Breast cancer in men
11/2/2011, 11 a.m.
Male breast cancer rare, but often aggressive Men are most frequently diagnosed with skin, prostate, lung and colon cancers. But there is one type of cancer not usually associated with men that accounts for approximately 1,970 new cancer cases per year and causes roughly 390 deaths annually. The disease is breast cancer. Common symptoms of male breast cancer include a lump or swelling in the chest area, nipple discharge, and skin dimpling or puckering. Men most likely to develop breast cancer are between the ages of 60 and 70, have a family history of the disease or a BRCA2 gene mutation, have been exposed to radiation, have high estrogen levels caused by liver disease or a genetic condition such as Klinefelters syndrome, or are overweight or inactive. I have however seen a number of men in my practice diagnosed with breast cancer at younger ages and seemingly otherwise healthy. They noticed a lump in their chest and when they came to me for a biopsy, learned they had breast cancer. The long-term prognosis for men with breast cancer is similar to that for women diagnosed with the disease. However, male breast cancer often is identified at a later stage, making it more difficult to treat. Thats why its important for men who are more susceptible to developing breast cancer to be proactive and take steps to develop a breast-screening program. If breast cancer is suspected, a number of tests may be used to diagnose the disease. A clinical breast exam can detect lumps or determine the size and location of the mass. A mammogram can show images of the breast tissue using a series of X-rays. A breast ultrasound can help evaluate an abnormality using sound waves to generate images of structures inside the body. A nipple discharge examination can detect cancerous cells in fluid from the nipple. A biopsy can confirm a cancer diagnosis and help determine if further treatment is needed. There are three types of biopsies: fine-needle aspiration biopsy extracts a few cells from the suspicious breast lump; core needle biopsy removes a tissue sample for analysis; surgical biopsy removes all (excisional) or part (incisional) of the breast lump. If cancer is detected, additional tests may be ordered. An estrogen and progesterone receptor test may be performed to evaluate how cancer cells multiply and if hormone therapy may stop the cancer from growing. Human epidermal growth factor receptor-2 testing measures a growth factor protein that can cause cancer cells to spread rapidly; in this case monoclonal antibody therapy could halt the spread of cancer. Treatment options for male breast cancer depend on many factors, including the size and location of the cancer, whether it has spread, type of cancer, and the mans age and overall health. Surgical operations include a: Simple mastectomy all breast tissue is removed. Modified radical mastectomy the entire breast and some underarm lymph nodes are removed. Radical mastectomy all breast tissue, lymph nodes and chest wall muscle is removed. Chemotherapy uses drugs, taken either orally or by injection, to kill cancer cells. Radiation therapy uses high-energy X-rays to target cancer cells. Hormone therapy may help destroy cancer cells that have spread or shrink breast tumors. While male breast cancer is rare, it can be successfully treated when detected early. I recommend that men also perform breast/chest self-exams. Be sure to see your primary care physician immediately if you notice any changes. North Shore Medical Centers Community Cancer Center is accredited by the American College of Surgeons and treats all types of adult cancers, including Breast Cancer. North Shore Medical Center specializes in external beam radiation therapy using some of the latest IMRT (Intensity Modulated Radiation Therapy) techniques and HDR (High Dose Rate) brachytherapy for Breast Cancer. Dr. Hkan Charles-Harris is Board Certified by both the American Board of Surgery and the American Board of Vascular Medicine Endovascular. He is a newly appointed Professor of Surgery at the Florida International University School of Medicine. Caring for the North Miami community since 2000, Dr. Charles-Harris has served three consecutive terms as Chief of Surgery at North Shore Medical Center, and one term as Vice-Chief of Staff at North Shore Medical Center. He specializes in diagnosing and treating breast cancer. By Hkan Charles-Harris, MD FACSBoard Certified by American Board of Surgery & American Board of Vascular Medicine