Breast cancer affects millions of people worldwide. October is observed as Breast Cancer Awareness Month with the aim to increase awareness about the disease and raise funds for research into its cause, prevention, diagnosis, treatment, and cure. And while the majority of those diagnosed with breast cancer are female, it can also be a health risk for men.

Understanding breast cancer

"Breast cancer is often considered a women’s disease, but men can develop it too. Though rare, accounting for 0.5–1 percent of cases globally, it still affects thousands of men each year. Male breast cancer occurs when abnormal cells grow uncontrollably in the small amount of breast tissue men have, with invasive ductal carcinoma (IDC) being the most common type," says Dr Ramesh Sarin, senior consultant, surgical oncologist, Indraprastha Apollo Hospital, New Delhi.

Although breast cancer in men is uncommon, understanding the symptoms and risk factors can lead to early detection, improving the chances of successful treatment. Dr Malay Nandi, group director, Haemato Medical Oncology, Yatharth Super Specialty Hospital, Noida Extension says, "Breast cancer in men is a rare but serious condition. Although it predominantly affects women, men also have a small amount of breast tissue and are susceptible to developing breast cancer. Early detection is key to effective treatment, making awareness of symptoms and risk factors crucial."

Like women, men should check their chests regularly for symptoms. As with all cancers, early detection is key. However, a diagnosis of any kind of cancer is often overwhelming and confusing, let alone breast cancer in men. Therefore, it is important to stay educated on the causes, symptoms, and available treatments.

Awareness can cause early detection, counter stigma

One of the biggest challenges in addressing male breast cancer is stigma. "Men often feel embarrassed by a diagnosis associated with women, which can delay diagnosis and treatment. Educating the public, encouraging open discussions about men’s breast health, and supporting diagnosed men are key to breaking this stigma," says Dr Ramesh Sarin.

According to him, by breaking the stigma and raising awareness, we can ensure better support and outcomes for men facing breast cancer. Breast cancer is a human issue, not just a women’s one, he adds. “Including men in breast cancer campaigns, encouraging healthcare providers to discuss the issue, and sharing survivor stories are effective ways to highlight this often-overlooked condition. Treatment for male breast cancer is similar to that for women and may include surgery, radiation, chemotherapy, or hormone therapy, depending on the cancer’s stage,” says Dr Ramesh Sarin.

Many men are unaware they can get breast cancer, leading to delayed diagnoses. "However, early detection significantly improves survival rates. Risk factors include age, family history, genetic mutations like BRCA1 and BRCA2, obesity, liver disease, and prior radiation exposure. Symptoms to watch for include a lump in the breast, skin changes, nipple discharge, or inversion. While not all lumps are cancerous, any unusual changes should be checked by a doctor," adds Dr Ramesh Sarin.

Effective breast cancer treatment

Regarding treatment, the principles of systemic treatment — including chemotherapy, targeted therapy, and radiotherapy — are similar for both males and females.

Dr Malay Nandi says, "In terms of surgical intervention, a total mastectomy is performed in all cases of male breast cancers, whereas breast conservation surgery may be an option for selected patients in women. Men should consult an oncologist whenever there is any abnormality in the breast that could be due to cancer. Due to the smaller size of male breast tissue, the disease tends to be diagnosed in advanced stages more often than in women. However, about 80 percent of male breast cancers are hormone receptor-positive, making them biologically less aggressive, even though the disease stage is often locally advanced."

The exact cause of breast cancer in men remains unclear, but several factors can increase the risk; Dr Malay Nandi lists them and much more:

Symptoms

1. Lump or swelling: A painless lump or thickening in the breast or chest area is the most common symptom.

2. Changes in breast shape or size: This could include swelling or shrinkage of one side.

3. Nipple abnormalities: Redness, scaling, or inversion (nipple turning inward).

4. Discharge from the nipple: Any fluid discharge, especially if it contains blood, should be examined by a doctor.

5. Skin changes: Dimpling, puckering, or redness of the breast skin.

Causes

1. Age: The risk increases with age, particularly for men over 60.

2. Family history: A family history of breast cancer can elevate risk.

3. Genetic mutations: Inherited mutations in genes like BRCA1 and BRCA2 can increase susceptibility.

4. Hormonal imbalances: Conditions that increase estrogen levels, such as liver disease or obesity, can heighten risk.

5. Radiation exposure: Prior exposure to chest radiation for other cancers may raise the likelihood of developing breast cancer.

6. Testicular conditions: Issues like undescended testicles or orchitis can increase risk.

Precautions

1. Regular self-exams: Men should perform regular self-checks to detect any abnormalities in the breast tissue or chest area.

2. Awareness of family history: Knowing your family’s cancer history and discussing it with a doctor can lead to early screening if necessary.

3. Limit alcohol consumption: Excessive drinking is associated with a higher risk of breast cancer.

4. Maintain a healthy weight: Obesity is linked to higher estrogen levels, which can contribute to the risk.

5. Monitor testosterone levels: Men with low testosterone should monitor hormonal changes closely, as this could increase breast cancer risk.

Prevention

1. Healthy lifestyle: Maintaining a balanced diet, exercising regularly, and avoiding tobacco use can help lower the risk.

2. Regular screenings: Men with a high risk due to family history or genetic mutations should discuss screening options, such as mammograms or genetic testing, with their doctors.

3. Limit radiation exposure: Avoid unnecessary radiation exposure to the chest area.

4. Early treatment of hormonal imbalances: Addressing hormonal disorders like hypogonadism or liver conditions early can help reduce risk factors.

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