5.19 Male Breast Cancer
5.19 Male Breast Cancer
Breast cancer in women is 100 x more common than in men. Breast cancer represents less than 1.5% of all cancer in men.
Breast cancer affects 1 in 100,000 men in the U.S. The American Cancer Society has reported that 1,450 men were diagnosed with breast cancer in the United States in 2009; about 450 men died from breast cancer in that year.
Male breast cancer can present with the following symptoms and signs:
- A small, painless lump behind the nipple or in the upper outer breast quadrant.
- Nipple retraction or ulceration.
- Nipple discharge.
- A solitary axillary mass.
If a lump or small mass is found in the male breast there is a large chance that it is a benign breast lump. There are various (non-cancerous) tumours found in the male breast too. (See Section 3d.)
- Age: Breast cancer usually affects males in their sixth decade.
- Radiation Exposure: A history or radiation therapy to the chest at an early age.
- Occupational History: Wood machining; exposure to high temperature; exposure to petroleum products; exposure to electromagnetic fields.
- Hormonal Factors: Estrogen for e.g., prostate cancer.
- Alcohol consumption and liver disease.
- Diabetes mellitus.
- Family history of breast cancer.
- BRCA2 gene mutations.
Figure 5.38 Male Breast Cancer.
A. Mammographic X-ray in a man shows an area of dense tissue below the nipple.
B. Photomicrograph of the histology of the core needle biopsy (CNB) of the
breast abnormality shows an invasive, well-differentiated (Grade 1) breast
cancer with a tubular pattern. (H&E x 20)
The male breast is composed of fatty tissue, connective tissue and a few branching ducts, but is without breast lobules. For this reason, invasive ductal carcinoma (IDC) is seen in the male breast, but not lobular carcinoma.
Male patients tend to be older than women at the time of presentation with breast cancer and may have a more advanced cancer stage and greater lymph node involvement at the time of diagnosis (Hotko 2013).
Male invasive ductal carcinoma (IDC) has a higher rate of estrogen receptor (ER) and progesterone receptor (PR) positivity than breast cancer in women. For the same stage of tumor, men have the same chances of survival of breast cancer as women.
Hotko, Y.S. (2013). Male breast cancer: clinical presentation, diagnosis and treatment. Exp Oncol 35(4), 303-310. (Retrieved November 12th 2014): http://exp-oncology.com.ua/article/6368
Giordano, S.H., Cohen, D.S., Buzdar, A.U., Perkins, G., Hortobagyi, G.N. (2004) Breast carcinoma in men: a population-based study. Cancer. 2004 Jul 1;101(1):51-7. (Retrieved January 19th 2015):
National Cancer Institute. Male Breast Cancer. (Retrieved January 19th 2014). http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/Patient/page1
BREASTCANCER.ORG What are the risk factors for breast cancer in men? (Retrieved November 14th 2014): http://www.cancer.org/cancer/breastcancerinmen/detailedguide/breast-cancer-in-men-risk-factors