Breast Cancer in Men: Signs and Risk Factors of Male Breast Cancer

Many men are supportive of their wives and female relatives as they fight breast cancer, yet they never consider the possibility that they, too, may be at risk for the disease. The American Cancer Society estimates there are approximately 1,990 new cases of male breast cancer each year (about 1% of all breast cancer cases) and about 480 of those men will succumb to the disease.

Just as in women, early detection of breast cancer in men improves the chance of survival. Due to the smaller size of male breasts, breast cancer can spread out of the breast and into other areas of the body faster in men than in their female counterparts. For early detection to be possible, men need to be aware of the symptoms of male breast cancer, as well as the risk factors that increase their chance of developing the disease.

Breast Cancer in Men: Men Have Breasts?
Boy and girls are both born with a small amount of breast tissue, which consists of undeveloped ducts and small amounts of fat and connective tissue. As they reach puberty, the female hormones cause the breasts to grow and form lobules (milk glands), while the male hormones suppress any further development. The undeveloped tissue is still there though, sitting behind the nipples on the chest wall.

Breast Cancer in Men: Symptoms of Male Breast Cancer
The signs of male breast cancer are similar to female breast cancer. These include:
A lump, swelling, or thickening in the breast (the lump is often painless)
Dimpling or puckering of the skin in the breast area
Nipple retraction or indentation (the nipple turns inward)
Changes in the skin or nipple, such as redness, scaling or ulceration
Discharge from the nipple (bloody or opaque)

Cancer can cause other symptoms, especially if it has begun to spread outside of the breast. These include:
Malaise (not feeling well)
Weakness
Weight loss
Pain in various areas, such as the bones or muscles around the breast
Swollen or painful lymph nodes in the armpits or neck

Many men ignore the signs of breast cancer, especially lumps or skin changes, because they think these symptoms are caused by an infection or unrelated skin condition. While this may be true, any abnormality in the breast area should be checked by a doctor.

Breast Cancer in Men: Risks Factors for Male Breast Cancer
There are several factors that increase the chance of a man developing breast cancer. While these risk factors are commonly seen in cases of male breast cancer, men without them may also develop the disease.

Age: Male breast cancer can occur in at any age, but it is most often seen in older men between the ages of 60 and 70. The average age at diagnosis is 67 years old.

Family history: About 20% of men with breast cancer have a close blood relative (mother or sister) who has been diagnosed with the disease. The more blood relatives who have had the disease (even reaching out to grandmother and aunt), the higher the risk.

Much of the family risk is due to inherited genetic mutations. While several different genetic mutations can be responsible for causing breast cancer in men, the most common are in the BRCA1 and BRCA2 genes (breast cancer susceptibility gene 1 & 2). BRCA1 and BRCA2 are in a gene class called tumor suppressors. They make proteins that keep the DNA of cells functioning normally and prevent uncontrolled cell growth. When these genes mutate, they are not as effective in their job and the chance of cancer is increased. Men with BRCA2 mutations have a 6% chance of developing breast cancer, which is about 100 times higher than men without the mutation. The percentage for increased risk with BRCA1 has not been fully determined.

Radiation exposure: Men who have had exposure to high levels of radiation in the chest area, such as having received radiation treatments for Hodgkin's lymphoma or other forms of cancer, have a higher risk of developing breast cancer.

High levels of estrogen: Most of the breast cancers seen in men require estrogen to grow and survive. The treatment of prostate cancer frequently requires the use of estrogen, which increases the possibility of developing breast cancer. The risk is slight and is outweighed by the benefit of slowing the growth of prostate cancer.

Other causes of high estrogen in the male body include Klinefelter's syndrome (an inherited condition where a man has two X chromosomes instead of one) and hormone therapy after sex reassignment surgery (a.k.a. sex-change operation).

Liver disease: The liver produces proteins that help control hormone activity in the body. When the liver is diseased, such as in men with cirrhosis, the hormone levels are thrown off. This often results in higher levels of estrogen in the body, which can increase the risk of breast cancer.

Excess weight: Fat cells convert male hormones into female hormones, thus raising the levels of estrogen in the body. Men who are obese run a higher risk of breast cancer than men who control their weight with diet and exercise.

Excessive use of alcohol: Alcohol dramatically increases the levels of estrogen in the body within 30 minutes of having a drink. Men who drink excessive amounts of alcohol have a continual increase of estrogen in their body. This continual increase, added to the damage being done to the liver (damage that can also increase estrogen levels), greatly increases the risk of male breast cancer.

Conditions that affect the testicles: Current research suggests conditions such as having an undescended testicle or the surgical removal of one or both testicles can increase the chance of breast cancer in men. Having mumps as an adult can affect the testicles and possibly be a risk factor, as well. Occupations that expose the testicles to high levels of heat over a long period of time, such as working in a steel mill, may also be a risk factor. All of these cause concern because of they lower the levels of male hormones in the body, thus increasing the levels of estrogen.

Breast Cancer in Men: Reducing the Risk of Male Breast Cancer
Preventing male breast cancer is not currently possible, but there are things a man can do to lower his risk of getting the disease. Eating a healthy diet, not consuming large amounts of alcohol and getting regular exercise are all things that can increase his chance of remaining healthy.

For men who have a family history of breast cancer or other risk factors that are out of his control, paying close attention to breast health and seeking medical attention at the first sign of a problem are key to early detection and the best possible treatment of male breast cancer.

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Sources:
Mayo Clinic:
Male Breast Cancer: Causes
Male Breast Cancer: Risk Factors
Male Breast Cancer: Symptoms

MedicineNet:
What is male breast cancer? How common is male breast cancer?
What are causes and risk factors of male breast cancer?
What are the signs and symptoms of male breast cancer?

American Cancer Society:
Can Breast Cancer in Men Be Found Early?
How Is Breast Cancer in Men Diagnosed?
What Are the Risk Factors for Breast Cancer in Men?
Can Breast Cancer in Men Be Prevented?

National Cancer Institute:
BRCA1 and BRCA2: Cancer Risk and Genetic Testing

Cornell University:
Understanding Wine and Beer