Male Breast Cancer: Rare but There

It is October again and pink is taking over – Breast Cancer Awareness Month is here! In 2017, an estimated 253,000 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 63,000 new cases of non-invasive breast cancer. Overall, about 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime.
But what about men?

A man’s lifetime risk of breast cancer is about 1 in 1,000 – representing less than 1% of all breast cancers diagnosed each year. In 2017, about 2,500 new cases of invasive breast cancer are expected to be diagnosed in men. Although that number is small compared to the 253,000 cases in women, it is still important to know the risks. Unfortunately, male breast cancer is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can even develop breast cancer.

As with women, the incidence of breast cancer in men rises with age, but men tend to be approximately 5 to 10 years older than women at the time of diagnosis, around the age of 67. Most men with breast cancer generally find a painless, firm mass behind the nipple. There may be associated skin changes, including nipple retraction, ulceration, or fixation of the mass to the skin or underlying tissues. In advanced cases, lymph nodes are typically found in the armpit also.

Although, positive family history increases the breast cancer risk from two- to fourfold, other risk factors for male breast cancer include:
• Klinefelter syndrome
• BRCA1 or BRCA2 mutation
• Family history of breast cancer in a first-degree male or female relative
• Hyperestrogenism
• Advanced age
• History of chest irradiation
• History of exogenous estrogen treatment for feminization purposes

Now, most breast lumps found will not be breast cancer. Benign gynecomastia, or enlarged breasts in men due to hormonal imbalance, is the most common abnormality of the male breast. At clinical examination, gynecomastia usually manifests as an easily compressible, mobile, soft mass behind the nipple. Causes of gynecomastia vary and include medications, marijuana, cirrhosis, malnutrition, testicular tumors, hyperthyroidism, hypogonadism, chronic kidney disease, and hormone therapy for prostate cancer. Sometimes no abnormality is detected as the cause of gynecomastia.

If you find a lump in you breast, seek help early. Just because you are a man, do not think you cannot get breast cancer. Make an appointment with your physician if there is:
• Persistent breast lump
• Changes in the skin covering the breast
• Changes in the nipple
• Discharge from the nipple

Like women, men diagnosed with breast cancer at an early stage have a good chance for a cure. So, do not forget blue in the pink month of October.

 

Dr. Brandon Behjatnia is a radiologist with a focus on women’s imaging. His primary research is focused on breast cancer screening in women 40-49 years old. Dr. Behjatnia believes in a personalized approach to breast care. His philosophy on care is to offer his patients the highest order of integrity, compassion, and respect. To learn more about Dr. Behjatnia click here.

Sources
Breastcancer.org. 2017.
Nguyen C, Kettler MD, Swirsky ME, Miller VI, Scott C, Krause R, Hadro JA. Male breast disease: pictorial review with radiologic-pathologic correlation. Radiographics. 2013 May;33(3):763-79. PMID: 23674773.
Uptodate.com. 2017.