MALE BREAST CANCER

The male breast is similar in characteristics to the preadolescent girl's breast. Although breast cancer in males is very rare, it still can happen. All types of breast cancer seen in women can develop in men. In Canada, there will be 150 estimated new cases for 2005 of male breast cancer, and 45 deaths. In the USA, there will be 1,690 estimated new cases, and 460 deaths.

Early detection can be achieved by learning and practicing Breast Self Examination (BSE) on the same day every month.

   RISK FACTORS

1. Age - risk of male breast cancer increases with age
2. Ethnicity - higher in black men and Jewish men of European ancestry
3. Geography - African countries are very high
4. Socioeconomic Status - higher in college graduates employed as professionals or managers
5. Heredity - can run in families
6. Hormones - pre-existing disorders with hormonal components or abnormal hormone activity
7. Gynecomastia - excessive growth of male mammary glands
8. Klinefelter's Syndrome - rare disorder characterized by abnormal chromosome pattern (xxy)
9. Testicular Disorders - physical, infection, injury
10. Radiation - exposure to radiation associated with treatment of childhood disease

   SYMPTOMS

• small painful lump usually beneath the areola (dark circle around the nipple)
• clear or bloody discharge from nipple
• nipple retraction
• changes in the skin around the breast
• skin ulceration
• palpable lymph nodes in the axilla (armpit)

   DIAGNOSIS

A diagnosis of male breast cancer is confirmed by a physical exam of the breast, mammography, thermography and the definitive biopsy.

   TREATMENT

1. Local
   1. Surgery - mastectomy or removal of breast and the removal of lymph nodes in the axilla
   2. Radiation Therapy
   3. Adjuvant Chemotherapy
   
   
2. Advanced
   
   Metastases can occur in the bones, lungs, lymph nodes, liver or brain.
   
   
   1. Surgical removal of the testes or adrenal glands or pituitary gland
   2. Additive Hormonal Therapy - synthetic estrogen (diethylstilbestrol DES) or progesterone
   3. Antiestrogens - Tamoxifen
   4. Chemotherapy

   The diagnosis of breast cancer in males and the follow-up treatment can present certain problems. The psychosocial impact of a male getting a recognized female disease can impact his masculinity. As with a breast cancer diagnosis in females, he may experience feeling alone and helpless. Because of the surgery, it is recommended that patients do arm exercises to prevent frozen shoulder. Lastly, care must be taken of the arm on the surgical side to prevent Lymphedema, a serious and sometimes life-threatening swelling of the arm.

   SIDE EFFECTS

Every man's experience is unique and different. Some of the side effects are:

• arm may be stiff on the surgery side
• pins and needles sensations in the incision and arm
• some temporary swelling in the arm and hand
• may have a drain in the incision for about one week
• may experience emotional ups and downs (grief, fear, shock, anger, resentment)
• physical changes to the breast area

   RESOURCES

Web Sites

• MedlinePlus: Male Breast Cancer
• Canadian Cancer Society
• CCS: Cancer Information Service  Canada
• American Cancer Society
• CIS: Cancer Information Service  USA
• Lymphovenous Canada
• Paget's Disease of the Nipple
  
  
• Testicular Cancer Resource Center
• Testicular Self Examination
• Canadian Prostate Cancer Network - Internet Resource Centre