Everyone recognizes the pink ribbons that signify breast cancer awareness, but few think the cause relates to men. After all, women are 100 times more likely to be diagnosed with breast cancer than men.
More than 2,400 new will be diagnosed this year, reports the American Cancer Society, but there’s still a lot to be discovered about the disease. “Research needs to better understand the biology of male breast cancer,” says Ayca Gucalp, MD, an oncologist who specializes in male breast cancer at Memorial Sloan Kettering Cancer Center in New York City.
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Male breast cancer is rare
Only one in 1,000 men will develop breast cancer in his lifetime. The American Cancer Society predicts 460 men in the United States will die from breast cancer in 2017. That pales in comparison to the estimated 40,290 women who will die from breast cancer this year. The three most common cancers among men are prostate cancer, lung cancer, and colorectal cancer, according to the CDC, while breast cancer is the most common cancer among women.
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Lumps are a telltale symptom of breast cancer in men
Men may feel a lump when diagnosed with breast cancer, just like women. “Most men present with a mass, a lot of times behind the areola,” the darker-colored area of skin around the nipple, says Dr. Gucalp.
How can you tell if a lump is something serious? "Breast cancers are typically hard, similar to the consistency of a frozen pea," Holly J. Pederson, MD, director of breast services at the Cleveland Clinic, told Health in a previous interview.
For men, a lump or hard mass is the most obvious sign, while breast cancer in women is often found during a routine mammogram or breast screening. Since breast cancer is rare in men, they do not have regular mammograms.
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Family history is a major risk factor for male breast cancer
Like women, men are more likely to have breast cancer if a close family member also has or had the disease. Around one in five men diagnosed has breast cancer in his family, according to the American Cancer Society.
Men who inherit a BRCA gene mutation have an even higher risk of breast cancer, and, yes, men can pass those mutations on to their own families. In fact, if a man in your family has a BRCA gene mutation, you are even more likely to develop cancer than if a woman in your family carries the same gene mutation, according to Dr. Gucalp. (If a man in your family has or had breast cancer, consider seeking out a genetic counselor to walk you through testing options.)
Men with a BRCA gene mutation may also have an increased risk of prostate and pancreatic cancer and should be screened for those diseases, says Sarah P. Cate, MD, director of special surveillance and the breast program at the Mount Sinai Downtown-Chelsea Center in New York City.
Other risk factors for breast cancer in men include obesity and a rare genetic condition called Klinefelter syndrome.
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Men are diagnosed with breast cancer at more advanced stages
Since men don’t get mammograms on the regular, an affected area may develop into a larger lump before it is found in a male patient, says Dr. Cate. This means by the time a man sees his doctor about a lump, the breast cancer may already have progressed to a later stage. “They don’t expect [breast cancer] and have the potential to delay their diagnosis,” explains Dr. Gucalp. A delayed diagnosis can make breast cancer more difficult to treat. More invasive approaches may be required, like a mastectomy or chemotherapy.
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It’s staged the same way as breast cancer in women
Breast cancer, like all other cancers, is assigned stages that take into account a number of factors. “Staging is based on the size of the breast cancer in the breast, the number of lymph nodes under the armpit with cancer in them, if any, and if there is disease outside of the breast and the lymph nodes in the armpit,” explains Dr. Cate.
In breast cancer, these stages range from 0, the lowest stage, to 4, the highest stage, and do not vary between men and women.
The stage determines the type of treatment options that are most effective and a patient’s chances of survival. To learn more about each stage, read the 5 Stages of Breast Cancer, Explained.
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Treatment options are readily available
Men with breast cancer have a variety of treatment options, depending on the stage of their disease, including radiation, chemotherapy, mastectomy, and hormone therapy.
Most forms of male breast cancer require anti-estrogen treatment, says Dr. Cate. This suppresses the hormone estrogen, which fuels the spread of some breast cancers.
Unlike women, men have only one option for breast cancer surgery. “Most men do not have a lot of breast tissue, so they can only get a mastectomy as the surgical treatment, as opposed to a lumpectomy or breast conservation,” says Dr. Cate.
Many women, on the other hand, can elect to have a lumpectomy, which preserves much of their breast tissue. (Women may also choose to undergo reconstruction procedures to rebuild their breasts after breast cancer surgery.)
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Research on male breast cancer is lacking
Due to the rare nature of male breast cancer, the majority of research currently focuses on women only. As a result, treatment options for men are based on the results of women-based studies, says Dr. Gucalp.
Learning more about the biological differences between male breast cancer and female breast cancer could help experts develop more effective and personalized treatment options for men. “Ultimately we need to focus either entire trials on men, which is difficult given the incidence of breast cancer in men, or develop trials with cohorts of male patients,” Dr. Gucalp says, noting that the field is improving in male breast cancer research.