When it comes to breast cancer awareness, it seems the overall education is geared towards breast cancer in women. Though breast cancer in men is very rare (less than 1 percent of all breast cancer diagnoses occur in men), it’s important to remember that both cis and transgender men can be diagnosed, too.
“Breast cancer in men is uncommon, but that’s what makes it dangerous,” says Dr. Beatriz Amendola of the Innovative Cancer Institute in Miami, Florida. “Because breast cancer in males is so uncommon, it has been widely ignored by the public, the media, and many healthcare professionals.”
Because of the dangerous lack of awareness, Dr. Amendola says that when men are finally diagnosed with breast cancer, “it tends to be at a more advanced stage than with breast cancer in women.” She notes that approximately 40 percent of men with breast cancer receive a diagnosis in stage 3 or stage 4, “when the disease has already spread to other parts of the body.”
However, early-stage breast cancer can be just as fatal. According to breastcancer.org, “Men diagnosed with early-stage breast cancer are more likely to die from the cancer than women diagnosed with early-stage disease.” Men with early-stage breast cancer only survived for about six years, while women with breast cancer survived for about 15 years.
Breast cancer, says Dr. Amendola, doesn’t discriminate. “It is simply an abnormal mutation that can happen to anyone at any time. It’s hard to prevent, but it can be cured when it’s detected early.”
Since education is key, here’s everything you’ve ever wanted to know when it comes to breast cancer in men.
What Are the Causes and Risk Factors of Breast Cancer in Men?
“The cause of breast cancer in men are likely the same as women,” says Dr. Kathleen Dunham of Compass Oncology in Portland, Oregon. Some of these causes can be due to older age, liver disease, increased alcohol use, obesity, previous testicle disease or surgery, and a family history of breast cancer and/or prostate cancer.
Since, as Dr. Dunham notes, the exact cause of breast cancer in men has not been pinpointed, it is known that “it is the result of rapidly dividing abnormal cells within breast tissue related to risk factors.”
Men particularly at risk for breast cancer include those who “carry a BRCA mutation,” as well as those who have had “prior radiation exposure to the chest (for the treatment of lymphoma), and the presence of an X-chromosome in Klinefelter syndrome.”
Transgender men are also at risk for breast cancer due to exposure to estrogen and taking higher levels of hormones. “If you take estrogen-related drugs and hormones your risk of breast cancer is increased,” says Dr. Amendola.
What Are the Signs and Symptoms of Breast Cancer in Men?
The signs and symptoms of breast cancer are similar in both men and women, though, as Dr. Dunham explains, “Men usually have less breast tissue and changes may be easier to detect.”
Some of the symptoms men should look out for, however, include a palpable lump, changes in the nipple, retraction of the nipple, nipple discharge, skin changes including redness or puckering, and swelling in the armpit. Dr. Amendola notes, “Breast cancer in men is more likely to start near—and spread to—the nipple.”
“On the one hand, because men have very little breast tissue compared to women, it can be easier for men or their doctors to feel small masses, or what we call tumors,” Dr. Amendola says, “On the other hand, because men have so little breast tissue, the cancers don’t have as much room to grow and it will spread to the nipple and other nearby tissues.”
How Can Men Check For Breast Cancer?
A physical examination in the shower is a great place to start, says Dr. Amendola. The things to look for during a self-examination are a lump in one breast (typically painless), nipple retraction (as well as ulceration and discharge), skin puckering or dimpling on the breast, or redness/scaling of the skin on the breast or nipple.
When cancer has spread, Dr. Amendola says other symptoms you may feel are breast pain, bone pain, and swelling in the lymph glands, in or near the underarm area. If you notice any of these things, you should call your physician for a full evaluation and diagnosis.
How is Breast Cancer in Men Diagnosed?
“Breast cancer is diagnosed with the same modalities in men and women,” says Dr. Dunham. “Once a symptom is noted, he will then have imaging including a mammogram and an ultrasound. The area would then be biopsied with a needle and the tissue is sent to a pathologist for evaluation.” The pathology report will have the full details of the type of breast cancer.
What Are the Treatment Options for Breast Cancer in Men?
When a man has been diagnosed with breast cancer, Dr. Dunham says it can depend on the specific findings indicated in the pathology report, “as there are many types of breast cancer, and treatment is individualized.”
Depending on the type of breast cancer, treatment options can include surgery, radiation therapy, hormone therapy, and chemotherapy.
“The typical treatment for men is a mastectomy, in which your entire breast is removed,” Dr. Amendola says. “The other surgical option is a lumpectomy, if it is caught early and can be removed without removing the entire breast. However, because of the limited amount of tissue in male breasts/chest often a lumpectomy not always applicable.”
When it comes to radiation therapy, Dr. Amendola explains, it is “used after a mastectomy or lumpectomy. It’s a targeted way to kill cancer, Dr. Amendola notes, adding that radiation therapy is minimally invasive, has great cosmetic results, and is shown to minimize recurrence.
Chemotherapy, Dr. Amendola says, is when oncologists use drugs to kill cancer cells in a systematic way to treat the whole body, which can be necessary when the cancer spreads beyond the breast.
What Are Some of the Biggest Stigmas and Misconceptions About Breast Cancer in Men?
“The biggest misconception is that men cannot get breast cancer,” says Dr. Dunham, adding, “Another misconception is that male breast cancer is associated with fatty breast tissue or gynecomastia. All males have breast tissue.”
Another misconception is that breast cancer cannot affect younger people, as Dr. Dunham points out, “The truth is that breast cancer can occur at young ages and no new symptoms should be ignored because one feels that they are at low risk.”
Because of the misconceptions and lack of overall awareness, some men who are diagnosed with breast cancer may feel shame or embarrassment. “There is no shame in getting cancer and fighting it with dignity that women do,” says Dr. Amendola.
However, it is OK to feel vulnerable, Dr. Amendola says, and it doesn’t affect your masculinity or femininity. In order to find positive coping mechanisms, both doctors suggest finding support groups (both in-person and/or online) to speak with others who have gone through what you’re going through.
As Dr. Dunham puts it, “Having reliable information and talking to people who have experienced the disease and treatment themselves helps to de-stigmatize the diagnosis.”