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Male Breast Cancer: How is it Different?

separator “What? You have breast cancer? Men can get that?” If you’re a man who’s got breast cancer, you’ve probably experienced that kind of reaction. Maybe you’ve even had that reaction about yourself.

According to Srinivas Boppana, M.D., radiation oncology, most men are shocked to hear they have breast cancer. “Some of them,” says Dr. Boppana, “even wonder whether they have female hormones circulating in their bodies, which is not the case at all. The prognosis for men with breast cancer is equivalent to that for women, but men often take the news harder.”

For some men who have breast cancer, it can be an isolating experience. Many people think breast cancer only occurs in women. Even the ribbons worn at breast cancer fundraising events are pink. There can be a feeling of shame or embarrassment. “Why did a guy like me end up with a woman’s disease?”

But breast cancer isn’t unique to women, as you’re probably finding out if you’ve been diagnosed with it. According to the American Cancer Society, breast cancer accounts for about 1 percent of all cancers in men. Some of the causes include:

  • Klinefelter’s syndrome
  • Testicular dysfunction and other problems that cause hormone imbalance
  • Previous radiation to the chest
  • Male or female family members with breast cancer
  • Becoming older (male breast cancer is diagnosed, on average, at age 65)

How gender makes a difference in breast cancer
Breast cancer, like any cancer, is generally easier to treat and cure if it’s detected early. In men, breast cancer can often be felt during a routine exam at an earlier stage than in women. That’s because men have so much less breast tissue than women, which makes it easier to detect small masses.

On the other hand, men usually don’t have routine checkups as often as women. So even though they may have a breast tumor that could be easily felt, they’re not going to the doctor for the exam.

But small breast size isn’t always an advantage. A tumor in a man’s breast doesn’t have to spread very far before it reaches the skin that covers the breast or the muscles that are underneath the breast. So frequently, breast cancer is in a more advanced stage when it’s detected in men.

Another difference in detection is that many men simply aren’t aware that they can develop breast cancer. Sometimes, a man knows that there is a lump or other mass in his breast, but he doesn’t even consider that it could be cancer. It’s also common for a man to feel embarrassed or ashamed about a breast lump, thinking that’s only something women get. So he avoids going to the doctor.

Stages of cancer: The stages of breast cancer are the same, whether the cancer is in men or women. And survival rates, which are based on the stage, are also the same for men and women. In other words, a man who has Stage II breast cancer that has spread to the lymph nodes has the same survival rate as a woman who has a similar stage of breast cancer.  You can read about breast cancer staging in our cancer e-magazine article entitled "Finding Out You Have Breast Cancer.

Treatment: In terms of the different treatments for breast cancer, radiation and chemotherapy are generally the same for men and women, because these treatments are based on the stage of the cancer. But if surgery is necessary, that’s where men and women may have different experiences. For most men who need surgery for breast cancer, the entire breast will have to be removed. This isn’t always the case for women, because there’s so much more breast tissue that it’s sometimes possible to remove the cancerous tissue while conserving some of the breast. Additionally, hormonal treatment may differ for men and women, depending on the type and stage of the tumor.

Men who have a family history of breast cancer or ovarian cancer could be at higher risk, just as women are. Some families have mutated forms of two genes, called the BRCA1 and BRCA2. This gene mutation increases the risk for breast or ovarian cancer. Men and women who have this mutation should talk with their doctors to determine how often they should be screened for breast and ovarian cancer. And men who develop breast cancer should be sure that their daughters are screened for the condition.

“Don’t bottle it up”
Dr. Boppana says that many men who have breast cancer tend to be secretive about it. “They don’t want anybody to know,” he says. “Sometimes, they feel like less of a man.” But keeping it a secret is the last thing anybody should do, says Dr. Boppana. “They should go to a support group for cancer patients,” he says, and not focus on the fact that it’s so rare for men to have breast cancer.

The American Cancer Society; The National Cancer Institute; Srinivas Boppana, M.D., Radiation Oncology.
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