The reality of male breast cancer

Editor's note: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon at Orlando Health and past president of the Florida Urological Society..

CNN
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A few years ago, I had a male patient who came to me complaining that his breasts had enlarged.

At first we thought it was a side effect of his medication for enlarged prostate. However, during the exam, I felt that something about one of them didn't suit me.

I decided to order a mammogram to find out more. As a result, an abnormal area was found, and the patient was consulted by a specialist.

What is this man's diagnosis? breast cancer.

Breast cancer in men is so rare that it can be misdiagnosed or overlooked. Early detection can save lives.

When most people think of breast cancer, they think of “pink” and female breast cancer. But the truth is that men develop breast cancer, too. men make up Approximately 1% Of all breast cancer cases, 1 in 726 men will be diagnosed during their lifetime. Although this diagnosis is rare in men, many men still develop breast cancer.

One of the biggest challenges with breast cancer in men is that it is often invisible. Many men are not aware that they can develop breast cancer, and there are no guidelines for regular screening like there are for women.

In fact, more 40% of male breast cancer cases are diagnosed at late stages (Stage 3 or 4). As a result, men receive more aggressive treatment than women due to delayed diagnosis.

Symptoms may be subtle, such as lumps, discharge from the nipples, skin changes, or swelling around the chest. If you notice any changes in those male chests, don't ignore them. It is always better to get tested.

mutation of BRCA1 gene and BRCA2 geneis more commonly associated with breast and ovarian cancer in women, but may increase the risk of breast cancer in men. Approximately 0.2% to 1.2% of men have BRCA1 and 1.8% to 7.1% with genetic mutation changes in BRCA2 You will get breast cancer by the age of 70.

in contrast, Approximately 0.1% of men The general population develops breast cancer by the same age. 7% to 8% of men have BRCA2 mutations The lifetime risk of developing breast cancer is much higher than that of the average male. Therefore, men with a family history of breast cancer, especially those with BRCA mutations, should consider genetic testing to be more sensitive to any changes in breast tissue.

Relationship between BRCA and prostate cancer

These same BRCA mutations also increase the risk of prostate cancer in men.

Recently, a young patient came into my office with the problem of prostate cancer, which many people at that age would not expect. His mother and sister had been diagnosed with breast cancer, and despite being in his mid-40s, he requested genetic testing for both the BRCA gene and breast cancer. prostate specific antigenor PSA, blood test.

While waiting for genetic test results, his PSA was higher than expected. At that point, genetic testing became less important. He underwent a biopsy, which confirmed he had early-stage prostate cancer. So if you have a family history of breast cancer, it's not just the women in your family you should be concerned about. Men in the family should also be involved in the conversation.

Comparison of breast cancer in men and women

Although there are similarities between male and female breast cancer, there are also some important differences. Because men have less breast tissue, cancer is often closer to the chest wall, which can affect how cancer spreads. of The 5-year survival rate for male breast cancer is approximately 77.6%86.4% in women, partially due to later diagnosis.

However, treatments such as surgery, radiation, and chemotherapy are almost the same for men and women. The big difference is awareness. Great work has been done to raise awareness of breast cancer in women, but men are often left out of the conversation. That needs to change.

Although there are no official guidelines for men's breast self-examination, men can take active steps to monitor their breast health through suggested self-examination methods. It is recommended that these tests be performed at the same time each month, perhaps at the same time as your monthly testicular exam.

First, stand in front of a mirror in your birthday suit (aka shirtless), place your arms at your sides and raise them above your head, and check for any abnormalities such as swelling, lumps, dimples, or changes in your nipples. For manual testing, lie down with a pillow under your shoulders and the arm on the side you are testing behind your head.

With your other hand, gently press your fingers in small circles all over the breast and under the armpit, applying varying amounts of pressure and lightly squeezing the nipple to check for any discharge. If you notice any changes or abnormalities, contact your health care provider.

Keep in mind that these self-examination steps are suggestions to help men identify potential problems early. Because such detection is critical, especially for men who are at higher risk due to family history or genetic factors such as BRCA mutations.

If an abnormality is found, the next step is usually a mammogram or ultrasound to further evaluate the lump. If the imaging tests suggest something suspicious, a biopsy is done. During a biopsy, breast tissue is analyzed under a microscope to determine whether it is benign or malignant.

Based on the biopsy findings, your doctor may discuss appropriate treatment options, including surgery, radiation, or other treatments, depending on the stage and type of cancer found on the biopsy and staging imaging. there is. All of these treatments are similar to those offered to women diagnosed with breast cancer.

Breaking down the barriers of gender and heart

There is an unfortunate stigma attached to male breast cancer. Many men are embarrassed or shocked by the diagnosis and may be reluctant to seek help early. But Cancer doesn't care about gender, and neither should you. Regardless of gender, early detection is the best way to fight this disease. The key is to be open about it.

The most important thing a man can do is pay attention to his body. If you notice a lump, pain, swelling, or change in your breast or chest, don't ignore it. Please consult your doctor. Also, consider genetic testing if you have a family history of breast or prostate cancer.

Breast cancer in men is rare, but that doesn't mean it's less serious. By raising awareness during this period, Breast Cancer Awareness MonthBy breaking down the stigma and encouraging men to talk to their doctors, we can catch cancer early and help men live longer lives.

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