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Thursday, October 28, 2021

What is breast cancer in men?

Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer. Cells in nearly any part of the body can become cancer and can spread to other areas.

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body.

Male breast tissue

Until puberty (on average around age 9 or 10), young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola (the area around the nipple). At puberty, a girl’s ovaries make female hormones, causing breast ducts to grow and lobules to form at the ends of ducts. Even after puberty, boys and men normally have low levels of female hormones, and breast tissue doesn’t grow much. Men’s breast tissue has ducts, but only a few if any lobules.

Where breast cancer starts

Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). Men have these ducts and glands, too, even though they aren’t normally functional. There are also types of breast cancer that start in other types of breast cells, but these are less common. A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers. Although many types of breast cancer can cause a lump in the breast, not all do.

It’s also important to understand that most breast lumps are benign and not cancer (malignant). Benign breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life-threatening. Any breast lump or change needs to be checked by a health care provider to determine whether it is benign or malignant (cancer).

How breast cancer spreads

Breast cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body.  The lymph system is a network of lymph (or lymphatic) vessels found throughout the body. The lymph vessels carry lymph fluid and connect lymph nodes. Lymph nodes are small, bean-shaped collections of immune system cells. Lymph vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune system cells.

Risk factors

Factors that increase the risk of male breast cancer include:

o          Older age. The risk of breast cancer increases as you age. Male breast cancer is most often diagnosed in men in their 60s.

o          Exposure to estrogen. If you take estrogen-related drugs, such as those used for hormone therapy for prostate cancer, your risk of breast cancer is increased.

o          Family history of breast cancer. If you have a close family member with breast cancer, you have a greater chance of developing the disease.

o          Liver disease. Certain conditions, such as cirrhosis of the liver, can reduce male hormones and increase female hormones, increasing your risk of breast cancer.

o          Obesity. Obesity is associated with higher levels of estrogen in the body, which increases the risk of male breast cancer.

o          Testicle disease or surgery. Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase your risk of male breast cancer.

Symptoms of breast cancer in men

The main symptom of breast cancer in men is a lump in the breast. The nipple or skin may also be affected.

Breast lumps only happen in 1 breast, grow under or around the nipple, are painless (but in rare cases they can hurt), feel hard or rubbery, do not move around within the breast, feel bumpy rather than smoot get bigger over time

Most lumps and swellings are not a sign of cancer. They’re usually caused by something fairly harmless, such as an enlarged male breast, a fatty lump, or a fluid-filled bump.

Other symptoms

Other signs of breast cancer in men include:

-the nipple turning inwards

fluid oozing from the nipple (nipple discharge), which may be streaked with blood

-a sore or rash around the nipple that does not go away

-the nipple or surrounding skin becoming hard, red or swollen

small bumps in the armpit (swollen glands)

You may get further symptoms if cancer spreads to other parts of your body, such as your bones, lungs, or liver.

These symptoms can include:

feeling tired all the time, aching or painful bones, shortness of breath

feeling sick, itchy skin with yellowing of your skin and eyes (jaundice)

Causes of breast cancer in men

The exact cause of breast cancer in men is not known, but there are some things that increase your risk of getting it.

These include:

genes and family history – inheriting faulty versions of genes called BRCA1 or BRCA2 increases the risk of breast cancer;

conditions that can increase the level of estrogen in the body – including obesity, and scarring of the liver (cirrhosis)

previous radiotherapy to the chest area

It’s not certain that can do anything to reduce the risk, but eating a balanced diet, losing weight if overweight and not drinking too much alcohol may help.

Diagnosis

Clinical breast exam. The doctor uses his or her fingertips to examine the breasts and surrounding areas for lumps or other changes. Your doctor assesses how large the lumps are, how they feel, and how close they are to your skin and muscles.

Imaging tests. Imaging tests create pictures of the breast tissue that allow doctors to identify abnormal areas. Tests may include a breast X-ray (mammogram) or an ultrasound, which uses sound waves to create images.

Removing a sample of breast cells for testing (biopsy). A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, your doctor uses a specialized needle device guided by an X-ray or another imaging test to extract a core of tissue from the suspicious area.

Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in breast cancer, the aggressiveness (grade) of cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.

Treatment-breast cancer in men

The treatment for breast cancer in men largely depends on how far cancer has spread. Possible treatments include surgery, radiotherapy, and medicines.

If cancer has not spread very far beyond your breast, a cure may be possible. This will usually involve surgery, possibly followed by radiotherapy or a course of medicine.

If cancer has spread into other parts of your body, a complete cure may not be possible. But treatment can help relieve symptoms and slow down the spread of cancer.

Surgery

An operation called a mastectomy (removal of the breast) is the main type of surgery for breast cancer in men. It involves removing all the breast tissue from the affected breast as well as the nipple, and possibly also the glands in your armpit and some of the muscle under your breast.

Possible complications

Side effects and risks of a mastectomy include:

pain and discomfort for 1 to 2 weeks – you’ll be given painkillers to help with this

numbness or tingling around the scar and in your upper arm – this should pass within a few weeks or months, but can occasionally be permanent

a wound infection, causing redness, swelling, warmth or discharge from the wound – tell your nurse or doctor if you get any of these symptoms.

o          Radiotherapy

o          Radiotherapy is a treatment where radiation is used to kill cancer cells. In breast cancer in men.

o          Chemotherapy

o          Chemotherapy is a treatment where powerful medicine is used to kill cancer cells. It may be used if hormone therapy is not suitable.

Testicle disease or surgery. Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase your risk of male breast cancer.

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