Breast Cancer Month: Men succumb to breast cancer too; everything you need to know

Breast cancer in men is a rarity.

However, men get breast cancer too.

The incidence of male breast cancer is similar in Western countries as it is in the Indian population (between 0.75-1 percent). There will be approximately one male breast cancer patient to every hundred women with breast cancer. Men have a small amount of breast tissue with milk ducts and milk-producing glands from which cancer can arise. Most often, men between 60-70 years are most at risk of suffering from this type of cancer.

Risk Factors

• Old age
• Obesity
• High estrogen levels due to hormone
• Therapy for prostate cancer
• Family history.

Types of breast cancer

• Ductal carcinoma (most common type)
• Lobular carcinoma
• Paget’s disease
• Inflammatory cancer

What to look for

The most common symptoms is a painless lump in the breast. Both symptoms could also appear as thickening or redness or scaling of skin over nipple-areola complex, discharge from the nipple or a recent retraction of the nipple.

Tests to detect breast cancer

• Mammography and sonography of both breasts
• Fine needle aspiration cytology (FNAC) or true cut biopsy from the lump.
• PETSCAN to diagnose or exclude spread of disease to other organs

Treatment

Treatment for male or female breast cancer is usually similar, and depends largely on the stage at which the disease is detected. Surgery to remove the breast and tumour along with axillary lymph nodes is necessary for early stages of cancer. In case the disease has not spread to axilla, then node sampling (sentinel node excision) can be carried out.

Radiotherapy will be done after surgery in the majority of patients, to reduce the risk of recurrence of the cancer in the same area. A majority of the patients will receive adjuvant chemotherapy (Adriamycin-based or Taxol-based), or hormonal treatment (tamoxifen, aromatase inhibitors). The treatment will be based on biological markers of the tumour, namely the estrogen and/or progesterone receptors.

If the cancer is HER2-positive, then targeted drugs like trastuzumab or pertuzumab can be used along with chemotherapy.

Survival

The prognosis of male breast cancer is dismal, since the symptoms often present themselves in fairly late stages. Odds of survival hinge on the stage at which it is discovered.

A localized disease may have ~90 percent changes of five-year survival compared to the ~20 percent often seen in advance or metastatic forms of breast cancer. Male patients with breast cancer may need counselling as it is difficult for males to accept it easily.

The author is the Director of Surgical Oncology at Jaslok Hospital & Research Centre.

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