Yes, men can get breast cancer - here are the symptoms to watch for

Tabitha Britt,Crystal Fancher

Dec 12, 2020, 03:05 IST

Yes, men can get breast cancer - here are the symptoms to watch for

Men can develop breast cancer, though it's rare.Igor Alecsander/ Getty Images

Though rare, men can develop breast cancer and account for about 1 in 100 cases of breast cancer.
Symptoms of breast cancer in men include lumps, inversion of the nipples, or nipple discharge.
Having an increased level of estrogen or a genetic history of breast cancer are risk factors.

While breast cancer is usually considered a disease that only affects women, anyone with breast cells and tissue can be diagnosed with breast cancer, males included. Even so, male breast cancer is rare.

"This isn't a disease that's 'just for women.' Patients often don't realize this which can, unfortunately, lead to delays in diagnosis," says Abisola Olulade, MD, a family medicine physician at Sharp Rees-Stealy Downtown in San Diego, California. "In the United States, male breast cancer represents between 0.5% and 1.0% of all breast cancers diagnosed each year. This means that about one out of every 100 breast cancers diagnosed in the United States is found in a man."

In this article we'll discuss the most common forms of male breast cancers, its symptoms, and potential risk factors.

What is male breast cancer?

Male breast cancer occurs when malignant cells form in the tissues of the breast. Common forms of male breast cancer include:

Infiltrating (or invasive) breast carcinoma. According to the Memorial Sloan Kettering Cancer Center, there are two types of invasive breast cancer: Invasive ductal carcinoma (IDC) and invasive lobular carcinoma. IDC is the most common type of breast cancer in men, making up 80% of all breast cancer diagnoses. IDC develops in the breast duct and then proceeds to grow outside of the ducts and into other parts of the breast tissue. IDC can spread, or metastasize, to other parts of the body.
Invasive lobular carcinoma. This type of breast cancer begins in the lobules (i.e. the glands that produce milk) and can spread to other areas of the body. Invasive lobular carcinoma is extremely rare in men.
Ductal carcinoma in situ (DCIS). Also referred to as "intraductal carcinoma," ductal carcinoma in situ (DCIS) is a disease that may lead to breast cancer. DCIS occurs when cancer cells develop in the lining of the ducts but have yet to spread to other tissues in the breast. DCIS can be treated via radiation therapy or surgery.

Unfortunately, doctors are still unsure of the exact causes of breast cancer, though genetics and increased levels of estrogen may be risk factors.

In particular, increased estrogen is associated with conditions like liver disease, obesity, and certain hormone therapies like anti-androgen therapy, says Monisha Bhanote, MD, a triple board-certified physician and cytopathology specialist in Jacksonville Beach, FL. where she runs her own private practice.

"Hereditary causes may include BRCA2 mutation carriers, PTEN mutation (Cowden syndrome), and CHEK2 mutation carriers," says Bhanote

BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) are genes that are related to breast cancer risk. While everyone has both BRCA1 and BRCA2 genes, some people inherit a gene mutation in one or both of these genes. This mutation increases the risk of developing breast cancer.

"Men with BRCA mutations are recommended to have annual screening," says Bhanote. "Examination for any masses, nipple discharge, or skin dimpling/puckering on a daily basis will

be helpful."

Additional factors that may increase a person's risk are medications such as antidepressants, marijuana, and radiation from cancer treatment.

Male breast cancer spreads in the same way that female breast cancer spreads, through the lymphatics and blood vessels. An estimated 520 men will die from breast cancer this year.

What are the symptoms of male breast cancer?

Signs and symptoms of male breast cancer can include:

Lump or swelling under the nipple (often painless, but not always)
Nipple discharge
Rash or redness of nipples
Inversion of the nipples
Nipple ulceration (late sign)

While finding a lump on one or both of your breasts can be alarming, finding a lump doesn't necessarily mean that you have breast cancer. It could be gynecomastia or enlarged breast tissue.

Though gynecomastia has many causes, liver disease and drugs or medications that contain high doses of testosterone account for about 25% of gynecomastia cases, according to Harvard Men's Health Watch.

Gynecomastia is often benign and resolves on its own. That being said, it's still a good idea to see your doctor if you notice any lumps or changes, especially if you're experiencing pain or discomfort.

How to check for male breast cancer

Because men are less likely to receive a mammogram, it's important to learn how to perform a male self-breast examination. As a patient, it's imperative to become familiar with your body so you can advocate for yourself and notice when changes occur. Here's a quick step-by-step guide on how to self-check your breasts at home:

Stand in front of a mirror with your arms on your hips. Tighten your chest muscles and examine your chest for swelling, dimpling, or nipple inversion.
Raise your arms above your head to examine your breasts and underarm area.
Lower your arms and move your fingertips in a circular motion around each breast. Check for lumps or any sign of nipple discharge.

You can also check your breasts while lying down. To do this, set a pillow underneath your right shoulder and bend your right arm over your head. Use the fingertips of your left hand to check all areas of your breast and armpit. Once you're finished, switch the pillow to your left shoulder and repeat this process.

If you're uncomfortable doing a self-breast examination, or you fear that you're not doing it correctly, ask your physician to perform a clinical breast exam for you. Depending on how the examination goes, your physician may order a mammogram, an ultrasound, or an MRI.

How to treat male breast cancer

If you're diagnosed with male breast cancer, your treatment plan will depend on how far the cancer has spread. Practicing monthly self-breast exams, in addition to receiving a breast examination by your physician, could improve your chances of detecting breast abnormalities early. Early detection is the key to successful treatment.

Possible treatments for male breast cancer include:

Surgery
Radiation therapy
Hormone therapy
Chemotherapy
Targeted therapy

Who is at risk for male breast cancer?

Although researchers can't pinpoint the causes of breast cancer in men, they have found a few risk factors.

Risk factors that may lead to developing male breast cancer include:

Aging
A family history of breast cancer
Inherited gene mutations (BRCA2, CHEK2, PTEN, and PALB2)
Klinefelter syndrome
Radiation exposure
Alcohol
Liver disease
Estrogen treatment
Obesity
Testicular conditions (undescended testicle or orchiectomy)

"Unfortunately, there isn't anything you can do to prevent male breast cancer," says Nicholas Jones, MD, FACS. "However, you can lower your risks by being active, and limiting your alcohol consumption."

In addition, avoiding hormonal supplements, such as sexual performance enhancement supplements, may help to prevent male breast cancer. According to a 2019 study, the use of hormonal male enhancement supplements can lead to the higher levels of androgens, which may cause the growth of tumors.

Insider's takeaway

Though the likelihood of developing male breast cancer is low, it's important to pay attention to your body. If you notice any changes in your skin color, new rashes, lumps, or bumps, you should seek medical help right away.

"There isn't a great screening tool for men," Jones adds. "The best action is to know your body, live a healthy lifestyle and if you notice anything out of the norm, visit your doctor. Specifically for male breast cancer, any change involving the nipple may be a sign that there is an underlying cancer."