Understanding Breast Cancer - Insurancewith : Insurancewith

2. Understanding breast cancer in men

Breast cancer is a condition that’s largely associated with women. However, this way of thinking is a little bit outdated. Whilst breast cancer in women is a lot more common, men can also develop the potentially fatal disease and, as such, greater awareness is required.

So, how common is a breast cancer diagnosis in males? Well, there is around one new case for every 100,000 men – adding to between 350-400 incidents in the UK each year. Worldwide, male breast cancer enters into the thousands.

But breast cancer isn’t on the male radar – it comes in as just the 17th most feared cancerous disease amongst men, in comparison with women, who rank it as second behind bowel cancer. And the stats continue to alarm. Despite the number of diagnoses in males, 24% of those males surveyed didn’t think it was even possible for them to be diagnosed with breast cancer in the first place.

For men, breast cancer usually starts in the tissue behind the nipples and a typical symptom will be that of a hard, painless lump. That said, the more likely cause of a lump will be because of gynaecomastia - a common non-cancerous condition where male breast tissues are enlarged. Visiting your GP will be the first step to identifying the cause of the lump.

Male breast cancer may also be identified by nipple problems, such as the nipple turning in on itself. Again, a healthcare professional will be able to assess your condition.

When should you visit a GP?

Men noticing anything strange affecting their breasts should always see a GP – at least for the peace of mind that nothing sinister is at large. This could include a lump or even discharge from your nipples. Even if breast cancer isn’t to blame, it’s still important to understand what’s behind your bodily changes.

Just 20% of men said they would go to the doctors as soon as they noticed the tell-tale signs of breast cancer. Even more worryingly, after noticing the symptoms and them not going, just 25% of men would head to the doctor at this stage.

“Should always see a GP”

What are the causes & symptoms of male breast cancer?

As with breast cancer in women, identifying the underlying factors for male breast cancer is difficult. However, there are some factors to be aware of that are known to increase your risk of developing cancer.

Age: Older men are more likely to be diagnosed with breast cancer, especially those aged 60 and over.
Family history: Breast cancer is known to be related to family history. If a direct relative was diagnosed, you are more at risk.
Obesity: Obesity is also related to breast cancer in men – particularly those with a body mass index rating of 30 or more.
Oestrogen: There is evidence that oestrogen levels have a correlation with breast cancer. Men could have higher levels of oestrogen present in their body because of things such as hormone treatments or transgender procedures.
Cirrhosis: Otherwise known as liver scarring and evident after long-term alcohol misuse.
Klinefelter syndrome: A rare genetic condition where boys are born without the ability to produce standard levels of testosterone. As testosterone helps limit oestrogen, it can lead to these men being more likely to develop breast cancer.
Occupational: Working in hot environments is suggested to increase the likelihood of breast cancer up to two times. These such environments include blast furnaces, steel works and rolling mills.
Radiation: Exposure to radiation has also been linked to the increase in breast cancer amongst men. In fact, men undergoing a course of radiotherapy where high energy X-rays are used on the upper chest, are seven times more likely to develop breast cancer.

With this said though, men of any age can be diagnosed with breast cancer and should be aware of the symptoms and treatment.

For many cases, as mentioned above, a hard and often painless lump will be the primary symptom. This lump will be found underneath the nipple and areola (the dark coloured skin around the nipple).

There are other, less common, symptoms too though – including the following:

1.
The nipple beginning to turn on itself
2.
A hard or inflamed nipple
3.
The nipple leaking discharge

If the cancer is allowed to spread it can affect other parts of the body, such as the bones, liver or lungs. This is known as metastatic breast cancer.

Symptoms associated with metastatic breast cancer include:

1.
Bone pain
2.
Swelling of lymph nodes (glands around the armpit)
3.
Shortness of breath
4.
Nausea
5.
Itchy skin and signs of jaundice (yellowing of skin and eye whites)

Diagnosing breast cancer in men

As advised previously, if you notice anything different with your breasts, it makes sense to visit the GP. They’ll take a look and determine the next best course of action. If, for instance, you have a hard lump, the GP will check for other symptoms (such as swollen lymph glands). If your GP suspects anything untoward you’ll be sent for further tests.

Mammogram

This type of X-ray will determine if there have been changes to the breast tissue that could be the direct result of cancerous activity. A radiographer will compress one of your breasts between two X-ray plates (this shouldn’t be painful, but tell the professional if you’re too uncomfortable). Once in the correct position, the X-ray will take a clear picture of the inside of your breast. The same procedure will be undertaken on the second breast.

Ultrasound

This test uses high-frequency sound waves to produce an image of the inside of your breasts – the same technology used to assess the health of an unborn baby in pregnant women. A probe or sensor will be placed over one or both breasts and the resulting image will highlight any abnormalities or areas of concern.

Biopsy

As a result of an unknown entity discovered in the breasts by a mammogram or ultrasound, a biopsy will most likely be completed. This can either rule out or diagnose breast cancer. A tissue sample will be extracted and examined in a laboratory to analyse if cancerous cells are present. Typically, a core biopsy is recommended and this has the dual benefit of examining if the cancer is spreading into the surrounding areas. A biopsy will be performed under local anaesthetic, using a hollow needle to extract a small amount of tissue. The biopsy will also ascertain if special proteins (oestrogen receptors) are present – found in more than half of all cases. If these are found, the cancer can be treated with hormone therapy.

Treating breast cancer in men

Treatment for breast cancer varies in accordance to how far the cancer has spread. Multidiscipline teams usually work together to identify the best course of treatment and recommend this to the patient. If you’re diagnosed with breast cancer, it’s therefore important to conduct a little research prior to your appointment – so you’re better educated on what to expect.

Personal treatment plan

Scientists suggest breast cancer is more likely to be found in those who have had first-degree relatives also diagnosed. As such, if breast cancer has been in the family it’s recommended to have early screening tests.

Breast cancer surgery

In most cases, a mastectomy will be recommended. This removes the entire breast (and sometimes the nipple, lymph nodes and muscle underneath). This will leave the patient with a scar across the chest and indentation, highlighting where the breast once was. Patients will then be discharged from hospital within one to three days, though it could be several weeks before men can start completing strenuous activities.

Radiotherapy treatment

Radiotherapy releases high energy waves as a means to destroy cancerous cells in the body. It’s designed to work in conjunction with surgery, in that radiotherapy will be later used to prevent the cancer from returning. Treatment can be across a number of weeks with each session lasting just 10-15 minutes each. Whilst not painful itself, there are side effects to be aware of, such as tiredness, nausea and skin irritation. Radiotherapy can also be used as a way to reduce the spread of cancer in terminal cases.

Hormone therapy

Cancerous cells require oestrogen to continue growing and spreading across the body, so one form of treatment is to reduce the level of oestrogen found. Although men have smaller levels of oestrogen than women, it is still present. Hormone therapy blocks oestrogen in the breast tissue and can be used both after surgery or as a way to limit the growth in terminal incidents. Hormone therapy medication includes tamoxifen and aromatase inhibitors.

Chemotherapy

If hormone therapy isn’t recommended because it would be ineffectual, chemotherapy will likely be the alternative treatment. It can be used post-surgery and on patients who have terminal cancer. Chemotherapy typically lasts up to six months, with appointments on a two to three-week basis. It can be provided by tablets or injections, with a number of symptoms common, including sickness, diarrhoea, loss of appetite, ulcers, rashes, infertility and hair loss. These symptoms should start to fade once treatment has concluded.

Biological therapy

The purpose of biological therapy is to block biological processes that cancerous cells rely on to grow and reproduce. Sessions are usually scheduled in once every three weeks for those with early symptoms. There are a number of side effects though and treatment is known to cause an allergic reaction. Trastuzumab is one such form of biological therapy, admitted though a drip, before targeting and destroying cancer cells.

GO TO THE CHAPTER 3: Breast Cancer Awareness Month & useful links