Breast Cancer in Older Men

Breast cancer is not as common in men as in women, but there are 2400 cases diagnosed in men each year compared to 232,000 new cases of breast cancer diagnosed in women each year. Unfortunately, most men with a breast lump, bump, or discharge from the nipple will ignore the problem. As a result many men do not seek medical care and are diagnosed when the cancer is at a more advanced stage and is more difficult to treat.

The cause of breast cancer in men is not known. However, there appears to be a relationship between male breast cancer and an increase in estrogen in men. Estorgen is the hormone that is responsible for a woman’s breast development. Since men produce very little estrogen, men rarely get breast cancer. It is thought that the extra estrogen in men may be responsible for breast cancer. Also, breast cancer occurs in older men usually at the time that testosterone, the male hormone produced in the testicle, production is in decline.

It is rare for a man under age 35 to get breast cancer. The likelihood of a man developing breast cancer increases with age. But breast cancer is less common in men because their breast duct cells are less developed than those of women and because they normally have lower levels of female hormones that affect the growth of breast cells.

Most male breast cancers are detected between the ages of 60 to 70 years. Other risk factors of male breast cancer include: a family history of breast cancer in a close female relative, a history of radiation exposure of the chest, enlargement of the breasts following hormone treatment, a rare genetic condition called Klinefelter’s syndrome. severe liver disease. diseases of the testicles such as mumps orchitis, a testicular injury, or an undescended testicle. Another newly identified risk factor is an inherited mutated gene or the BRCA2 gene.

Most breast cancer starts in the lining of the milk ducts in the breast and then if undetected or not treated will spread to the lymph nodes under the arm.

The diagnosis is made by the physical examination of the lump or mass noted in the breast tissue. The diagnosis is made by a mammogram which is the same test used for women with a breast mass and is confirmed with a breast biopsy where a small piece of tissue is removed and examined under a microscope.

The treatment of breast cancer in men is based on the tumor stage which is determined by the size and a determination of how far the cancer has spread. A grade 1 tumor is not very fast growing whereas a grade 3 tumor is more like to grow and spread to the lymph nodes and other organs.

The breast cancer found in men is very receptive to an oral drug tamoxifen, which inhibits the action estrogen on the breast tissue. Tamoxifen works like key blocking a keyhole and stops breast cancer cells from multiplying or growing. The side effects of tamoxifen include hot flashes, decreased sex drive, weight gain, and changes in moods. These are the same symptoms that women experience during menopause.

Bottom Line: Breast cancer in men is not very common. However, if detected early it is curable. If you are a man or a woman and experience a new lump or bump in your breast, make an appointment and see your physician.

Neil Baum, MD

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA, and author of Marketing Your Clinical Practice: Ethically, Effectively, and Economically, Jones Bartlett Publishers. He is also author of Social Media For The Healthcare Profession, Greenbranch Publishing, 2011. He blogs at http://neilbaum.wordpress.com/