Male Breast Cancer: Know the Facts

Father’s Day is a day when we honor the men in our life. What better way to do so than to inform ourselves about potential health risks men face?

One rare, though oft ignored, due to its taboo nature, disease is male breast cancer. Men, like women, suffer from breast cancers that infiltrate the ductal tissue, lymph nodes and nipple. Also, like breast cancer in women, male breast cancer is marked by uncontrolled growth of the abnormal cells.

Incidence

Male breast cancer makes up less than 1% of all breast cancers. Approximately 2,000 cases of male breast cancer are reported each year in the U.S. Roughly 400 men die each year from the disease. It occurs most often in older men between the ages of 60 and 70. The cause is not entirely known, but both environmental influences and genetic factors likely play a role and as with women, hormones influence the growth of certain cancers. An interesting note: although male breast cancer remains relatively rare, the incidence of male breast cancer has increased by 26% since 1975 according to data from the National Cancer Institutes Surveillance, Epidemiology and End Results (SEER) database.

Risk Factors

Men who have previously undergone radiation therapy to treat malignancies in the chest area (for example, Hodgkin’s lymphoma) have an increased risk for the development of breast cancer.

The majority of breast cancers in men are hormone receptor positive. Remember, men have the same compliment of steroid hormones as women. They differ only in the concentrations/levels. Women have higher estrogens and men higher androgens. As many as 77% of tumors are either estrogen receptor-positive, meaning that they grow in response to stimulation by endogenous estrogens such as estradiol and estrone or exogenous synthetic estrogens, or are progesterone receptor positive, tumors grow in response to endogenous progesterone or synthetic progestins/progestagens. There is also evidence linking metastatic prostate cancer to male breast cancer and the medications associated with the treatment of prostrate cancer. Additional conditions associated with an increased rate of breast cancer include:  Klinefelter’s syndrome, cirrhosis of the liver and obesity.

Klinefelter’s syndrome is an inherited condition affecting about one in 1,000 men. Men with Klinefelter’s syndrome have inherited an extra female X chromosome, resulting in an abnormal sex chromosome makeup. Klinefelter’s patients produce high levels of estradiol and develop enlarged breasts. Men with Klinefelter’s have a 50 times greater risk for development of breast cancer than that of normal men.

Cirrhosis of the liver can result from alcohol abuse, viral hepatitis, or rare genetic conditions that result in accumulation of toxic substances within the liver. With cirrhosis, liver function is compromised and the levels of male and female hormones in the bloodstream are altered. Men with cirrhosis of the liver have higher blood levels of estradiol and estrone and have an increased risk of developing breast cancer.

Obesity. Men with a body mass index (BMI) greater than 30 have twice the breast cancer rate than men with BMIs <25.

Genetics. Men who have several female relatives with breast cancer also have an increased risk for development of breast cancer. About 15% of breast cancers in men are thought to be attributable to mutations in the breast cancer-associated  BRCA-2 gene.

Finasteride, a drug used to treat baldness (Propecia) and benign prostatic hyperplasia (Proscar), may be associated with an increased risk for male breast cancer. Further studies are needed to clarify whether a causal relationship between the drug and the disease actually exists.

Symptoms of Male Breast Cancer

The most notable symptoms of male breast cancer include:

1. Lumps
2. Changes to the nipple (inversion) or breast skin
3. Pain or discharge of fluid from the nipple
4. Enlarged lymph nodes under the arms.

Of note, men with breast cancer experience bloody nipple discharge and inversion more commonly than women.

Treatment for male breast cancer is usually a mastectomy. Other treatments include radiation, chemotherapy and/or hormone therapy.

This Father’s Day, ask yourself if the man in your life may be at risk. If he is, have a conversation with him about what you’ve just learned. Who knows, you may save a life, and wouldn’t that be a great Father’s Day gift?