Male Breast Cancer
What is male breast cancer?
Male breast cancer is a type of cancer that grows in a man’s breast tissue. Although male breasts can’t produce milk, they do have fatty tissue, ducts and breast cells. Breast tissue in men is similar to young girls’ breast tissue before they start puberty. Cancer develops when cells in these tissues grow uncontrollably, forming a tumor.
Treatment for male breast cancer includes chemotherapy, radiation, surgery, hormone therapy and targeted therapy. The outlook depends on the tumor’s size and whether it has spread to other parts of the body.
How common is male breast cancer?
Breast cancer in men is rare. It affects about 2,600 men in the United States every year. Less than 1% of breast cancers occur in men. Male breast cancer is most common among men over 60. Black men are slightly more likely to develop the disease.
What are the types of male breast cancer?
Breast cancer in men usually begins in the breast ducts. Ducts are tubes that carry milk to the nipple. Although men have milk ducts and glands that create milk, they don’t work like the ducts and milk-producing glands in women.
The types of male breast cancer include:
- Invasive ductal carcinoma: Cancer begins in the breast ducts and spreads to other parts of the breast. Cancer cells may also spread (metastasize) to other areas of the body. Invasive (or infiltrating) ductal carcinoma is the most common type of breast cancer in people regardless of gender.
- Invasive lobular carcinoma: Cancer begins in the lobules (glands that produce milk). Lobular breast cancer can also spread to other parts of the body.
- Ductal carcinoma in situ (DCIS): Cancer cells grow in the lining of the breast ducts. They have not spread to other parts of the breast or the rest of the body. Ductal carcinoma in situ is uncommon in men.
- Inflammatory breast cancer: Usually a type of invasive ductal carcinoma, inflammatory breast cancer is very rare in men. The breast tissue is swollen and red. It feels warm to the touch, and the skin may be dimpled, but there is no lump.
- Paget’s disease of the nipple: Cancer cells grow in the ducts and spread to the nipple and the area around the nipple. Paget’s disease of the nipple is also called Paget’s disease of the breast or mammary Paget disease.
Symptoms and Causes
What are the symptoms of breast cancer in men?
Because men don’t have regular mammogram scans like women, physical signs of breast cancer are often the first indication a man notices. The most common symptoms of breast cancer in men include:
- Breast lump: A thickened area, lump or mass may grow on the breast, behind the nipple or in the armpit.
- Change in appearance: The breast tissue may look larger, puckered, misshapen or sunken. There may be a dimple or several small divots or pits, like the skin of an orange.
- Pain: You may have tenderness, sensitivity or pain in the breast tissue or underarm area. Instead, you may have a painless lump in the breast or armpit.
- Problems with the nipple: Clear fluid or bloody liquid may come out of the nipple. An inverted nipple (it goes in rather than sticking out) can be another sign of breast cancer.
- Skin changes: Red, flaky or scaly skin may appear anywhere on the breast or nipple area. You may see ulcers on the skin.
What causes male breast cancer?
Anyone can get breast cancer. Overall health, family history and genetic factors increase the risk of developing the disease. Risk factors of male breast cancer include:
- Age: Men over 60 are more likely to develop breast cancer.
- Overall health: Men with obesity may have gynecomastia (enlarged male breast tissue that can feel like a lump). Gynecomastia increases the risk of developing breast cancer.
- Estrogen levels: Certain drugs that contain estrogen (such as medications to treat prostate cancer) cause estrogen levels to rise. Cirrhosis (liver disease) can also increase estrogen levels. A genetic disorder called Klinefelter syndrome increases the risk of several health issues, including breast cancer.
- Family history: Men who have a first-degree relative (of any gender) with breast cancer have a higher chance of the disease.
- Genes: Genetic mutations increase the risk of developing breast cancer. These include changes in the BRCA gene (BRCA1 and BRCA2). Mutations in these genes also increase the risk of pancreatic cancer and prostate cancer.
- Radiation therapy: Men who had radiation therapy in the chest or torso have a higher risk of developing breast cancer.
- Testicular issues: People who have had surgery to remove their testicles have a higher risk of breast cancer. Testicle injuries also increase the risk.
Diagnosis and Tests
How is male breast cancer diagnosed?
Your healthcare provider will ask about your symptoms and examine your breast tissue, paying close attention to any lumps or abnormalities. Your provider may take a sample of your blood (complete blood count or CBC and complete metabolic panel or CMP) and send it to a lab.
To look for cancer cells in breast tissue, your provider may do a biopsy. Using a thin needle, your provider removes a sample of the breast tissue and sends it to a lab. The lab tests the tissue for cancer cells.
To see pictures of your breast tissue, your provider may order imaging studies. These include:
- Mammogram: A mammogram is an X-ray of breast tissue.
- Ultrasound: An ultrasound uses sound waves to see images of soft tissues.
- MRI: An MRI produces images of breast tissue using a high-powered magnet and radio waves.
What are the stages of male breast cancer?
After diagnosing breast cancer, providers classify the disease using a process called staging. Providers measure the tumor and look at its location. They determine whether the tumor has spread to lymph nodes, surrounding breast tissue or other parts of your body. Lymph nodes are small organs that move fluid through the body and help protect you from illness.
The stages of male breast cancer are:
Stage 0: Cancer cells are only in the ducts. Cancer has not spread to other breast tissue.
Stage I: The tumor is small and hasn’t spread to the lymph nodes.
Stage II: One of these is true:
- The tumor is smaller than 20 millimeters (mm) and has spread to a few axillary lymph nodes. Axillary nodes are lymph nodes in the armpit.
- The tumor is 20 mm to 50 mm across and has not spread to the axillary lymph nodes (stage IIA). Or the tumor is 20 mm to 50 mm and has spread to the axillary lymph nodes (stage IIB).
- The tumor is larger than 50 mm and has not spread to a few axillary lymph nodes. (50 mm is about the size of a lime.)
Stage III: Cancer has spread typically to several lymph nodes. Cancer cells may also be in the chest wall or skin. It has not spread to other areas of the body away from the breast.
Stage IV: Cancer cells have spread to other parts of the body away from the breast. Cancer can spread to all areas of the body, including the lungs, bones, liver or brain.
Recurrent: Cancer that comes back after treatment is called recurrent cancer.
Another important part of staging comes from looking at the cancer cells under a microscope and using additional tests. This helps determine the grade of cancer, which is a scoring system based on the appearance of the cancer cells. This also helps identify the presence of certain proteins on the cancer cells called receptors. These proteins include estrogen receptor (ER), progesterone receptor (PR), and HER2/neu receptor. These provide important information about what is causing the cancer cells to grow.
Management and Treatment
What are the treatments for male breast cancer?
Male breast cancer treatment depends on the type and stage of the disease. Your team of providers will discuss your options with you. Your medical history will help guide what treatment is best for you. Treatments include:
- Surgery: During breast cancer surgery, your provider removes as much of the tumor as possible. You may need a lumpectomy (surgery to remove a lump) or a mastectomy (surgery to remove the entire breast). Because men have limited breast tissue, mastectomy is more commonly done. You may also need surgery to remove lymph nodes.
- Radiation: Your provider uses targeted radiation therapy to kill cancer cells. Radiation for breast cancer usually follows surgery (typically lumpectomy).
- Chemotherapy (commonly called chemo): Your provider delivers chemotherapy drugs into a vein, usually through an infusion. You might also take oral chemotherapy pills (by mouth). These medications kill cancer cells and stop them from multiplying. You may receive chemo treatments over several weeks or months.
- Hormone therapy (also called endocrine therapy): Your provider prescribes medications that affect your hormones. These drugs may lower levels of estrogen or block the effects of estrogen. Providers usually use hormone therapy to treat women with breast cancer, but it can be an effective treatment for men, too. These medications treat breast cancers that use hormones (estrogen and/or progesterone) to grow. Hormone therapy can be given in the form of pills and/or injections.
- Medications: Several medications kill cancer cells or stop them from growing. Your provider will discuss these medications (and any side effects) with you. These may include medications called targeted therapy.
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.
Outlook / Prognosis
What is the outlook for men with breast cancer?
The prognosis for men who have breast cancer depends on the tumor’s 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 don’t 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%.
When should I see my healthcare provider about male breast cancer?
If you notice any symptoms of breast cancer, call your provider right away. It’s essential to see your provider for an evaluation as early as possible. Early detection and treatment can greatly improve the prognosis.
A note from Cleveland Clinic
Many men don’t think breast cancer can happen to them. So they may not recognize signs when they appear. If you think something isn’t right with your chest tissue, see your provider for an evaluation. Early diagnosis and treatment can have a significant impact on the long-term prognosis. Be honest with your provider about your symptoms and how long you’ve had them. If you have any risk factors for male breast cancer, talk to your provider about how you can reduce your risk.
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