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October, also called Pink Month, is set aside as Breast Cancer Awareness Month to raise awareness about breast cancer, encourage early detection, promote access to screening and treatment, and support people affected by the disease.
In celebration of this cause, this article seeks to shed light on an often-overlooked part of the story – breast cancer also affects men.
While breast cancer occurs mainly in women, there have been recorded cases of breast cancer in men, though rare. Despite this reality, many men do not believe they can have breast cancer.
What is breast cancer and why does it affect men?
Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumour that can often be seen on an X-ray or felt as a lump. If the cancer is not treated, the cancer cells can grow into (invade) surrounding tissues or spread (metastasise) to other areas of the body.
So, because men have breast tissue, they can also develop breast cancer. Male breast cancer can occur at any age. While the overall risk is low, it increases with age. The average age at diagnosis is between 60 and 70 years.
For men, the average lifetime risk of getting breast cancer is about 1 in 755. But each man’s risk might be higher or lower than this, based on certain risk factors for breast cancer.
What causes male breast cancer?
According to the Mayo Clinic. It’s not clear what causes male breast cancer.
Male breast cancer starts when cells in the breast tissue develop changes in their Deoxyribonucleic acid (DNA). A cell’s DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time.
However, in cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.
Cancer cells may form a mass called a tumour, which can grow to invade and destroy healthy body tissue. With time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.
What are the risk factors for Men?
The risk of male breast cancer increases with several factors, including old age. Most cases of breast cancer are diagnosed in men in their 60s.
- Hormone Therapy is another factor. Estrogen-containing medicines, including some treatments for prostate cancer, can increase risk.
- Family History: Having a close relative with breast cancer increases the risk. Mutations such as BRCA1 and BRCA2 can increase the likelihood of developing breast cancer.
- Klinefelter Syndrome: This condition affects hormone levels and can increase breast cancer risk.
- Hormonal disruption: Conditions such as cirrhosis can disrupt hormone balance and raise the risk. Higher body weight can increase estrogen levels, which is linked to greater risk.
- Obesity: Older men who are overweight or have obesity have a higher risk of getting breast cancer than men at a healthy weight.
- Testicular Inflammation: Conditions such as testicular inflammation (orchitis) or removal of a testicle (orchiectomy) can increase the risk.
What are the types of male breast cancer?
- Ductal Carcinoma: This cancer begins in the milk ducts. This type of breast cancer starts in the tubes that connect to the nipple. These tubes are called ducts. Ductal carcinoma is the most common type of male breast cancer.
- Lobular Carcinoma: This cancer begins in the milk-producing glands. These glands are called lobules. Lobular carcinoma is less common in people assigned male at birth because they usually have fewer lobular cells.
- Other Types of Cancer: Other rarer types of male breast cancer include Paget’s disease of the nipple and inflammatory breast cancer.
How can breast cancer be detected in men?
Finding breast cancer early improves the chances of successful treatment. This is why breast cancer screening with regular mammograms (breast X-ray) is recommended for women.
However, because breast cancer is so uncommon in men, there is unlikely to be a benefit in screening men for breast cancer with mammograms or other tests.
Instead, most breast cancers are found in men using the signs and symptoms. For most men, the best way to find breast cancer early is to be aware of any lumps in the breast tissue or nipple changes.
It is important to note that because breast cancer in men can be harder to diagnose early, cancer can reach the nipple, skin or underlying muscles more quickly. Although tumours may be smaller when detected, they are more likely to have spread to nearby tissues or lymph nodes.
Lack of awareness also contributes to delayed diagnosis in men. Because many men do not realise they can develop breast cancer, they may ignore or misinterpret a breast lump. Embarrassment or concerns about masculinity also discourage men from seeking medical care, allowing the cancer to progress before diagnosis.
How is breast cancer diagnosed and treated?
Doctors use a combination of physical examinations, imaging tests and laboratory tests to determine whether a breast lump or other change is cancerous.
- Clinical Breast Examination: A healthcare professional examines and feels the breast and surrounding areas, including the armpit, for lumps or other abnormalities. The examination can help determine a lump’s size, texture, and location, and whether it appears close to the skin or underlying muscles.
- Imaging Tests: Imaging creates pictures of the breast tissue and can help doctors identify areas that may be abnormal. Tests may include a mammogram (a breast X-ray), an ultrasound, or an MRI scan. The type of imaging used may depend on the symptoms and what the healthcare professional finds during the examination.
- Biopsy: Imaging can show that an area looks suspicious, but it cannot confirm cancer on its own. A biopsy helps make a diagnosis. During the procedure, a healthcare professional uses a needle to remove a sample of breast cells or tissue. The needle may be guided using a mammogram or another imaging test.
The sample obtained is sent to a laboratory, where specialists examine the cells under a microscope to determine whether cancer is present. Additional tests may also determine whether the cancer cells have hormone receptors or particular genetic changes. These results can help doctors choose the most appropriate treatment.
NOTE: Doctors may carry out other tests depending on the individual’s symptoms and circumstances.
How Does the Cancer Evolve?
Once breast cancer has been confirmed, doctors determine how far the cancer has spread. This is known as staging. The cancer’s stage helps healthcare professionals understand the person’s prognosis and develop an appropriate treatment plan.
Staging may involve additional imaging tests to determine the tumour size and whether the cancer has spread to other parts of the body.
These tests may include a bone scan, which can help identify whether cancer has spread to the bones, and a computed tomography (CT) scan, which produces detailed images of structures inside the body and can help detect signs of spread.
A positron emission tomography (PET) scan, which uses a small amount of radioactive material to help identify areas of abnormal activity in the body, can also be done.
These tests help determine the Cancer stage. Breast cancer stages range from 0 to 4. Stage 0 means the cancer is very small. At this stage, the cancer is inside the milk ducts. It has not broken out into the breast tissue. Doctors sometimes call this noninvasive cancer. As the cancer grows and invades the breast tissue, the stages get higher. Stage 4 breast cancer means the cancer has spread to other areas of the body.
Expert Opinion
Bukola Ayandare, a general medical doctor at the University of Ilorin Teaching Hospital, confirmed that men can develop breast cancer, even though cases are considerably less common than in women.
“I have seen rare cases of men having breast cancer, but the incidence is very low compared to women,” she said.
Bukola identified family history, elevated oestrogen levels and obesity as factors that can increase the risk of male breast cancer. She also cited excessive alcohol consumption and smoking as other possible risk factors. She explained that men who take hormonal supplements may also face an increased risk, depending on the substances they contain and how they affect hormone levels.
Bukola further highlighted the role of inherited genetic changes, particularly those involving the BRCA genes, in increasing breast cancer risk.
“There is a particular gene that, if it is in a family, they are at risk of having it; the gene is the BRCA gene,” she said.
BRCA1 and BRCA2 are genes that normally help protect cells from developing cancer. However, certain inherited mutations in these genes can increase the risk of breast cancer in both men and women.
She noted the importance of awareness, particularly among men with a family history of breast cancer or other risk factors. Although the disease is rare in men, recognising unusual breast changes and seeking medical attention promptly can help prevent delays in diagnosis.
We contacted other medical professionals for their opinions on male breast cancer but had not received responses at the time of publication.
Conclusion
Although breast cancer is not as common in men as in women, its rarity does not make it impossible. Men should watch for changes in the breast or body and seek appropriate medical care.