Male Breast Cancer

 

Breast Cancer in Men – Etiology, genetics, risks, prevention, frequency, current research, statistics in the US and worldwide

Jonathan Karickal and Dr Lopamudra Das Roy

Published 2020

@BreastCancerHub, All Rights Reserved

Etiology [1]

Male breast cancer does not have a known cause so there is always a chance to get breast cancer. Doctors know that breast cancer originates when the individual’s breast cells start to divide more quickly compared to the healthy cells. The rapidly growing cells may spread to surrounding tissues. For example, the cells may metastasize to the lymph nodes or to other body parts. 

Every individual at birth has a small amount of breast tissue. During puberty, women develop more breast tissue whereas men do not. Even with this minute amount of breast tissue, men are still able to develop breast cancer. 

Types of breast cancer that men might develop are the following:

  • Cancer that begins in the milk ducts (ductal carcinoma) 

    • Most of the male breast cancer is ductal carcinoma

  • Cancer that begins in the milk producing glands (lobular carcinoma) 

    • This type of breast cancer is quite rare since men have very few lobules in their breast tissue

  • Other types of cancer 

    • A rarer type of breast cancer that are found men include inflammatory breast cancer and Paget’s disease where the disease is primarily located around the nipple

Genetics [1/3/8]

Men could inherit mutated genes like BRCA1 and BRCA2 which are genes that will increase your risk to develop breast cancer, prostate cancer, and pancreatic cancer. Therefore, if you have a family history of cancer it would be best if you consulted with a doctor. After meeting with a doctor, they might consider you for genetic testing to see if you carry the mutated genes that might increase your risk for cancer. 

If a man tests positive with the defective gene, his children will have an equal chance of receiving the gene whether they are male or female. 

Men who have Klinefelter’s syndrome carry more than one copy of the X chromosome which in turn causes irregular development of the testicles. Through this genetic disease, the individual will produce more female hormones (estrogens) compared to the male hormones (androgens). With the influx of female hormones, the individual will increase their risk of breast cancer.

Risks [1/3/9]

Many factors may increase your risk for male breast cancer which include: 

  • Old age

    • As you age, the risk of breast cancer also increases

  • Exposure to estrogen

    • If you take estrogen-based drugs like used for hormone therapy for prostate cancer will increase your risk of breast cancer

  • Family history of breast cancer

    • If you have a strong family history with cancer, there might be a chance that you may carry the genes which might increase your chances of breast cancer

  • Klinefelter’s syndrome

    • This genetic syndrome develops when boys carry more copies of the X chromosome which causes abnormal development of the testiclces. Therefore, men with this genetic disorder would decrease male hormones (androgens) and increase female hormones (estrogens)

  • Liver disease

    • Conditions on the liver like cirrhosis will decrease male hormones and increase female hormones which in turn increase your risk of breast cancer

  • Obesity

    • Obesity is closely linked to higher levels of estrogen which in turn increases your risk of breast cancer 

  • Testicle disease or surgery

    • If you have inflamed testicles (orchitis ) or need surgery to remove a testicle (orchiectomy) which increases your risk of breast cancer

  • Radiation Exposure

    • Long periods of radiation exposure increases your risk of breast cancer

  • Gynecomastia

    • Largening or swelling of breast tissues in males (decrease in androgen and increase in oestrogen). It has a minor risk towards male breast cancer.

Prevention [2/10]

Since male breast cancer does not have a known cause there is always a chance to get breast cancer, but there are a few ways to lower your risk of breast cancer.

  • Maintain a healthy weight

    • Increased body weight and weight gain are correlated to higher risk for breast cancer

  • Avoid or limit alcohol

    • Best to not drink alcohol

    • Men who drink alcohol should have no more than two alcoholic drinks in a day

  • Exercise regularly

    • Those who engage in moderate to vigorous activities have proven that to lower breast cancer risk

    • American Cancer Society advises adults to receive minimum of 150 to 300 minutes of moderate activity and 75 to 150 minutes of vigorous activity a week

  • Avoid Smoking / Tobacco

    • Best to not smoke or use any forms of tobacco

    • Men who smoke should try to stop or find healthy alternatives to help you prevent smoking 

Frequency [4/5]

Breast Cancer found in men is very rare. Less than one percent of all breast cancer cases occur in men. In other words, only one in 833 men will be diagnosed with breast cancer.

The rates of breast cancer present were 52%  higher in black men than in white men.

  • 2.75 per 100,000 black men were diagnosed with breast cancer

  • 1.81 per 100,000 white men were diagnosed with breast cancer

Current Research [7]

Diagnostic and treatment options:

  • Improving surgical options

    • New technological advances like surgical methods can save tissues and prevent scarring 

  • Radiation therapy advances

    • New advances in radiation therapy can lower the risks of side effects

  • New medications and drug combinations

    • New therapies and combinations can better treat the men with breast cancer which include chemotherapy, hormonal therapy, targeted therapy, and immunotherapy 

  • Palliative care / supportive care

    • Finding ways to reduce or prevent symptoms and side effects of current breast cancer treatment will improve and better the lives of those affected with breast cancer

Statistics in the United States of America [5/6]

The American Cancer Society projects the breast cancer cases found in men in 2020:

  • About 2,620 new cases of breast cases will be diagnosed

  • About 520 men will die from breast cancer

The overall 5-year survival rate for male breast cancer is 84% but individual survival rates vary depending on factors and the stage of the disease. The graph below shows the five-year survival rates for male breast cancer depending on the location(s) of the tumor.

Statistics around the World 

There is minimal information about the statistics of male breast cancer throughout the world excluding the United States of America. Even if there is information about male breast cancer, it is not up to date and current. With this lack of knowledge, we must raise awareness for male breast cancer and keep information published up to date. BCH is intensively raising awareness for Male Breast Cancer by collaborating with Male Breast Cancer Coalition. 

Conclusion

In short, there are primarily three types of male breast cancer : ductal carcinoma, lobular carcinoma, and inflammatory cancer / Paget’s disease. Male breast cancer could be passed down through mutated genes like BRCA1, BRCA2, and Klinefelter’s syndrome. These risks will increase your chances of breast cancer : old age, exposure to estrogen, family history of breast cancer, Klinefelter’s syndrome, liver disease, obesity, testicle disease or surgery, radiation exposure, and gynecomastia. If you follow these preventive techniques, it will lower risk of breast cancer : maintain a healthy weight, avoid or limit alcohol, exercise regularly, and avoid smoking / tobacco. One in 833 men will be diagnosed with breast cancer and based of racial groups, African Americans have the highest chance of breast cancer. In 2019 - 2020, scientific research is looking for the best diagnostic and treatment options : improving surgical options, radiation therapy advances, new medications and drug combinations, and palliative care / supportive care. In the United States, the overall 5-year survival rate for male breast cancer is 84% but may differ depending on the location(s) of the tumor. Throughout the world, there is minimal information about male breast cancer; therefore, we must raise awareness for male breast cancer.








References

  1. “Male Breast Cancer.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Feb. 2020, www.mayoclinic.org/diseases-conditions/male-breast-cancer/symptoms-causes/syc-20374740#:~:text=It's%20not%20clear%20what%20causes,other%20parts%20of%20the%20body.

  2. “Can Breast Cancer in Men Be Prevented?” American Cancer Society, 9 June 2020, www.cancer.org/cancer/breast-cancer-in-men/causes-risks-prevention/prevention.html#:~:text=Since%20the%20cause%20of%20most,of%20breast%20cancer%20in%20women.

  3. “Male Breast Cancer.” National Breast Cancer Foundation, 23 Sept. 2019, www.nationalbreastcancer.org/male-breast-cancer#:~:text=Even%20so%2C%20male%20breast%20cancer,underneath%20the%20nipple%20and%20areola.

  4. DePolo, Jamie. “U.S. Black Men Have Higher Rates of All Types of Breast Cancer Compared to White Men.” Breastcancer.org, 24 June 2020, www.breastcancer.org/research-news/black-men-have-higher-bc-rates-vs-white#:~:text=The%20results%20showed%20that%20rates,were%20diagnosed%20with%20breast%20cancer.

  5. “Key Statistics for Breast Cancer in Men.” American Cancer Society, www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html#:~:text=The%20American%20Cancer%20Society%20estimates,will%20die%20from%20breast%20cancer.

  6. “Breast Cancer in Men - Statistics.” Cancer.Net, 19 Feb. 2020, www.cancer.net/cancer-types/breast-cancer-men/statistics#:~:text=It%20is%20estimated%20that%20520,with%20breast%20cancer%20is%2084%25.

  7. “Breast Cancer in Men - Latest Research.” Cancer.Net, 20 Nov. 2019, www.cancer.net/cancer-types/breast-cancer-men/latest-research.

  8. “BRCA Mutations: Cancer Risk and Genetic Testing Fact Sheet.” National Cancer Institute, www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#:~:text=80%20(2).-,What%20other%20cancers%20have%20been%20linked%20to%20mutations%20in%20BRCA1,and%20peritoneal%20cancer%20(5).

  9. Niewoehner, Catherine B, and Anna E Schorer. “Gynaecomastia and Breast Cancer in Men.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 29 Mar. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2276281/.

  10. Cook, Michael B, et al. “Tobacco and Alcohol in Relation to Male Breast Cancer: an Analysis of the Male Breast Cancer Pooling Project Consortium.” Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, U.S. National Library of Medicine, Mar. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355041/.

  11. https://www.canva.com/design/DAEDHzJF034/llTJwel1ttObmVkhfBbXxw/edit?category=tADWs1tIKvE (Custom Etiology Graph)

  12. “Genetic Testing for Breast Cancer.” National Breast Cancer Foundation, 19 Sept. 2019, www.nationalbreastcancer.org/genetic-testing-for-breast-cancer.

  13. https://www.canva.com/design/DAEDH9UDPTY/97JUP4aWljE5ac7zKvZnfQ/edit (Custom Risks Graph)

  14. https://www.canva.com/design/DAEDaazCsMQ/FOKtirfPeagRRmg9OYpyIw/edit (Custom Frequency Graph)

  15. https://www.canva.com/design/DAEDat_SMgY/qAHmpLRYP3fl9jEM8aD5ZA/edit (Custom Current Research Graph)

  16. https://www.canva.com/design/DAEDav2Q9XU/OsNCnCo98iU58Tc-VBAdqg/edit (Custom Statistics in the United States of America)

  17. Cong-Huyen, Melissa. “Self Breast Exam Card.” Breast Cancer Hub, Breast Cancer Hub, 17 Jan. 2020, www.breastcancerhub.org/news-2/self-breast-exam-card.

“Awareness & Education.” Breast Cancer Hub, www.breastcancerhub.org/about-breast-cancer.

 
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