Can men get breast cancer?

The tenth month of the year, October, is designated as Breast Cancer Awareness Month. Major breast cancer organisations sponsor this annual international health campaign and aim to collect funds for studies into the disease’s causes, preventions, diagnoses, and treatments. According to the World Health Organization (WHO), it is the most common cancer worldwide and a leading cause of cancer death among women, disproportionately affecting individuals in low- and middle-income countries.

Despite being more prevalent in women, this disease can also strike men.

In this report, Fact Check Ghana explains all you need to know about breast cancer in men, its risk factors, its symptoms, and its treatment.

What is Breast Cancer?

Breast cancer is a disease in which cells in the breast grow out of control. These cells typically develop into tumours, often appearing as noticeable lumps or visible on X-rays. It may begin in either the left or right breast.

Breast cancer is now the most common cancer worldwide, surpassing lung cancer for the first time in 2020. The breast is an organ on top of the upper ribs and chest muscles. There is a left and right breast, and each one has mainly glands, ducts, and fatty tissue. In women, the breast makes and delivers milk to feed newborns and infants. The amount of adipose tissue in the breast determines the size of each breast.

Can men get breast cancer?

Breast cancer is the most commonly diagnosed cancer in women and the most common cause of cancer death in women. However, more than 2,500 new breast cancer cases are diagnosed in men yearly, with 500 men dying from their disease each year. The American Cancer Society estimates that 2,800 men will be diagnosed with breast cancer, and approximately 530 will die this year.

Men also have breast tissues and are at risk of developing breast cancer.

The breast tissues in men

Young boys and girls have a small amount of breast tissue up to puberty, typically at age 9 or 10, consisting of a few ducts under the nipple and areola (region around the nipple). When a girl reaches puberty, her ovaries produce female hormones that cause her breast ducts to grow and develop lobules, the gland produces milk, at their ends. Boys and men often have a small amount of female hormones even after puberty, and breast tissue doesn’t expand significantly. The breast tissue of men possesses ducts, but there are not a lot if any, lobules.

Risk factors of breast cancer

Risk factors for breast cancer in men include age, radiation exposure, estrogen treatment, heavy alcohol intake, obesity, female relatives with breast cancer, an inherited gene mutation (BRCA2 gene) in the family, testicular conditions, and liver disease.

Types of breast cancer in men

There are numerous types of breast cancer in men, but the most common are ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, inflammatory breast cancer, and Paget’s disease.

1. Ductal carcinoma in Situ (DCIS): Ductal carcinoma in situ (DCIS) is a rare, non-invasive form of breast cancer from milk duct cells. It accounts for 1 in 10 cases in men and is usually curable with surgery.

2. Invasive Ductal Carcinoma: Invasive ductal carcinoma (IDC) is the most common type of breast cancer, starting in a milk duct and breaking through the duct wall. It grows into the breast’s fatty tissue and can spread through the lymphatic system and bloodstream. At least 8 out of 10 male breast cancers are IDCs, starting closer to the nipple due to their smaller size.

3. Invasive Lobular Carcinoma: Invasive lobular carcinoma, a rare breast cancer, originates in milk-producing glands and spreads to nearby breast tissue.
4. Inflammatory Breast Cancer: Inflammatory breast cancer is rare, aggressive, and often mistaken for breast infection, causing swelling, redness, warmth, and tenderness in the breast.
5. Paget’s Disease: Paget’s disease is a rare type of breast cancer that develops under the nipple and areola, causing itch, swelling, redness, crusting, or thickening of the nipple and areola. It starts in the breast ducts and may spread to the areola, causing crusted, scaly, red skin, itching, oozing, burning, or bleeding.

Symptoms of Breast Cancer in Men

The most common symptoms of breast cancer include:

1. A chest lump or thickening
2. Changes in the skin covering the chest, such as dimpling, puckering, scaling, or colour changes
3. Changes in the nipple, such as colour or scaling or a turning inward nipple
4. Discharge or bleeding from the nipple

Similarities in Male and Female Breast Cancer

Breast cancer cells can be found in lymph nodes in both men and women, with similar spread patterns. The staging system for male breast cancer is identical to that for female breast cancer. Both types are assessed for prognosis, including lesion size and lymph node cancer cells. These factors influence treatment choices and outcomes. Overall survival rates are similar, although male breast cancer is often diagnosed later.

Treatment of Breast Cancer in Men

Male breast cancer is treated with surgery, with modified radical mastectomy being the most common procedure, involving breast removal, lymph node removal, chest muscle lining, and chest wall muscle resection.

Some others include:

1. Radiation Therapy: It is often performed as an external beam therapy, directly targets cancer cells, shrinks tumours, and relieves symptoms, with special shields used to protect surrounding tissue.
2. Chemotherapy: Chemotherapy uses anticancer medicines to kill cancer cells by interfering with cell growth or reproduction, with different groups working differently, and a cancer doctor recommends a treatment plan.
3. Hormone Therapy: Hormone therapy is a cancer treatment involving substances that interfere with hormone activity, with hormone receptor tests assessing cancer cell sensitivity to hormones.
4. Adjuvant therapy: Post-surgery radiation therapy, chemotherapy, or hormone therapy is used to eradicate non-visible cancer cells.

The writer of this report, Benjamin Tenkorang, is a fellow of the Next Generation Investigative Journalism Fellowship at the Media Foundation for West Africa (MFWA).