October is breast cancer awareness month, which is an annual campaign to increase the awareness about the deadly disease. I am sharing a series of articles on breast cancer this month. There is a common belief that breast cancer only occurs in women, but contrary to the popular belief breast cancer does occur in men.
Male Breast Cancer is a very informative article authored by Dr. Avinash Deo, M.D., from his Health and Wellness website All About Cancer. Dr. Deo is a Medical Oncologist and Haematologist, Medical Blogger and Medical Writer based at Mumbai, Mumbai, Maharashtra, India.
Male Breast Cancer
The pink ribbon is for breast cancer because pink is for women. Some of the breast cancers are not pink. They are blue. About 0.5-1% of the breast cancer patients are men. In Africa as many as 6% of the breast cancer patients are men. This is about a ribbon pink to the world, blue from inside.
What Causes Breast Cancer in Men?
The risk of breast cancer increase with age. Men develop breast cancer at an older age than women. On an average, a patient with a male breast cancer is 5 years older than a female patient with breast cancer. Male breast cancer is more common in blacks.
Male relatives of female breast cancer have a higher risk of breast cancer. The risk is doubled if a first degree (immediate) relative has suffered from breast cancer. One of the reasons for this is BRCA gene mutations. BRCA genes are involved in repair of DNA. There are two BRCA genes. The lifetime risk of breast cancer in men with BRCA2 gene mutations is about 5-15% and for BRCA1 gene mutations is up to 4%. This is opposite that seen in women. Women with BRCA1 mutations have a higher risk of breast cancer than those with BRCA2 mutations.
Conditions associated with an increase in the female hormone, estrogen, increased the risk of breast cancer. The conditions include
Klinefelter’s syndrome: Klinefelter’s syndrome, a disease where the patient has one extra X chromosome, increases the risk of breast cancer 50 times.
Liver Disease: Patients with a chronic liver disease have increased levels of estrogens and an increased risk of breast cancer.
Other Diseases: Obesity and testicular dysfunction may increase the risk of male breast cancer.
Exposure to radiation increases the risk of male breast cancer.
What Are The Symptoms of Male Breast Cancer?
The symptoms of male breast cancer include:
Lump in the breast
Ullcer or deformity of the nipple
Lump in the armpit
Rarely there may be swelling of the arm
Diagnosis of Breast Cancer In Men?
The diagnosis of breast cancer is made by a biopsy of the lump. Almost all males with breast cancer have cancers that have oestrogen receptors. This means that these cancers depend on the female hormone oestrogen for growth. This is a paradox as more breast cancers in men than in women depend on female hormones. Only 80% of the breast cancers occurring in women depend on female hormones for growth. Breast cancer in women can be diagnosed early by mammography. Mammography is not useful in men.
How is Male Breast Cancer Treated?
Male breast cancer is treated like female breast cancer with surgery followed by chemotherapy and/or radiation. There are however a few differences.
Male breast cancer patients have a more advanced cancer. Many need radiation and chemotherapy.
Almost all breast cancers in men depend on oestrogens for growth. They need to be treated with hormonal drugs that deprive the cancer of oestrogens. Tamoxifen is such a drug. Another category of drugs that deprive a cancer of oestrogen is aromatase inhibitors. It is not certain is they are as active in men as in women. Tamoxifen can cause nausea, headaches, fatigue, hot flashes, skin rash, sexual dysfunction, mood changes an and weight gain.
Men with breast cancer may carry a BRCA mutation, that is also likely to affect other members of the family. Women with BRCA mutations are at a very high risk of breast and ovarian cancer. Men with breast cancer should be tested for BRCA mutations. If a mutation is detected blood relatives should also be tested.
Is Male Breast Cancer More Dangerous?
Male breast cancer is perceived to be more dangerous than female breast cancer. In reality, males and females have comparable cure rates if they are diagnosed at the same stage. Lack of awareness about male breast cancer results in a delay in both men consulting a physician and the physician ordering the appropriate investigations. The delay results in a diagnosis at a more advanced stage and makes the disease more difficult to control.
Men with breast cancer are older than women with breast cancer. Age-related diseases like cardiac diseases that are more common in men come in the way of giving the complete treatment. This reduces the cure rate.
The Pink Ribbon Should Have A Blue Streak!
Should the pink ribbon have a blue streak? Probably yes. To remind us that about one percent of patients with breast cancer are men. To remind men not to ignore a lump under the nipple. Men who are diagnosed late because of lack of awareness about the male breast cancer. Men who have to deal with the psychological consequences of suffering a “woman’s disease”.
