When looking at the face of breast cancer, most assume it is a face of a woman. But should men be talking about it, too? Breast health experts are also raising awareness of the disease and its effects on men. Even though breast cancer affects a small minority of men, it’s still important to be aware of the risks.
Men at Risk
“Although the absolute number of male breast cancers is low at less than 1 percent of all breast cancers diagnosed in the USA, there is a concern about a rise in the incidence of this problem, with some reports suggesting about a 25 percent increase in the last 25 years,” says Dr. Bhanu Vakkalanka, a medical oncologist with Mid-Illinois Hematology and Oncology Associates and a member of the medical staff at Advocate BroMenn Medical Center in Normal.
According to the American Cancer Society (ACS), 2,350 men in the U.S. were expected to be diagnosed, and 440 (nearly 19 percent) expected to die from the disease in 2015. Additionally, the National Cancer Institute, says the average age of men diagnosed with breast cancer is between the ages of 60 and 70 years, though men of all ages can be diagnosed with the disease.
The ACS lists several potential risk factors for the disease, including aging, a family history of breast cancer, inherited gene mutations, radiation exposure, a high level of estrogen, heavy alcohol use, and obesity.
Dr. Vakkalanka also recommends that all male breast cancer patients receive genetic counseling and additional studies to rule out genetic mutations that could significantly increase the risk of developing breast cancer.
Symptoms and Detection
Men exhibit some of the same breast cancer symptoms as women. Lumps in the breast area, near the nipple, are the most identifiable symptom of breast cancer. Men should be aware of any changes in their breasts, and should seek medical attention if they feel a new lump.
Doctors will generally evaluate a suspicious mass with a clinical breast exam, as well as an ultrasound or MRI for further evaluation. A needle biopsy may be recommended. Dr. Vakkalanka adds that, as opposed to females, male breast cancers are easily detectable at a relatively early stage. “In view of the low incidence of male breast cancers, screening is not recommended,” he says.
Diagnosis and Treatment
Men tend to be diagnosed at a later stage because of decreased awareness of male breast cancer. Unless caught early, the cancer may spread to the lymph nodes or other areas. Nevertheless, treatment is available. Typical treatment for male breast cancer may include:
- Surgery: (mastectomy or lumpectomy) “As the amount of male breast tissue is relatively small, the surgical treatment of choice is mastectomy, along with removal of the sentinel nodes,” Dr. Vakkalanka says. If these nodes test positive, it may lead to a complete removal of the axillary, or armpit, lymph nodes.
- Chemotherapy and/or radiation therapy: Dr. Vakkalanka says that the lack of breast tissue in males may mean that the tumor is closer to the chest wall. This may cause the need for chemotherapy prior to surgery in order to shrink the tumor and facilitate complete removal.
- Hormone therapy: (A treatment that removes or blocks hormones to stop cancer cell growth.) All male breast cancers are routinely tested for estrogen receptors, which are present in the majority of patients. “The hormonal intervention of choice is tamoxifen, which blocks the interaction between the circulating estrogen and the corresponding receptors on the breast cancer cells,” says Dr. Vakkalanka.
- Targeted therapy: (A treatment that uses drugs or other substances to attack specific cancer cells without harming normal ones.) “Male breast cancers that express a growth factor receptor called HER-2 are more aggressive,” Dr. Vakkalanka says. “Such patients will derive significant benefit by receiving treatment with a targeted therapy such as trastuzumab (Herceptin).
October is Breast Cancer Awareness Month. Men should be aware that breast cancer is a possibility for them, and should report a suspicious lump to their doctor. While mammograms are not necessary for men, the American Cancer Society recommends yearly mammograms starting at age 40 for women — or sometimes earlier if there is a family history of breast cancer.
Advocate BroMenn Medical Center offers state-of-the-art 3D mammograms at two locations in Bloomington-Normal: at the hospital’s Women’s Center, 1304 Franklin Avenue, Normal, and at the Advocate Outpatient Center, 3024 E. Empire Street, Bloomington (across from the airport). Same-day appointments and 24-hour results are available in most cases. For an appointment at either location, call 1-800-3-ADVOCATE (1-800-323-8622). For more information about breast cancer, visit storiesofthegirls.com.