International Men’s Day 2019: Let’s talk about male breast cancer

Representational image. Image source: Getty Images.

Launched in 1992, International Men’s Day is celebrated on 19 November every year. And it isn’t just a day to celebrate the men in your life – no, it’s a day dedicated to spreading awareness about men’s issues. And while most of these conversations are aimed at mental health, we thought there was another issue that also needed some attention. 

Male breast cancer

Yes, while it is rare, breast cancer can occur in men as well. It makes up less than 1.5% of all breast cancer cases in India. Just like every other cancer, those diagnosed at an earlier stage have a much better likelihood of survival.

Risk factors of male breast cancer 

It is not well understood what causes male breast cancer but older men, mostly those over 60 years of age, are more likely to be affected by it.

Those with a strong family history of the disease are also more at risk since the mutated gene BRCA2 that has been linked to breast cancer is passed down by parents to their children. Estrogen-related drugs that work by increasing the amount of estrogen in the body, obesity, testicular disease or surgery can also increase the chances of getting the disease. Klinefelter syndrome, a genetic condition in which boys are born with an extra X chromosome (XXY instead of XY) and may cause lower production of testosterone, is also strongly associated with the disease.

This suggests that largely hormonal and genetic pathways are responsible for the condition.

Types of male breast cancer

Boys are born with some breast tissue, same as women. Male breast tissue has ducts (tubes that carry milk to the nipples) but very few lobules (milk-producing glands). During puberty, the hormones produced in a girl’s body promote the growth of the breast tissue. Since boys have very low levels of estrogen, even as adults, their breast tissue doesn’t grow a lot.

The most common form of male breast cancer is ductal carcinoma. As men have fewer lobules, there is a lower chance of developing lobular carcinoma. Other types of cancers that can be found in men include Paget disease and inflammatory breast cancer.

Read Also:  Men’s Health Checklist

Symptoms may include a painless lump or thickness in the breast tissue, changes to skin around the breast, such as dimpling, redness or scaling, a nipple that appears inverted, and discharge (sometimes bloody) from the nipple. If you experience any of these symptoms, it is a good idea to consult your doctor.

Diagnosis and interventions

Your doctor will conduct a clinical breast exam and check for lumps or other changes. They may order imaging tests such as mammography or may conduct a biopsy to ascertain the pathology of the lumps if any. If there is a malignant growth, your doctor may wish to investigate the grade and spread of cancer and request a bone, CT, or PET scan.

Treatment will depend on the type of cancer that is found. In cases where the disease has advanced significantly, a mastectomy or excision of the breast may be required followed by radiation or chemotherapy. In some cases, systemic hormonal treatment with Tamoxifen (which lowers the production of estrogen and related hormones) may be recommended post-surgery.

Studies on male breast cancer

Very limited studies have been conducted on male breast cancer. However, meta-analyses have shown that the likelihood of survival is similar in females and males. However, diagnosis is often delayed in males which leads to a higher mortality rate. This is significant because people diagnosed at the earliest stages (0 and 1) have a five-year survival rate of 100%. On the other hand, those diagnosed at stage 4, when cancer has metastasised, have been shown to have a 25% rate of survival over the next five years.

Even though it is rare, male breast cancer is a deadly disease if not diagnosed in time. Further research on it will shed more light on how and why it happens, the diagnoses and treatment options. A lack of awareness about the disease has been cited as a major reason for late diagnosis (if you feel there’s something amiss in your chest tissue, consult your doctor immediately).