By Dr. Suraj Subramaniam – General Surgeon, Fortis Hospital, Vadapalani

Male breast cancer, it may sound strange, but it is true. While it is rare for men to get affected with breast cancer as female. All men produce a small amount of estrogen which is perfectly normal. When there is more estrogen secretion then the risk linked to male breast cancer increases. There are several factors lead to male breast cancer of which aging is the primary reason. Most breast cancers in men are diagnosed above the age of 60, at the advanced stage. The other reasons are family history, high radiation exposure, faulty gene, hormone therapy and so on.

The most worrying part is that the majority educated men too are not aware that breast cancer can occur in male too. In India there are perception that men won’t get breast cancer. Result, they visit the doctor when it is in full-blown breast cancer stage. Men are less suspicious of anything happens in chest area, so they could ignore identifying the lumps at early stage.  We need to be more vigilant and not turn blind eye to any breast lumps, also not feel shy to visit the doctor. Men who have female relatives, like mother or sisters, with breast cancer then they are at high risk of male breast cancer. The pacifying thing is that most male breast cancers respond better treatment than women, diagnosing early in an added advantage.

Symptoms of male breast cancer:

Male breast cancers most common symptoms include

• Painless lump in chest area or lower arm
• Fluid discharge from nipple which may or may not be blood stained
• Enlargement of breast or swelling
• Ulcer in the skin of the breast
• Rash or dryness or itching around the nipple
• Nipple pulled inward

These may be red flags to you. If you have any of the above symptoms visit your family doctor or general physician immediately. Do not hesitate or feel shame to talk to your friends and relatives, especially doctors. Detecting cancer early-stage results in better treatment response. Since the breast tissues is less in male, the prolonged delay will lead the cancer spread around the chest area and skin.

Lifestyle and male breast cancer:

Lifestyle of an individual has changed a lot over the years. Sedentary lifestyle with other factors like obesity, excess alcohol intake and smoking attributes to the risk of breast cancer at a younger age.  A decade ago, breast cancer was seen among the age group of 50-70 years which has come down to 40-50 years now.

• Though the incidence of male breast cancer is less compared to women, the causes are the same. Lifestyle changes that are recommended to women also applicable to men, mostly, to check the breast cancer. They are

• Limit alcohol intake: Pandemic has increased the habit of binge drinking. More alcohol means greater the risk of developing breast cancer; even small amount increases the risk.
• Maintain right BMI: Many medical theories connect obesity as a reason for 13 types of cancer. If you are obese workout a right strategy to reduce your weight. You can also reduce the daily amount of calorie intake and gradually increase exercising.
• Be physically active: High fat level increases the estrogen level, which in turn make the hormone receptor positive for breast cancer to develop and grow. Physically active will help to maintain healthy weight which in-turn prevent breast cancer
• Eat healthy diet: Healthy diet have strong connection in decreasing the risk of some types of cancer, heart disease and stroke. Include more plant-based foods like fruits and vegetables, whole grains, legumes, and nuts to your daily intakes.

Types of breast cancer in men:

Most breast cancers are carcinomas. The most common types of breast cancers in men are invasive ductal carcinoma, invasive lobular and ductal carcinoma in situ. The other less common types are sarcomas, Paget’s disease, phyllodes and angiosarcomas. These cancers start in the cells of the muscle, fat, or connective tissues. In some rare types of the cancer cells may not form tumor at all. Depending on the extent of the breast cancer the name changes.

Risk factors and survival rate:

The risk level will be high with

• One’s age
• Over radiation exposure
• Hormone treatment
• Klinefelter syndrome
• Family history
• Obesity
• Liver infection

For any cancer the survival rate is high when it is diagnosed early. The breast cancer survival rate is less in male when compared to female only because of lack of awareness and late diagnosing. There are incidences that doctor too gave antibiotic to early-stage symptoms and not diagnosing for male breast cancer in the beginning.

Diagnosing and treatment:

Ultrasound and/or mammogram technique will be used to scan the breast and lymph nodes to identify the breast cancer initially. Biopsy will be done to find out the specific type and stage of the breast cancer. The other tests to identify or measure the cancer spread include MRI scan, CT scan, bone scan, and liver scan.

The treatments for breast cancer in men is almost like those followed for women. Considering of the type, size, spread and grade the treatment may vary, like surgery, radiotherapy, chemotherapy, hormone therapy and targeted cancer drug therapy. In case the cancer has already spread or might recurred after treatment your doctor might recommend combined treatment therapies.

When compared to women, most male breast cancers respond well to the treatment. So, men should never fear or feel shame of admitting that they have a lump in the breast and talking to doctors, friends, and relatives about their breast cancer. Because of hesitation to speak about it, most cases are diagnosed in stage I and stage II.

Remember, breast cancer is the most treatable cancer with advanced techniques and targeted therapies, but early screening and intervention is critical. Please visit the doctor if you happen to encounter any one of the symptoms listed above and lead healthy and happy life.