Researchers are investigating genetic changes that may help explain why some men develop breast cancer, although the role of many of these changes in the disease remains uncertain.
The research described in an earlier report examined genetic data from men with breast cancer and identified hundreds of genes for further investigation. However, the precise study details and the figures quoted in that report could not be independently confirmed against the original scientific publication.
Cancer Research UK says researchers continue to investigate genetic changes in male breast cancer to understand what contributes to the disease and how its development may differ from breast cancer in women.
Breast cancer is uncommon in men, but it can occur because men also have breast tissue. Cancer Research UK estimates that about 420 men are diagnosed with the disease each year in the United Kingdom.
What researchers know about genetic risk
Inherited changes in the BRCA1 and BRCA2 genes can increase a man’s risk of developing breast cancer. These genes normally help cells repair damaged DNA, and harmful inherited changes can interfere with that process.
Other factors associated with increased risk include older age, a family history of breast cancer, previous radiation treatment to the chest, certain testicular conditions and illnesses that affect hormone levels. Having one or more risk factors does not mean a person will necessarily develop the disease.
Researchers are also examining other genes that may contribute to breast cancer risk. Identifying a genetic change, however, does not automatically establish that it causes cancer or accurately predict whether an individual will develop the disease.
Further research is needed to determine how particular genetic variants affect risk and whether they could help doctors identify men who may benefit from closer monitoring.
Symptoms that require medical assessment
Men should seek medical advice if they notice a new lump or thickening in the breast, changes to the nipple, nipple discharge, or changes to the skin around the breast.
These symptoms can have causes other than cancer, but a medical assessment is necessary to determine what is responsible.
Doctors may use a clinical examination, mammography, ultrasound and, where necessary, a biopsy to investigate a suspicious breast change. A biopsy involves examining a sample of tissue to determine whether cancer cells are present.
Routine screening mammograms are not generally recommended for all men. Those with a strong family history or a known inherited cancer-risk variant should discuss their individual risk with a healthcare professional.
Genetic testing and treatment
Genetic testing can help identify inherited changes associated with cancer risk. For men diagnosed with breast cancer, testing may also inform treatment decisions and help relatives understand whether they could have inherited a relevant genetic variant.
The National Cancer Institute recommends considering genetic counselling and testing in appropriate cases, including men diagnosed with breast cancer. Testing should be interpreted in the context of personal and family medical history.
There is no single treatment that applies to every case of male breast cancer. Depending on the type of tumour and how far the disease has spread, treatment may include surgery, radiotherapy, chemotherapy, hormone therapy or targeted medicines. Treatment decisions depend on the individual diagnosis and the characteristics of the cancer.
Researchers hope that a better understanding of the genetic factors involved in male breast cancer will eventually improve risk assessment, diagnosis and treatment. For now, the presence of a genetic variant must be interpreted carefully, since not every variant is harmful and not every person who carries a harmful variant will develop cancer.
The symptoms
- Breasts or armpits swollen or lumpy
- Pain or discomfort in the breast, armpit or chest area
- Nipple changes, for example, reduced in size or areola changes
- Nipple discharge that is tinged with blood or has red or white patches
- A lump or swelling in a breast that does not move
- A lump or swelling in a breast that moves
- Nipple discharge that is thick or white
- A lump in the armpit or underarm area
- Changes in the skin on the breast
- Nipple changes, for example, the nipple is flattened, hard, bent or inverted
- a lump in the neck (cancer in situ)
- Any other changes that do not fit the symptoms of breast cancer
- Existing or potential cancer in the lymph nodes in the armpit or chest area, which can be found by a mammogram
Treatment: what are the options?
There are currently no medical treatments available that can specifically target the BRCA1 or BRCA2 genetic alterations, but other treatments may be able to lower the risk of breast cancer in men.
Men who are diagnosed with breast cancer are still at a higher risk than women who may suffer the same life-threatening symptoms.
The cause of the increase in the risk of developing breast cancer in men is still not known, but it is believed that this could be the result of the decline in male hormone levels.
However, men can lower their risk of developing breast cancer by eating a healthy diet, staying active and making sure to get a full physical check-up when he is age 40 and above.
Studies have found that it may be possible to lower the risk of cancer in men by 50 per cent by following a healthy diet and doing regular physical activity.
Staying away from tobacco products, maintaining a healthy weight and managing stress levels may also be helpful.
Proactive mammography screening is recommended for women who are over 40 years old with a close family history of breast cancer. Women with this risk may opt for having a genetic test to determine if they have the BRCA1 or BRCA2 genetic alterations.
What are the male breast cancer stages?
According to the CDC, breast cancer is the most common cancer in women, with more than one million cases diagnosed each year. Men also suffer from it.
In most cases, breast cancer in men is discovered late. The CDC estimates that in the U.S. about 11 per cent of new breast cancer diagnoses are in men.
The CDC said that there are different stages of breast cancer for men, but most stages of the disease do not depend on sex.
The stages of breast cancer for men according to the CDC are:
Stage 1 – lump/tumour found.
Stage 2 – mass or thickening that gets larger over time.
Stage 3 – solid mass that has undergone changes and is 3 cm (1.2 in) or larger in diameter.
Stage 4 – a tumour that is large enough to be felt in the armpit, underarm or between the breast and the collarbone.
Stage 5 – hematoma, which occurs in about 3 per cent of men, occurs when blood vessels in the skin are filled with abnormal lymphocytes.
How is breast cancer diagnosed?
The three most common breast cancer symptoms in men are:
- A lump or swelling in a breast
- Wet, red or white discharge from the nipple
- Nipple changes, for example, the nipple is flattened, hard, bent or inverted
If you notice any of these signs or symptoms, make sure to visit a doctor right away.
The key to making sure you get the best treatment for breast cancer in men is to visit a doctor who can perform a breast cancer mammogram because treatment is the key to survival.
A mammogram is a special type of x-ray that allows a doctor to see if you have breast cancer and treat it as soon as possible, which increases your chances of survival.
This test is one of the most important tools in the fight against breast cancer.
Read more about the mammogram here.
