Breast cancer in men

introduction

Breast cancer in men is a rare disease that is usually recognized relatively late due to the stigmatization that breast cancer only occurs in women. For example, in 2014 there were 650 men who developed breast cancer. For women, on the other hand, it is around 70,000 per year.
The age of onset in men is between 65 and 79 years.

What are the typical signs?

The signs of breast cancer in men are similar to those in women. The following signs usually occur:

• palpable lumps in the armpit and chest area
• asymmetrical skin changes on the chest
• Fluid discharge from the nipple
• Signs of inflammation such as redness, swelling, or overheating
• small wounds that no longer heal on their own
• Retraction of the chest wall in the form of dents

Please also read our pages:

• How do you recognize breast cancer in men?
• Lump in the man's chest

Concomitant symptoms

In the early stages, patients usually do not have any general symptoms. Only when the tumor has progressed and grows into other organs do other symptoms appear. Examples include:

• Weight loss
• Exhaustion
• fatigue
• Reduction in performance

In addition, there may be symptoms in the areas where metastases form. If daughter ulcers have formed in the lymph nodes of the armpit, the arm can swell, as water retention occurs as a result of the lack of removal of the lymph.
If there are metastases in the lungs, coughing and shortness of breath can result. With affected bones, patients often experience bone pain. If the liver is affected, the skin may turn yellow and liver function impaired, which can even lead to liver failure. Finally, metastases can also form in the brain, which then lead to neurological failures.

More information on this topic: Lymphedema of the arms

Is Pain a Symptom?

Pain is rather rare in breast cancer. The lumps that can be felt in the chest are swollen and thickened, but this is usually painless. Pain can result from inflammation in the area of ​​the tumor or when other organs are affected.

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therapy

The treatment of breast cancer in men is essentially no different from treatment in women. An operation is usually performed first to remove the tumor and suspicious lymph nodes in the armpit region. How much of the breast needs to be removed depends on how far the tumor has spread. Many men require complete breast removal. A reconstruction can also be carried out here, as with the woman.

Depending on how advanced the tumor was and how high the risk is that the tumor will come back, follow-up treatment is recommended.Here, either radiation therapy can be carried out in which the tumor region and the surrounding tissue are irradiated again to reduce the risk of recurrence, i.e. to keep the risk of relapse as low as possible.

Another option is chemotherapy, which affects the entire body and thus combats any small metastases that may already be present.
For many men, hormone therapy is also recommended for breast cancer, since men's breast tumors usually have at least one hormone receptor. This can then be specifically inhibited. so that tumor cells are targeted.

Breast cancer treatment for both men and women takes place in specialized breast centers. These are centers across Germany and elsewhere that specialize in treating breast cancer, and the doctors are usually gynecologists. Since the therapy in men does not differ from that in women, no additional doctor needs to be consulted.

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• Surgery for breast cancer
• Chemotherapy for breast cancer

causes

Some risk factors for breast cancer have been discovered that favor the disease in men, but do not explain all the cases that have occurred. With some patients, you simply don't know what the cause is.

One group of risk factors that are known are the genetic factors. On the one hand, the hereditary breast cancer form via the BRCA (Breast cancer gene) is one possibility. Some patients have this gene, which is a mutation that occurs in the DNA of all cells in the body and is thus inherited. Affected patients should therefore get tested for this gene, especially if there are other cases of breast cancer in the family.

Another cause of breast cancer in men can be the so-called Klinefelter syndrome. Here the man has an additional X chromosome and thus a 20-60 times higher risk of developing breast cancer.

Radiation exposure can also be a cause. This mainly affects men who, for example, were exposed to radiation on their upper body in childhood due to another cancer.

An increased production of the hormone estrogen can also be a factor. Men normally produce little of this hormone. However, overweight men, especially those who have abused alcohol, can produce increased estrogen production.

Read more information at: Breast cancer- these are the causes

diagnosis

On the one hand, there is the possibility of early detection in patients who are already at high risk. This is the case, for example, in the case of a family history of the mutation in the BRCA gene or in patients with Klinefelter syndrome. If the cancer is already present, it can usually be recognized by the classic lumps in the area of ​​the nipple and any skin changes on the breast.

If such changes are present, an ultrasound can be done to confirm the suspicion. In addition, every man should have a mammogram. This diagnostic means is a chest x-ray.

Since both ultrasound and mammography are somewhat less reliable in men than in women due to the different structure of the breast, the final diagnosis must be made through a biopsy. A biopsy involves taking a sample of tissue that is examined by a pathologist. It determines the growth pattern of the possible tumor and performs specific tests to detect hormone receptors (estrogen receptor, progesterone receptor, androgen receptor, etc.).

Then the lymph nodes are examined to see whether metastasis has already taken place.

This topic might interest you: Tumor markers in breast cancer

forecast

The chances of recovery are slightly worse for men than for women. The survival rate after 5 years for men is 78%, the 10-year survival rate is 65%. This is probably mainly due to the fact that tumors are often detected later in men, as there are no screening programs for men and both doctors and those affected often do not think of breast cancer first in men.

Therefore, by the time the diagnosis is made, many men already have metastases in the lymph nodes, which worsen the prognosis. Because most men have tumor types that have hormone receptors, targeted therapy can take place here, which, even if they cannot be cured, can significantly extend and improve life for many patients.

Also read our topic: Chances of recovery in breast cancer