October is designated Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. You are likely to have heard a lot about breast cancer but not very likely to associate this disease with men. In fact, breast cancer affects men as well as women although breast cancer in men is rare.

What causes male breast cancer?

It is not clear what the exact causes of male breast cancer are, but there are certain factors that may increase the risk, such as:

  • Age – The incidence of breast cancer in men increases with age. Male breast cancer occurs most frequently in men over 60, although younger men may also get it.
  • Family history of breast cancer – Family history of breast cancer in first-degree relative is associated with increased risk of breast cancer among men. The two inherited genes, BRCA1 and BRCA2, give rise to the majority of hereditary breast cancer. Men who have inherited the mutation, especially BRCA2 mutations, have an estimated 6 percent lifetime absolute risk of breast cancer, which represents a 100-fold higher risk than in the general male population.
  • High oestrogen levels – The hormone oestrogen can stimulate the development of breast cancer. Men naturally have small amounts of oestrogen in their bodies, but long-term liver damage, obesity, marijuana use, thyroid disease and some genetic conditions may cause higher levels.
  • Radiation – Men whose chests were exposed to radiation over long periods may face an increased risk of developing breast cancer.

A Look at the Numbers

  • Less than 1% of all breast cancer occurs in men.
  • Only one in 1000 men will ever be diagnosed with breast cancer.
  • Over an 18-year period, the National Cancer Centre Singapore only diagnosed about 62 cases of male breast cancer.
  • Doctors think that 10 – 20% of male breast cancers are due to inherited faulty genes.
  • Most men who develop breast cancer are 60 – 70 years old.

What are the symptoms of male breast cancer? 

The most common symptom is a lump on the chest. The lump is usually firm painless, and found close to the nipple.

Other symptoms include:

  • Swelling of the breast
  • Ulceration on the breast or nipple
  • Tender or inverted nipple (pulled inwards)
  • Rash on or around the nipple
  • Lump in the underarm area
  • Oozing discharge from the nipple, sometimes with blood

Any change in the breast area, including the nipple, can be a symptom of male breast cancer. Seek treatment immediately if you observe any of these changes.

How is male breast cancer treated?

Breast cancer in men is treated the same way as breast cancer in women. The aim of treatment is to remove the cancer and try to prevent it from recurring or spreading to other parts of the body. Doctors will decide on the most appropriate treatment or combination of treatments, based on the type of breast cancer, the size of the cancer and how far it has spread, and so on.

Treatments for breast cancer include:

  • Surgery – Usually the first option in the treatment of male breast cancer. There are two main types of operation. A mastectomy involves removing the whole breast, including the nipple and lymph nodes. Less commonly, in a lumpectomy, the cancer is removed along with a border of surrounding normal breast tissue.
  • Radiotherapy – High-energy X-rays are used to destroy cancer cells. Radiotherapy may be offered after surgery to reduce the risk of the breast cancer recurring.
  • Chemotherapy – Anti-cancer drugs are used to destroy cancer cells. There are various types of chemotherapy drugs. Chemotherapy may be offered before or after surgery.
  • Hormone therapy – This aims to block the effect of oestrogen on cancer cells. The drug tamoxifen is used in hormone therapy for men, and usually has to be taken for five years.
  • Targeted cancer drug therapy – Drugs are given to prevent the cancer from growing and spreading, by directly targeting cells in the body.
  • Immunotherapy – Immunotherapy are medications that harness the body’s own immune system and allow it to recognise and destroy cancer cells.

Early detection saves lives. The earlier treatment is started, the better the chances of survival. If you suspect you may have male breast cancer, consult a doctor as soon as possible – don’t wait till it’s too late.