Breast Cancer In Men-Uncommon But Lethal

Breast cancer is commonly assumed to be a female disease, thus many people were taken aback when music producer and artist manager Mathew Knowles revealed in October 2019 that he had had breast cancer treatment. Knowles is also the father of Beyoncé and her previous manager. "Even males have breast tissue, which is why they acquire breast cancer," explains Dr. Nikita Shah of the Orlando Health UF Health Cancer Center's Breast Medical Oncology division. Men's reactions to such a typically feminine diagnosis can understandably be contentious. "Some men embrace it and run with it, while others wonder, 'What's wrong with me?'" she adds.

Male breast cancer is more likely in men who have a BRCA1 or BRCA2 gene mutation, according to Shah. Knowles carries a BRCA2 gene mutation. However, not every man or woman with these mutations will get breast cancer. "Men with these mutations may have a 6% lifetime risk of developing breast cancer, which means that most men, even if they have a mutation, may not get it," explains Leigha Senter, MS, LGC, licensed genetic counselor at The Ohio State University Comprehensive Cancer Center, in an email. Nonetheless, she advises males with a significant family history of breast cancer, or those who have already been diagnosed, to obtain genetic testing to see if a gene is at work.

In an email interview, Susan Brown, M.S., R.N., senior director of education and patient support with Susan G. Komen, notes, "The lifetime risk of acquiring breast cancer is roughly 1 in 833 in males compared to 1 in 8 in women." This demonstrates that breast cancer is primarily a female illness. Male breast cancer accounts for only 1% of all instances diagnosed in the United States each year, or approximately 2,000 cases each year, according to Shah.

Causes

You may be wondering why guys develop breast cancer. Breast tissue can be found in both men and women. Men, on the other hand, do not generally develop larger breasts like women do because they have low quantities of the feminine hormone estrogen and high levels of the masculine hormone testosterone. Breast tissue contains fat as well as milk-producing glands and ducts that transport the milk to the nipples. Breast cancer usually originates in the milk ducts in both men and women. This is known as ductal carcinoma. Breast cells regularly divide and grow in response to estrogen, and the more these cells divide, the more opportunities for errors to occur when replicating their DNA. These DNA errors could potentially lead to cancer. Unbalanced male and female hormones may raise the risk of breast cancer. According to the American Cancer Society, the cause of most male breast cancers is unknown.

According to Shah, there are a few factors that place males at a slightly increased risk of acquiring breast cancer. For example, gynecomastia, or male breast tissue expansion, can be caused by liver illness, hormonal imbalance, or certain drugs. "That's one of the most popular ones," Shah explains. Aging, a family history of breast cancer, obesity, liver disease, radiation exposure, frequent drinking, and some testicular diseases are also risk factors. African-American men are more vulnerable than white men. However, as previously said, the cause of breast cancer is frequently unknown.

Signs and Symptoms

While men are less likely than women to be diagnosed with breast cancer, the disease is generally fatal once it is discovered. According to the American Cancer Society, there will be 2,670 new instances of male breast cancer in 2019 and 500 deaths. "Men don't have that much breast tissue and they're not looking for it, so it's at a higher stage when it's diagnosed because men aren't going in for mammograms," Shah says. Knowles told "Good Morning America" that he noticed drops of blood on his shirt on a regular basis, prompting his doctor to order a mammogram, which revealed the breast cancer. "The most prevalent indicator of breast cancer in males is a painless lump or thickening in the breast or chest area," Brown writes, adding that "any change in the breast or nipple might be a warning sign of breast cancer in men." Others include:

• dimpling, puckering or redness of the skin of the breast
• itchy, scaly sores or rash on the nipple
• pulling in of the nipple inverted nipple or other parts of the breast
• nipple discharge or any other change in the general size or shape of the breast

Treatment

Breast cancer therapy varies depending on the type and stage, but "guys with breast cancer are not treated any differently than a postmenopausal woman with breast cancer," according to Shah. Chemotherapy, hormone therapy, radiation, and/or surgery may be used in treatment. "The key difference in therapy for breast cancer in men is that the surgery to remove the tumor is usually a mastectomy, rather than a lumpectomy, which is a partial removal of the breast," Brown adds. "Because of the tiny size of the male breast, lumpectomy, which is commonly used in women, is rarely employed in men."

Brown writes that treatment is then handled on a case-by-case basis, with some men requiring radiation therapy depending on the stage. Hormone therapy is frequently employed because the majority of male breast cancer patients are hormone-receptor positive. This medication works by preventing estrogen and progesterone hormones from connecting to receptors, so preventing malignant cells from growing. Chemotherapy is also stage and type dependant.

Breast cancer is a devastating diagnosis for any sufferer. However, when the condition is perceived as feminine, an additional layer of suffering is prevalent. "Men may feel uncomfortable if they need a diagnostic mammography or visit a breast surgeon or breast cancer oncologist where they are surrounded by pink and mistaken for a caretaker rather than the patient," Brown explains. To that end, it is on to caregivers and the general public to change the conversation to be more inclusive. "When talking about breast cancer, we should do a better job of intentionally include males in the story, acknowledging it may happen - normalizing the presence of breast cancer in men to remove the stigma," Brown of Susan G. Komen says. "And, as more males publicly communicate their breast cancer diagnosis, the stigma should fade."

Brown also recommends support groups for males who have received such a diagnosis. "Because breast cancer support groups may exclusively have female members, joining a support group for guys with any type of cancer may be more beneficial," she explains. Susan G. Komen also provides free six-week telephone support groups for males to address the issues of breast cancer.