Male Breast Cancer

Male breast cancer is a rare but serious form of cancer that occurs in the breast tissue of men. Although it is much less common than female breast cancer, it is important to recognise its existence, understand its risk factors, symptoms, diagnosis, and management.

Overview

Male breast cancer accounts for less than 1% of all breast cancer cases. The lifetime risk of a man developing breast cancer is about 1 in 833. The disease typically occurs in older men (60-70 years) but it can happens at any age.

Risk Factors

• Genetic Factors: Mutations in genes such as BRCA2 and, to a lesser extent, BRCA1 can increase the risk.

• Family History: A family history of breast cancer in first-degree relatives can elevate risk.

• Age: The risk increases with age, particularly after 50.

• Hormonal Factors: Conditions that increase oestrogen levels, such as Klinefelter syndrome, can be a factor.

• Radiation Exposure: Previous radiation treatment to the chest can increase risk.

• Obesity: Higher body weight can lead to increased estrogen levels, raising risk.

• Liver Disease: Conditions affecting liver function can alter hormone levels.

  
  

Symptoms

• Lump in the Breast: The most common symptom is a painless lump or mass in the breast.

• Changes in the Nipple: Nipple retraction, discharge, or changes in the skin around the nipple.

• Skin Changes: Changes in the skin over the breast, such as dimpling or redness.

• Swelling: Swelling in the breast area, which may or may not be accompanied by pain.

• Lymph nodes swelling in the arm pit

  
  

Diagnosis

• Clinical Examination: Physical examination by a healthcare professional.

• Imaging Studies: Mammography and ultrasound may be used to evaluate breast abnormalities.

• Biopsy: A definitive diagnosis is made through a biopsy, where tissue samples are examined for cancerous cells.

  
  

Management Approaches

The treatment of male breast cancer depends on the stage and grade of the cancer, as well as the patient's overall health. The most common treatment options include

1. Surgical Treatment

This is the primary treatment for most men with breast cancer. Depending on the size and the location of the tumour, it could be either:

• Mastectomy: The most common surgical procedure, involving the removal of the breast tissue and some lymph nodes.

• Lumpectomy: In select cases, a lumpectomy may be performed, removing only the tumour and a small margin of surrounding tissue. depending the size of the patient's breast and tumour size.

• Axillary lymph node biopsy or clearance

  
  

2. Radiation Therapy

• Typically recommended after surgery to eliminate any remaining cancer cells, Especially for patient who had lumpectomy or locally advanced breast cancer after mastectomy.

  
  

3. Systemic Therapy

• Hormonal Therapy: For hormone receptor-positive cancers, medications such as tamoxifen or aromatase inhibitors may be used. It works by blocking the effects of hormones that stimulate cancer growth.

• Chemotherapy: May be indicated for aggressive disease or if the cancer is hormone receptor-negative.

• Targeted Therapy: HER2-positive tumours may be treated with targeted therapies like trastuzumab.

Prognosis of Male Breast Cancer

Male breast cancer is relatively rare compared to female breast cancer, but its prognosis can vary based on several factors. Here are some key points regarding the prognosis:

Factors Influencing Prognosis

• Stage at Diagnosis: The stage of cancer at the time of diagnosis significantly impacts prognosis. Early-stage cancers (localized) generally have a better outlook than those diagnosed at a later stage (regional or metastatic).

• Histological Type: The type of breast cancer (e.g., invasive ductal carcinoma, lobular carcinoma) can affect treatment options and outcomes.

• Hormone Receptor Status: Cancers that are hormone receptor-positive (oestrogen and/or progesterone receptors) often respond better to hormonal therapies, improving prognosis.

• HER2 Status: HER2-positive cancers may have a more aggressive course but can be treated with targeted therapies, which can improve outcomes.

• Age and Overall Health: Younger patients and those in good overall health may have better treatment responses and outcomes.

  
  

Survival Rates

Survival rates for male breast cancer have improved over the years due to advancements in early detection and treatment. According to data:

• The 5-year relative survival rate for localised male breast cancer is approximately 99%.

• If cancer has spread to regional lymph nodes, the 5-year survival rate drops to about 85%.

• For metastatic breast cancer, the 5-year survival rate is significantly lower, around 27%.

Follow-Up Care

Regular follow-up is essential for monitoring for recurrence and managing long-term side effects of treatment. This typically includes physical examinations, imaging studies, and assessments of hormone levels.

Conclusion

While the prognosis for male breast cancer can be serious, many factors influence outcomes. Early detection and personalised treatment plans are crucial for improving survival rates and overall prognosis. Regular check-ups and awareness of symptoms can aid in early diagnosis.

EARLY DETECTION SAVES LIFE