Male Breast Cancer
While breast cancer primarily affects women, about 2,500 men are diagnosed with the disease in the United States each year.
The five-year survival rate for male breast cancer is slightly lower than for female breast cancer, as the chart below shows by cancer stage.
| Stage | Male survival rate (%) | Female survival rate (%) |
|---|---|---|
| Stage I | 87 | 90 |
| Stage II | 74 | 82 |
| Stage III | 57 | 57 |
| Stage IV | 16 | 19 |
There are a number of different reasons for the lower survival rate for male breast cancer patients. One is patient age, and the health challenges that come with that. At the time of diagnosis, the average age for a male breast cancer patient is 67, versus age 62 for females.
In addition, male breast cancer is typically more advanced when it is diagnosed. The tumor tends to be larger and the cancer is more likely to have spread to regional lymph nodes. Doctors attribute these later diagnoses to a general lack of awareness of male breast cancer, as well as the absence of widespread screening for the disease.
Types of male breast cancer
Like female breast cancer, male breast cancer can be classified by the molecular receptor status of the cancer cells.
Receptors are molecules that cancer cells produce on their surface. They can bond with, or recognize, specific proteins and hormones in the patient’s body. Researchers have identified receptors that fuel the growth of breast cancer cells when they bond with a specific protein or hormone. Interrupting this bond with cancer drugs can slow or stop the disease’s growth.
The three main receptor types for breast cancer (in both men and women) are:
- HER2-positive, a protein that promotes cell growth and multiplication. HER2-positive cancers have much higher levels of the HER2 protein than normal.
- Hormone receptor-positive, which recognizes the hormones estrogen and progesterone.
- Triple-negative, which doesn’t recognize HER2, estrogen or progesterone. Because there is no molecular receptor to interrupt, this is the most difficult breast cancer subtype to treat.
About 90% of breast cancers in men are hormone receptor-positive, while another 9% are both hormone receptor-positive and HER2-positive.
Male breast cancer treatment
Treatment for male breast cancer is very similar to treatment for female breast cancer. Options include surgery, chemotherapy, radiation therapy and targeted therapy. Because of the small breast size, most male breast cancer patients who get surgery undergo a full mastectomy (the removal of the entire breast) instead of a lumpectomy (the removal of just the tumor and a small amount of surrounding tissue).
Male breast cancer risk factors
Anything that increases the chance of a person developing cancer is a risk factor. Doctors have identified several risk factors for male breast cancer.
- BRCA mutations: Normal BRCA1 and BRCA2 genes suppress the development of tumors. People with a mutated BRCA gene have a higher risk of breast cancer. Between 8%-15% of male breast cancer patients have a BRCA mutation, compared to 5%-10% of female breast cancer patients. In addition to causing breast cancer, BRCA mutations are also linked to ovarian cancer, pancreatic cancer and melanoma.
- Family history of breast cancer: The risk of breast cancer is doubled for men who have a parent, sibling or child with the disease.
- Age: As men age, their chances of developing breast cancer increases.
- Obesity
- Gynecomastia, or enlarged breasts caused by a hormone imbalance or certain medications
- Radiation exposure, often as part of treatment for another cancer
- Race: African-American men have a higher risk of male breast cancer than non-Hispanic white men.
There are approximately 2,200 men in the United States who are
diagnosed with breast cancer each year, and I am one of them.
Until my diagnosis, I did not know men were susceptible to
breast cancer. Because the number of women with breast cancer is far
higher than the number of men, there is little mention of male
breast cancer in the media.
My male breast cancer diagnosis
My tumor was discovered by accident. I got a CT scan for a
cough, but the CT scan indicated a tumor located in my right
breast.
With a 99% probability that the tumor was benign,
I did not see cause for alarm. In fact, I did not tell my wife for
several weeks because I didn't want to cause her unnecessary worry. It
was not until I was scheduled for a core biopsy that I told her. In
retrospect, I made a bad choice.
The biopsy results were
conclusive: I had a small, malignant tumor in my right breast.
My male breast cancer treatment at MD Anderson
The decision about where to seek male breast cancer treatment
was easy. I wanted to be treated at a place whose staff had the most
knowledge of male breast cancer, which is extremely rare, occurring
only in ½ to 1 percent of men. I asked my doctor to contact MD
Anderson, and within two days, I was a patient of Gabriel
Hortobagyi, M.D.
By the third day, I was
undergoing diagnostic testing at Mays Clinic. On April 22, 2013, my
right breast was removed by my surgical oncologist, Barry Feig,
M.D. I am fortunate that my tumor was small (about a half-inch)
and had not escaped its boundaries, and my lymph nodes were clear.
During my mastectomy, however, it was necessary to remove three lymph
nodes as a result of vascular channel movement.
I did not
undergo breast reconstruction mainly as a result of my wife's and my
inability to choose either a large B or small C.
A low
chance of male breast cancer recurrence
After the mastectomy, tumor tissue was sent for DNA testing
under the Oncotype DX test. The results are calculated on a scale of 0
to 100, with lower numbers being best. My wait for the test results
was fraught with anxiety. Imagine my relief when my test results
number came in at 11. This gives me an 8% chance for male breast
cancer recurrence in the next 20 years. My only treatment now is
Tamoxifen.
I continue to receive what I call the
"best of the bad news." Because BRCA genetic mutations can
sometimes increase the risk for male breast cancer, I underwent
genetic testing for both BRCA 1 and 2 genetic mutations. I tested
negative for both. This meant I didn't have to get my left breast
removed.
Why I advocate for male breast cancer awareness
I know I am lucky. Many men are diagnosed too late when male
breast cancer has metastasized. Consequently, their prognosis is not
good.
This is why I want to establish a survivor support
team for male breast cancer survivors and be a cheerleader for male
breast cancer awareness.
I currently serve on the Patient
and Family Advisory Council at MD Anderson and volunteer with myCancerConnection, MD Anderson's one-on-one
support program that connects cancer patients and their caregivers
with others who have been there. I also am in the final stages of
approval to establish a survivor support team for male breast cancer
survivors.
When I talk to other male breast cancer
patients, I let them tell me their stories and vent. It is not always
easy to pull men into a conversation as personal as male breast
cancer, but given the right circumstances and opportunities, they will
usually open up.
After all, what better source of
information and comfort is there than someone who knows what it's like
to hear that you have cancer? Fear can be eased with knowledge.
Sometimes listening to another survivor is knowledge enough.
To connect with other cancer patients and caregivers through
myCancerConnection, please call 800-345-6324 or visit myCancerConnection online.