Friday, July 11, 2014

Yes, a man can get breast cancer, too

October 07. 2013 6:29PM

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When most people hear that someone has breast cancer, they likely assume the victim is a woman.

That’s because breast cancer in men is so rare, but it does exist. And it can be deadly if men ignore the symptoms and wait too long to seek treatment, oncologists say.

If detected early enough, breast cancer can be treated with chemotherapy, said Dr. Chi K. Tsang, radiation oncologist and medical director at the Cancer Treatment Center at Hazleton.

“When we see male patients, they usually need radiation treatment” in addition to chemotherapy, Tsang said.

Breast cancer in men is “very, very curable,” said Dr. Victor Vogel, director of Breast Medical Oncology and Breast Research for Geisinger Health Systems.

“The problem is, men delay coming in. I had one patient who delayed, and by the time it became uncomfortable and painful, it had already spread to his bone and muscle,” Vogel said.

“Men are lousy patients. I understand it’s not a manly thing to have a lump in your breast tissue, but we’ve got to get men over that,” he said.

Breast cancer is associated with women because the ratio of female to male breast cancer patients is 100 to 1, Tsang said.

Fortunately for men, it’s easier to detect in males than it is in women because men have much less breast tissue, and the cancer “can’t hide as easily,” Tsang said.

Tsang said breast cancer in men presents itself as a lump or bump, usually under the nipple area. There also can be changes in skin surface or texture, nipple discharge or a dimpling in the nipple but not necessarily.

“It will feel like a ball bearing where there should be soft tissue,” Vogel said.

As for testing, typically doctors will order a mammogram. Sometimes a biopsy can be performed just with a needle, Vogel said.

A simple mastectomy can remove the breast tissue with the tumor. Radiation and/or chemotherapy could be necessary as well.

A male with breast cancer also will likely be prescribed a hormone called Tamoxifen, an aspirin-size tablet that must be taken daily for five years, to prevent recurrence.

The cause of male breast cancer in men, as in women, is largely unknown. But a large proportion — about 40 percent — have one of two predisposing genes, Vogel said.

During a biopsy of a male breast-cancer patient, an oncologist also should remove lymph nodes from under the arm to test for predisposing genes. If a man has either a BRCA-I or BRCA-II gene, there is a greater likelihood that family members could be predisposed to breast cancer as well, Vogel said.

“It’s imperative that any man with breast cancer see a genetics counselor,” he said.

Vogel said it’s “cheap and easy” to screen for male breast cancer unless the man is morbidly obese. “Simply run your fingers over a man’s chest and feel around for a lump or bump.”

Tsang said family doctiors also should check men over 40 during annual physicals, but many physicians have not been trained to check for breast cancer in men.

“It’s often the spouse who alerts her husband to a lump on his chest,” Vogel said. “And it’s the urging of the spouse that gets them to seek medical attention.”


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