What Men Need to Know About Their Breast Health

June is Men's Health Month and while we talk a lot about the need for women to get regular screenings for breast cancer, men can be at risk for getting breast cancer, too.

Yes, men do have breasts, to the surprise of many men across the city and country. All men have a very small amount of breast tissue located in the same area as in women. Because it is so small, it is not noticeable for most men and is not traditionally associated with men. Because men do have breast tissue, even if it's just a small amount, they can develop breast cancer in their lifetimes. The risk for the majority of men is low. The American Cancer Society reports that the approximate risk for a man to develop breast cancer in his lifetime is 1 in 1000, compared to 1 in 8 for women. This is why men do not need to get screening mammograms like women.

Which men are at highest risk for breast cancer?

While most men will not experience breast cancer in their lifetimes due to the rarity of the cancer, there are certain men who are at higher risk to develop breast cancer.

Men with a family history of breast cancer or a known genetic mutation associated with breast cancer are at higher risk to develop breast cancer. The most well-known genetic abnormalities related to breast cancer are BRCA1 and BRCA2. According to the New England Journal of Medicine, men who have a BRCA1 mutation have a 1% risk of developing breast cancer and men who have BRCA2 have a 7% risk of developing breast cancer. This compares to the average male risk of 0.1%. Because men with these mutations are at significantly higher risk than the average man, the National Comprehensive Cancer Network (NCCN) recommends that men with BRCA mutations receive self-examination training and formal annual clinical breast exams starting at age 35. Men with BRCA2 should also consider evaluation with annual mammograms starting at age 50 or 10 years earlier than the youngest known man diagnosed with breast cancer in the family.

Denver Health provides genetic counseling and testing with a referral from a primary care physician. 

Men with elevated estrogen levels are also at increased risk for developing breast cancer. Conditions such as obesity, liver disease and Klinefelter syndrome can all raise a man's estrogen levels, as can testicular abnormalities, and can increase a man's risk for developing breast cancer. Prior radiation exposure to the chest has been shown to increase the risk for breast cancer. Lastly, black men appear to be more at risk than white men to develop breast cancer.

What does male breast cancer look like?

The most common symptom for male breast cancer is the development of a painless lump under the nipple. This is the location of the small amount of breast tissue in men and is where breast cancer typically develops. This lump can continue to grow in size and lead to nipple changes (including bleeding from the nipple), changes to the skin overlying the lump and surrounding area and also a noticeable lump in the armpit (an enlarging lymph node). A lump under the nipple is not normal for men and should be quickly evaluated by a doctor. Breast cancer in men is evaluated and diagnosed the same as it is in women. If a man feels a lump under his nipple or in his chest, a mammogram or chest ultrasound is the next step after he sees his doctor. If the results of the imaging are concerning, the lump should be biopsied to determine if it is cancer.

Prognosis and Treatment for Male Breast Cancer

Because the majority of men are not aware that they have a small amount of breast tissue and can develop breast cancer, men tend to be diagnosed at higher (more advanced) stages of their cancer compared to women. This results in an overall lower survival rate in men compared to women when it comes to breast cancer. When caught early though, treatment outcomes still are excellent for men. Breast cancer in men is typically treated using the same treatments as for women. For localized breast cancer, this often means surgical removal of the cancer with or without radiation after surgery. Men typically are then prescribed a medicine (either a hormone blocking pill called tamoxifen, chemotherapy, or both) to help prevent the cancer from coming back. 

What Men Can Do about Their Breast Health

• If you have a relative that was diagnosed with breast cancer (man or woman), speak to your doctor about genetic testing. You may qualify to be evaluated for a genetic condition that can cause breast cancer, allowing you to pursue screening if indicated.
• If you are diagnosed with BRCA 1 or 2, be intentional about following NCCN screening guidelines. Learn how to do a proper self-examination, follow up with a doctor annually, and start screening mammograms at age 50 or 10 years earlier than the youngest known man diagnosed with breast cancer in the family.
• If you have higher than normal estrogen levels or a condition that raises estrogen levels in your body, or have prior radiation to the chest, be aware that this may increase your risk of breast cancer.
• If you notice a lump under your nipple, in your chest or in your arm pit, go see your doctor quickly to determine if it needs to be further evaluated with imaging and a biopsy.

Talk to your doctor and call 303-436-4949 to schedule your mammogram with Denver Health today.