Symptoms of breast cancer in males. How it's different from females?

Breast cancer cases are being reported globally more than ever and it is the second most common cancer in women after skin cancer. Breast cancer occurs mostly in women and rarely in men, however, the awareness in males is less.

Breast cancer symptoms include a lump in the breast, bloody discharge from the nipple and changes in the shape or texture of the nipple or breast.

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The cases also occur in males, a report mentioned that about one out of every 100 breast cancers diagnosed in the United States is found in a man.

Though it is rare in men, but it may become critical if not taken properly in the absence of awareness and timely preventive measures. Male breast cancer forms in the breast tissue of men.

Dr Rajeev Agarwal, the senior director of breast surgery, breast cancer, cancer institute at the Medanta Hospital in Gurugram gave valuable inputs on this serious issue. Dr Agarwal weighed in on the symptoms of breast cancer in males and how it is different from females.

Question:How does breast cancer present in males?

Dr Rajeev Agarwal:Male breast cancer is a rare type of cancer that develops in men's breast tissue. Although it can happen at any age, older men are more likely to suffer from the same. The cells in almost any part of the body have the potential to develop into cancer and spread to other parts of the body. The breast cells start to proliferate uncontrollably with the onset of breast cancer. These cells typically develop into tumours, which are frequently felt like lumps and are visible on x-rays. However, the early detection of breast cancer in men increases the likelihood of successful treatment and prevents mortality.

Question:Explain the difference between male and female breast cancer.

Dr Rajeev Agarwal:Breast cancer can develop in any person; however, it is more common in females than males. The breast tissue in both genders is similar, however, men have mainly fat and fibrous breast tissue called stroma and their breast tissue lacks the specialized lobules, since there is no physiologic need for milk production by males.

Whereas women’s breasts mature during puberty, and they develop lobules and milk ducts to produce and carry milk after childbirth. Most breast cancers in women develop in these ducts and lobules.

Question:What are the symptoms of breast cancer in males, and how is it different from females?

Dr Rajeev Agarwal:The symptoms of breast cancer in men are by far similar to those in women. These symptoms include:

•Change in breast size or form

•A lump or swelling in the breast

•Redness or flaky skin in the breast

•Irritation or dimpling of breast skin.

•Nipple discharge and nipple Nipple inwardly turned

•Pulling in of the nipple or pain in the nipple area

Question:How is male breast cancer diagnosed and treated?

Dr Rajeev Agarwal:The diagnostic methods used for male breast cancer are similar to that of females. The doctor first examines the general health, including checking for symptoms similar to tumours or anything else that seems out of the ordinary. Based on the symptoms which could be indicative of breast cancer, the doctor conducts a number of diagnostic tests and procedures, such as:

1) Clinical breast exam:In this, the doctor examines the breasts and surrounding areas with his or her fingertips for lumps or other changes. Basis the examination, the doctor evaluates the size of the lumps, how they feel, and how close they are to the patient's skin and muscles.

2) Imaging tests:These tests help in producing images of the breast tissue that allow doctors to spot any abnormalities. Breast X-rays (mammograms) and ultrasounds, which use sound waves to create images are some examples of imaging tests.

3) Biopsy:Breast cancer can only be diagnosed definitively through a biopsy. During a biopsy, a doctor extracts a core of tissue from the suspicious area using a specialised needle guided by ultrasound or any other imaging test. The extracted samples are then sent to a laboratory for testing to determine whether the cells are cancerous. An analysis of the biopsy sample also helps in determining the type of cells involved in breast cancer, cancer's aggressiveness (grade), and whether the cancer cells have hormone receptors or other receptors that may influence the treatment options.

Post diagnosis, the doctor determines the stage of cancer which is done similarly to female cancer i.e. through PET scan, or ultrasound abdomen, chest x-ray and bone scan. Post this, a feasible treatment option based on the overall health and preferences of the patient is suggested to the patient. However, male breast cancer is often treated by surgery and may include other treatment methods as well, such as:

1) Surgery:The surgery helps in removing the tumour and surrounding breast tissue. The surgery involves - mastectomy i.e., removing all the breast tissues including the nipple and areola and sentinel lymph node biopsy i.e., removing of few lymph nodes if the cancer is found during the biopsy.

2) Radiation therapy:In this high-energy beams such as X-rays and protons are used to kill the cancer cells. In male breast cancer, it is often performed to remove the remaining cancer cells (if any) in the breast, chest muscles or armpit to prevent the recurrence of cancer.

3) Hormone therapy:In most cases of breast cancer in males the development or spread of the tumour is hormone sensitive. The hormone-sensitive tumour tends to have oestrogen and/or progesterone receptors in them. In such cases, hormone therapy as a treatment is suggested. The therapy includes medications such as Tamoxifen is used mainly to treat hormone receptor-positive breast cancer. However, the same should be taken only in consultation with the doctor.

4) Chemotherapy:Chemotherapy is performed to kill cancer cells by using medications. A doctor may recommend chemotherapy after surgery to kill the remaining cancer cells (if any) that might have spread outside your breast. The same may also be a credible option for men with advanced breast cancer.

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