Men Get Breast Cancer Too: Know the Risks

The following is a guest column by Lisa Sheppard, MD, a Radiologist and the Director of PINK Breast Center/ImageCare Radiology.

Breast cancer in women always gets the spotlight. But, men get breast cancer, too. Male breast cancer is rarely talked about … which often results in late diagnosis and devastating consequences.

The American Cancer Society estimates 2,00 new cases of invasive breast cancer in men will be diagnosed in 2024. While these numbers pale in comparison to the number of women affected by the disease, the outcomes can be just damaging. 

About one-quarter of those diagnosed – 530 men – will succumb to the disease. A JAMA Oncology study showed 5.8% of males are diagnosed with advanced-stage breast cancer compared to 3.8% in females. The five-year survival rate for men with breast cancer is 77.6% compared to 86.4% for women. That’s because most men aren’t aware of the risk factors or symptoms. They’re less likely to do breast self-exams, and they are not routinely screened for breast cancer. This makes them more likely to present with large tumors and more advanced diseases. 

This– combined with the fact that male breast cancer is so rare – makes this disease uniquely challenging. There’s an urgent need for awareness, so read on to learn more. 

The Risk Factors for Male Breast Cancer

Knowing the risks is key to proactive surveillance – even though having a risk factor doesn’t mean a man will get the disease. Likewise, not having these risk factors doesn’t ensure a man won’t get breast cancer. 

The common risk factors for male breast cancer include: 

• Aging: The risk of breast cancer increases as a man ages. Most men with breast cancer are diagnosed when they are in their low 70s. 
• Family History of Breast Cancer: Risk goes up if blood relatives have had breast cancer. About 1 out of 5 men with breast cancer have a close relative – male or female – with the disease.
• Inherited Gene Mutations: According to Cancer. Org, approximately 0.2%–1.2% of men with an inherited harmful change in the BRCA1 (BReastCAncer1) gene … and 1.8%–7.1% with an inherited harmful change in the BRCA2 (BReastCAncer2) gene – will develop breast cancer by the age of 70. In contrast, approximately 0.1% of men without a BRCA mutation will develop breast cancer by the age of 70. Mutations in CHEK2, PTEN, and PALB2 genes may also be responsible for some breast cancers in men. These genes are associated with tumor suppression, DNA repair, and cell growth, respectively.
• Klinefelter Syndrome: About 1 in 1,000 men are born with this condition which is caused by having an extra X chromosome. These men are 20 to 60 times more likely to get breast cancer than other men.
• Radiation Exposure: A man whose chest area has received radiation – to treat, for example, a cancer like lymphoma – is at increased risk.
• Liver Disease: The liver plays an important role in balancing sex hormone levels. When the liver is not working well – in the case of severe liver disease such as cirrhosis – the hormone levels are uneven. This can cause lower levels of androgens and higher levels of estrogen, putting men with liver disease at a higher risk of developing breast cancer.
• Alcohol: Because of the liver’s critical role, heavy drinking increases the risk. 
• Estrogen Treatment: Increased estrogen levels due to estrogen-related drugs once used to treat men with prostate cancer may slightly increase breast cancer risk.
• Obesity: Fat cells in the body convert male hormones into female hormones, which can increase the risk of breast cancer in men.
• Testicular Conditions: Men who have an undescended testicle, mumps as an adult, or one or both testicles surgically removed may be also at increased risk. 
• Transgender Patients: Individuals undergoing transition can face additional breast cancer risks due to hormone treatments and uncertainty about breast cancer screenings. 

The Symptoms

Similar to the changes associated with female breast cancer, noticeable physical changes in male breast tissue are often the first signs of breast cancer. They  include: 

• A usually painless lump in the breast, often beneath the areola 
• Lump(s) in the lymph nodes under the armpit near the affected breast
• Nipple changes including an inverted nipple or nipple discharge
• Red, flaky, or scaly breast skin
• Pitted or dimpled breast skin
• Pain or tenderness in the chest or underarm

The Diagnosis

Just as breast cancer is diagnosed in females, a healthcare provider will assess a patient’s symptoms, family history, and risk factors. They’ll do a breast exam, checking for skin changes, lumps, and other abnormalities. If needed, a mammogram – and possibly an ultrasound – will be done to further access the tissue. If results are suspicious, a biopsy removing tissue from the suspect area will be done and sent to a lab for analysis. 

At PINK Breast Center/ImageCare Radiology, we understand men may be uncomfortable coming into an imaging center to get a mammogram. We are dedicated to removing this barrier as a deterrent to having the imaging done. As such, we take special steps to ensure each patient’s level of comfort during the exam and make the scan as quick and informative as possible. That’s why many men routinely trust us for mammograms and other imaging exams including body ultrasound and DEXA bone density scans.

The Treatment

When cancer is found, treatment depends on the stage and type of cancer. There are five standard treatments used to treat male breast cancer:  

• Surgery: A lumpectomy may remove a tumor and a small amount of tissue around it. More often, a modified radical mastectomy, surgery to remove the entire breast and most of the lymph nodes under the arm, will be done. 
• Chemotherapy: Administered either orally or via injection, chemotherapy drugs are used to destroy the cancer cells or stop them from dividing. 
• Hormone Therapy: This treatment removes the hormones that fuel cancer or block their action. The type of hormone therapy administered depends on the type of breast cancer and whether it has spread or not. 
• Radiation Therapy: Radiation to the breast uses high-energy X-rays or other types of radiation to destroy cancer cells or inhibit them from growing.
• Targeted Therapy: This treatment attacks specific cancer cells using drugs or other substances that can identify and destroy them. 

What You Can Do

Now that you know the basics, know your risk factors – or those of a loved one – and act quickly if you or they experience any breast changes. And, ask your friends to do the same. The consequences of ignorance and lack of action can be deadly. Breaking the silence requires a concerted effort to raise awareness and educate others. Together, we can make a positive change in the detection and treatment of male breast cancer. 

For more information or to schedule a mammogram, visit PINK Breast Center/ImageCare Radiology at imagecarecenters.com.