Breast Cancer - Moose and Doc

A breast cancer explanations website

 

By Dr. Halls

Male Breast Cancer: Section 5.e.

 
CONTENTS:
 
5.19 Breast Cancer in Men

 

Dr. Halls Dr. Halls
Hey man, if you feel a lump behind your nipple, and if ultrasound shows some thickening of tissue there, there’s a 50% chance that it’s a cancer.


 
 

Back to section 5D on rare types. Forward to 6A on pathology tests.

 

5.19 Breast Cancer in Men

 
breast cancer in menBreast cancer in women is 100 times more common than breast cancer in men.  Male breast cancer represents less than 1.5% of all cancers in men.

Breast cancer affects 1 in 100,000 men in the U.S. The American Cancer Society predicts that in 2017 there will be around 2,470 cases of invasive breast cancer in men in the US.  In addition, 460 men will die of breast cancer in the US in 2017.

For all the latest statistics for breast cancer in men, see our latest, up-to-date post on incidence, survival and mortality rates HERE.

Signs and Symptoms of Breast Cancer in Men

 
Male breast cancer can present with the following symptoms and signs:

  • breast cancer in menA 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.)

 

Tyler Tyler
What happens if there is a lump behind a man’s nipple?

Dr. Halls Dr. Halls
Usually ultrasound scan first, then a very easy biopsy with lots of freezing.


 
 

Risk Factors for Breast Cancer in Men

 
The https://www.cancer.org/cancer/breast-cancer-in-men/causes-risks-prevention/risk-factors.html for breast cancer in men include the following:

  • Age: Breast cancer usually affects males in their sixth decade
  • Radiation Exposure: A history of radiation therapy to the chest at an early age
  • Occupational History: Wood machining; exposure to high temperature and petroleum products or breast cancer in menexposure to electromagnetic fields
  • Hormonal Factors: Estrogen for e.g., prostate cancer
  • Alcohol consumption and liver disease
  • Obesity
  • Diabetes mellitus
  • Hypertension
  • Hypercholesterolemia
  • Family history of breast cancer
  • BRCA2 gene mutations

 

Figure 5.38 Breast Cancer in Men

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)

Fig 5-38 breast cancer in men mammo and tubular
 

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).

 

Dr. Halls Dr. Halls
In my experience, yes, it’s generally older men that have cancer. Younger men usually have benign causes of lump behind his nipple.

Dr. Halls Dr. Halls
But, I disagree with the Hotko reference. I generally don’t see higher stage male breast cancers with positive axillary nodes. In my experience, that’s pretty rare.


 
 

Hormone Receptor Status for Breast Cancer in Men

 
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.
 

References

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):
https://www.ncbi.nlm.nih.gov/pubmed/15221988
 

More references for this section are on this page.

 

Patient Information

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): https://www.cancer.org/cancer/breast-cancer-in-men/causes-risks-prevention/risk-factors.html
 

More patient information for this section is on this page.

 

Back to section 5D on rare types. Forward to 6A on pathology tests.