Men Should Be Aware of Breast Cancer Risk
Breast cancer not only affects women: about 900 cases of breast cancer in men were diagnosed in the United States in 1989, contrasted with about 150,000 for women.
“The association of cancer and the female breast is so strong that its occurrence in men may be overlooked until the disease is at an advanced stage,” said Dr. Daniel F. Roses, a cancer surgeon at New York University Medical Center. “Early diagnosis and treatment are essential to provide the best prognosis.”
A simple procedure that can be performed in a physician’s office can easily diagnose male breast cancer in its early stages.
“Unlike women, who have learned to become concerned at once when they detect a lump, men usually do not consider that something they feel in their breast may indicate a malignancy,” Roses said. “Because male breast cancer is relatively rare, the appropriate association is sometimes not made until the condition becomes more advanced.”
Breast cancer occurs at a later age in men than in women--typically, after age 60. In women, the most significant incidence rate begins at age 40. The diagnosis of male breast cancer is complicated by the relative frequency of benign male breast enlargement, called gynecomastia.
“Gynecomastia develops most commonly in normal males during puberty, between the ages of 12 and 15,” Roses said. “It usually resolves spontaneously in a year or two.”
It is not uncommon for adult men who are taking certain drugs, such as androgens, estrogens, digitalis, spironolactone, or tricyclic antidepressants, or for men with a variety of systemic diseases, to develop an enlargement of one or both breasts.
“There is no evidence that gynecomastia predisposes a man to breast cancer,” Roses noted.
“We do not recommend a monthly systematic breast self-examination for men, because that would imply a high incidence,” he said. “But when one considers how easy it is to do, it does makes sense for a man to check regularly for changes in that area.”
A painless mass is the most common sign of breast cancer in men, as it is in women. Any such lump should be immediately evaluated. More advanced signs include bloody nipple discharge and erosion of the skin around the nipple.
Mammography, in which breast tissue is X-rayed, and biopsy, in which tissue is examined in the laboratory, can be used to evaluate for breast cancer malignancy in men as in women.
If a mass is detected, fine needle aspiration, in which a sample of breast cells is removed with a syringe, can be used to diagnose any breast enlargement or lump.
Treatment for primary male breast cancer entails surgically removing the breast and axillary lymph nodes. Some men may require further treatment with either chemotherapy or hormone therapy.
