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Male breast cancer: What men should know

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male breast cancer what you should know.JPGBreast cancer is typically thought of as a woman's disease. But men develop the disease, too. And, due to a lack of awareness about male breast cancer, it's often found at later stages, when the disease is more difficult to treat.

We recently discussed male breast cancer with Sharon Giordano, M.D., chair of Health Services Research and associate professor of Breast Medical Oncology at MD Anderson. Dr. Giordano sees more male breast cancer patients than any other doctor in the world.

Here's what she had to say.

How common is male breast cancer?  

Male breast cancer represents approximately 1% of all cases of breast cancer. In the United States, 2,190 new cases of male breast cancer were expected to be diagnosed in 2012, as compared to 229,060 cases in women.  

What causes male breast cancer?  

The cause of male breast cancer is not known. Risk factors include a family history of breast cancer, prior radiation exposure and Klinefelter syndrome, which is the presence of an extra X chromosome in a man.

BRCA1 and BRCA2 mutations also are a risk factor for breast cancer in men. In particular, BRCA2 mutations are linked to male breast cancer. Men with a BRCA2 mutation may have close to a 10% lifetime risk of developing breast cancer. 

Obesity may increase a man's risk of breast cancer, too. In most cases, though, it's unclear what causes male breast cancer.  

Is male breast cancer preventable?  

For women at high risk of breast cancer, medications such as tamoxifen or raloxifene have been shown to reduce risk.  However, no specific treatment has been proven to reduce the risk in men.  

What are common symptoms of male breast cancer?  
The most common symptom is a painless lump under the nipple. If a man develops a lump under his nipple, he should be evaluated by his doctor.  

Often, a breast lump can be caused by a benign condition called gynecomastia.  Other symptoms of male breast cancer can include nipple inversion, pain, bleeding or skin ulceration.  

How is male breast cancer diagnosed?

Usually, male breast cancer is diagnosed after a man or his doctor discovers a breast lump. After finding that lump, a man should get a mammogram. Then, if findings are suspicious, a doctor will perform a biopsy to confirm the diagnosis.  

How is male breast cancer treated?

The treatment is similar for male and female breast cancer patients. One difference is that a class of drugs called aromatase inhibitors are rarely used in male patients. That's because there are a lot of questions about the effectiveness of these drugs in men.

Also, most male patients are referred to a genetic counselor to discuss BRCA testing.  

What are the survival rates and statistics for those diagnosed with male breast cancer?  

On average, men are diagnosed at an older age and at a more advanced stage of the disease than women. However, when comparing patient of the same age and the same stage, the survival rates are similar. Based on a previous study we performed, the 5 year overall survival rate was 63%.

If a man has breast cancer, are his female relatives at higher risk of breast cancer? What about his male relatives?  

Yes, close family members of a man with breast cancer are at slightly higher risk of developing breast cancer. The risk is highest if the man carries a BRCA mutation.  

What advice would you give to male breast cancer patients and survivors?  

If they feel isolated, men should reach out to other male breast cancer survivors. They also should feel encouraged that researchers are banding together as an international community to improve our understanding of this rare disease and to work towards improving patient's treatment options and quality of life.

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