used along with chemotherapy to help treat or prevent cancer from coming back:

• Biologic therapy—Using medicines or substances made by the body to treat cancer. Biologic response modifier (BRM) therapy uses medicines to help or restore the body's natural defenses against cancer.
• Targeted therapy—Uses medicines to disrupt things the cancer cells need for them to grow. For example, medicines can block new blood vessels from growing or block chemical signals that let cancer cells grow and work.
• Hormone blocking therapy—This uses the fact that many breast cancers use estrogen to help grow and divide to fight the cancer cells. Anti-estrogen drugs prevent the cancer cells from using estrogen. This stops the cells from growing. It can delay or prevent the breast cancer from coming back.

Other Medicines

Cancer treatments can cause side effects such as:

Prevention

There are no current guidelines to screen for breast cancer in men. Finding breast cancer early and treating it right away is the best way to prevent death. Since breast cancer does not cause symptoms in the early stages, watch for any changes to the breasts or chest and talk to the doctor about them.