Breast cancer is a disease primarily associated with women but it is vital to recognise that it can also affect men as male breast cancer, though rare, is a critical issue that often goes unnoticed. Accounting for just about 1% of all breast cancer cases, it’s often overshadowed by its more prevalent counterpart.
Data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program in the USA reveals that between 2005 and 2010, out of 289,673 cases of breast cancer, only 2,054 were diagnosed in men, constituting just 0.7% of all breast cancer cases. Internationally, incidence rates vary, with the highest rates found in Brazil (3.4 cases per 100,000 man-years) and the lowest in Japan and Singapore (0.1 per 100,000 man-years).
In India, institution-based studies indicate that male breast cancer comprises less than 1% of all breast cancer cases, primarily affecting elderly men, typically in their 6th or 7th decade of life. In an interview with HT Lifestyle, Dr Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital in Delhi, shared, “The risk of male breast cancer increases with age. Understanding the risk factors for male breast cancer is crucial since men aren’t routinely screened for the disease. Risk factors include ageing, high estrogen levels, certain medical conditions, a strong family history of breast cancer or genetic mutations, and radiation exposure.”
He revealed, “Warning signs of male breast cancer include a lump in the breast, nipple pain, nipple discharge (clear or bloody), an inverted nipple, and enlarged lymph nodes under the arm. It’s important to note that bilateral breast enlargement is usually not cancer, but a condition called gynecomastia. Earlier diagnosis can be lifesaving. A study found that the average time between the first symptom and diagnosis is over a year and a half, likely due to the misconception that breast cancer doesn’t affect men.”
Dr Mandeep Singh Malhotra added, “Increased awareness can encourage men to seek medical attention promptly. Diagnosis involves mammograms, breast ultrasound, nipple discharge cytology, core needle biopsy of breast lumps, and imaging for evaluating distant spread. Treatment typically includes surgery followed by hormonal therapy if detected early. Chemotherapy and radiation are necessary for advanced cases. Male breast cancer may not have the same societal impact as female breast cancer, but it is no less important. Raising awareness of risk factors and the significance of early detection can save lives and improve outcomes for men facing this disease. Empowering men to be proactive about their breast health and seek medical attention if they notice any warning signs is essential.”
Asserting that male breast cancer is a lesser-known reality that demands our attention and understanding, Dr Bharat Bhosale, Founder and Director at Sunrise Oncology Centre, explained, “Beyond the prevalent misconception that breast cancer exclusively affects women, it is crucial to recognise that men, too, can be susceptible to this formidable adversary. In fostering awareness about male breast cancer, we empower ourselves with knowledge to detect, prevent, and support those affected. Unveiling the intricacies of male breast cancer requires dismantling stereotypes and embracing the truth. Men, like women, possess breast tissue, making them susceptible to the same malignancies.”
He elaborated, “Any change in breast size or skin over chest or any new lump or bleeding from nipple, retraction of nipple area needs to be taken seriously. Men should be aware that how normal chest or breast appears so any change can be picked up and bring it to attention of medical professionals. To confront male breast cancer is to cultivate a compassionate and informed society. By dispelling myths and fostering open dialogue, we pave the way for timely diagnoses and enhanced support systems. Together, let us champion awareness, erase stigmas, and stand united in the face of this shared challenge. Understanding male breast cancer is not just a matter of health; it is an act of solidarity, compassion, and the shared responsibility to ensure that no one faces this battle alone.”
Bringing his expertise to the same, Dr Mangesh Kamath, Medical Oncologist, Hematologic Oncologist at Apollo Spectra Hospital in Bangalore, highlighted a comprehensive overview of this less-discussed facet of breast cancer –
- Incidence and Risk Factors: Male breast cancer may only account for a small fraction of breast cancer cases, but it remains a significant health concern. While men of any age can develop this condition, it is more frequently diagnosed in older men, typically between the ages of 60 and 70. Several risk factors can increase the likelihood of male breast cancer –
- Family History: A family history of breast cancer, especially among close female relatives, can elevate the risk for men.
- Genetic Mutations: Inherited gene mutations, notably BRCA1 and BRCA2, are associated with a higher risk of male breast cancer.
- Radiation Exposure: Past exposure to radiation, particularly in the chest area, may increase the risk.
- Liver Disease: Certain liver conditions, such as cirrhosis, can result in hormonal imbalances that may raise the risk of male breast cancer.
2. Symptoms and Diagnosis:
The symptoms of male breast cancer closely resemble those in women and may include –
- A Painless Lump: The most common symptom is a painless lump beneath the nipple or areola.
- Nipple Changes: Any alterations in the nipple, such as inversion, redness, or discharge, could indicate a problem.
- Breast Pain: While less common, breast pain can sometimes be associated with male breast cancer.
Diagnosis typically involves a combination of a physical examination, imaging (mammography and ultrasound) and biopsy. If breast cancer is confirmed, further tests may be conducted to determine the stage and extent of the disease.