 |
 |
 |
|
Many people are unaware that men can develop breast cancer too. Delay in diagnosis and presentation with advanced disease are common. Any breast lump, nipple discharge, or change in the breast should be investigated.
Most of the breast tissue in a man is concentrated in the area immediately behind the nipple and areola. Androgen appears to suppress any tendency for ductal proliferation, but as men age and the overall level of androgen decreases, some physiologic enlargement of the breasts can occur. In most men this is of no concern. Because most of the breast tissue is beneath the nipple/areola complex, this is where most male breast cancer starts. There is a rich plexus of lymphatics beneath the nipple and areola in both men and women, and the subareolar location of most male breast cancers allows easy access of tumor cells to these lymph channels.
Incidence; Causes & Development; Risk Factors
Male breast cancer is rare but afflicts approximately 1,000 men per year in the U.S. Most men with breast cancer are in their 60s, but the disease can strike younger or older men.
For every 100 women who develop breast cancer in the US, one male is diagnosed with the equivalent disease. The overall incidence is between 0.1 and 3.4 cases per 100,000 man-years. This makes male breast cancer one of the rarest malignancies, contributing to the generally low level of public awareness. While the average age at diagnosis is around 65 years, the problem can occur in younger (or older) men.
Men have glandular breast tissue that is subject to hormonal influences. Excess estrogen, especially around the time of puberty, has been identified as a possible factor. Men with Klinefelter's syndrome have an increased risk of developing breast cancer, as do men who take estrogens or estrogen-like compounds. Androgen (and possibly progesterone) exert a protective influence. Men who are deficient in androgen seem to also be an increased risk (for example, men who have testicular atrophy from mumps orchitis, injury, or undescended testes). Brain tumors and conditions associated with excess production of prolactin have also been implicated in some cases of male breast cancer.
Men who work in steel mills, blast furnaces, rolling mills, or other environments of intense heat have a slightly increased incidence of breast cancer (probably due to thermal suppression of androgen production). Radiation to the chest wall increases the risk of breast cancer in men, as in women. Finally, genetic factors have been identified in some cases of male breast cancer.
Signs & Symptoms
The most common symptom is a breast mass. The mass is usually firm, nontender, and subareolar (although occasionally tumors occur in other areas). In several studies, the average tumor size was approximately 2.5cm. Because of the short distance to the nipple, nipple retraction, ulceration, or destruction are also common (occurring in almost half of the patients in one study).
Diagnosis & Tests
Because most cases present with a palpable mass, fine needle aspiration cytology is extremely useful. This is performed in the physician's office. A fine gauge needle is inserted into the mass and cells drawn out for examination under the microscope. Nipple discharge can be smeared on microscope slides and examined microscopically. Biopsy may be needed for confirmation. Because the condition is so rare, general screening by mammography, ultrasound, or other methods is not recommended.
Treatment & Prevention
Surgery is generally required; modified radical mastectomy is the most common operation. Reconstructive surgery should be offered if cosmetic or functional deformity results.
Prognosis
Prompt treatment can result in long-term survival.
|
|
 |
|
 |
Signs, symptoms & indicators of Male Breast Cancer:
KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Strongly counter-indicative |
GLOSSARY
Androgen
Any steroid hormone that increases male characteristics.
Aspiration
Inhalation, or removal of fluids or gases from a cavity using suction.
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Centimeter (Centimeters, cm)
A metric unit of length equaling one hundredth of a meter, or ten millimeters. There are 2.54 millimeters in one inch.
Discharge (Discharges)
A secretion, of pus for example, from a wound or bodily orifice.
Estrogen (Oestrogen)
One of the female sex hormones produced by the ovaries.
Glandular (Glandulars, Raw Glandulars)
Either referring to a gland, OR glands and organs from animals specially processed at temperatures not exceeding body heat and put into supplement form.
Klinefelter's Syndrome
Although still commonly used, the term "Klinefelter's syndrome" is slowly being replaced by the term XXY males to describe males having the extra X chromosome. It is the most common chromosomal abnormality in males, resulting in deficient testicular function and occurring in 1 out of 500 live births. Gynecomastia and various degrees of testosterone deficiency are usually noted.
Lymph
A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Mastectomy (Mastectomies)
Removal of breast tissue to prevent or treat breast cancer. 'Unilateral mastectomy' is the surgical removal of one breast. 'Bilateral mastectomy' is the removal of both breasts. 'Prophylactic mastectomy' refers to the removal of healthy breast(s) to reduce a woman's risk of developing breast cancer. Bilateral prophylactic mastectomy is the most effective means of reducing a woman's risk; however, the benefits of such surgery depend on each woman's individual risk.
Mumps
An acute infectious disease, caused by a paramyxovirus, and most common in children. Although it usually infects the parotid glands, and is often only a mild condition, it can spread to the testes or ovaries and cause serious problems, particularly when contracted by unresistant adults. A mild child's infection that is not properly monitored holds the potential for pancreatic or meningeal complications.
Nipple (Areola, Nipples, Subareolar)
The small projection near the center of the breast containing the outlets of the milk ducts, OR the corresponding projection of the male breast. The areola is the darker tissue that encircles the nipple. Subareolar describes the location beneath the surface of the areola.
Orchitis
Inflammation of the testes, manifested by swelling and tenderness, usually infectious, sometimes the result of trauma.
Progesterone
This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
Prolactin
An anterior pituitary peptide hormone that initiates and maintains lactation.
Testicles (Testicle, Testicular)
Egg-shaped sex glands in the scrotum that secrete male hormones such as testosterone, and produce sperm.
Ulcer (Ulceration, Ulcers)
Lesion on the skin or mucous membrane.
Ultrasound
Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Last updated: Mar 24, 2009
|
 |
|
|
