By Julie Van-Lare, RN, MSN
Heightening attention to male breast cancer is an issue of great importance.
Many people are still unaware that men can develop breast cancer. Many doctors are unaware of male breast cancer. The campaign’s slogan of the National Breast Cancer Awareness Month is “Pass the word that early detection saves lives”. As a health care provider and as one monitoring the trend, There is a great deal to be done to launch this message into the community. Every opportunity must be taken to make the public aware that the incidence of male breast cancer is increasing.
It is true that far fewer men develop breast cancer. The American Cancer Society (ACS) estimates that in 2006 some 1690 new cases of invasive breast cancer in men will be diagnosed in the United States. Of those, around 460 are likely to die.
Men have breast tissue and like women can develop breast cancer. What is alarming is male breast cancer has increased 50 % in the last five years according to the National Cancer Institute (2006). A family history of breast cancer is the most common risk factor.
In many ways the disease appears similar in both sexes. The reason we do not hear about the disease in men is simply because it occurs less frequently in men. Male breast cancer is rare. Researchers have had a hard time studying the disease and the effect it has on the larger community.
The most common kind of cancer in men is found in the breast ducts.
During the last decade, regular breast cancer screening has gained wide acceptance by women and physicians, data supporting the efficacy of screening like mammography have undergone intensive re-examination, and the benefits of regular mammography havebeen affirmed. Although the use of screening mammography has increased the number of male breast cancer found before they cause any symptoms, some are still missed. Themost common sign of breast cancer is a painless, hard lump or mass, some rare cancers are tender and soft. So it is very important to have anything unusual checked by a health care provider. Early detection of breast cancer saves lives.
Other signs of breast cancer are:
-A swelling of part of the breast
-Skin irritation or dimpling
-Nipple pain or the nipple turning inward
-Redness or scaliness of the nipple or breast skin
-A nipple discharge other than breast milk
-A lump in the underarm (armpit) area
Prevention is better than cure. Particularly because men are not routinely screened for the disease and don’t think about the possibility that they’ll get it. As a result, breast cancer tends to be more advanced in men than in women when it is first detected, treatment option is then limited. The earlier breast cancer is diagnosed, the better, so it is important to understand the risk factors for male breast cancer. It was frustrating to find that most information available on breast cancer research is specific to women. Male and female breast cancers do share many common features.
Although the cause of breast cancer remains unknown, but many studies have identified
several risk factors: -
Growing older: The median age of men diagnosed with breast cancer is about 67.
The chance of getting breast cancer goes up, as you get older, about 8 out of 10 breast cancers are found in women/men over age 50 (ACS).
Klinefelter Syndrome: This is a rare genetic condition where a man is born with an extra female chromosome. Klinefelter Syndrome is a condition present at birth that affects about 1 in 1,000 men. Normally men have a single X and single Y chromosome.
Men with Klinefelter syndrome have more than one X-chromosome (sometimes as many as four). For men who have this syndrome the risk of breast cancer is more than 20 times greater than average.
Family History: Sometimes breast cancer runs in families. This is called familial or hereditary breast cancer. The vast majority of breast cancers occur by chance and only a small number occurs as a result of a family history. However, familial breast cancer is more common in men, and it is thought that approximately 15 per cent of all breast cancers in men have a genetic link, compared to about 7 per cent in women.
A relative with positive genetic test for BRCA1 or BRCA2. (BR stands for Breast, and CA stands for Cancer), have an increased risk for male breast cancer. Men who carry a BRCA1 or BRCA2 mutation has an elevated risk of breast cancer
Radiation exposure: Having radiation therapy to the chest before age 30, and during adolescence may increase the risk of developing breast cancer. This has been seen in young people receiving radiation to treat Hodgkin’s disease. This increased risk is because of the known long-term effects of radiation on normal healthy tissue
High Estrogen Levels: Breast cell is stimulated by the presence of estrogen. Men can have high estrogen levels as a result of taking hormonal medicines
Obesity: Being overweight increases the production of estrogen.
Diseases of the liver: put men at risk for developing breast cancer because the liver plays an important role in sex hormone metabolism. Alcohol limits the liver’s ability to regulate blood estrogen levels.
Unfortunately, men are often diagnosed at a later-stage of the disease when the cancer has already spread to other part of the body-because men do not think that they are at risk and are less likely to report any symptoms to their health care provider. As discussed earlier, the causes of most breast cancer are not yet known; therefore, the focus now is early detection. Early detection of male breast cancer saves lives. The earlier breast cancer is found the better the chances that treatment will work. Breast awareness and breast self-examination is very important. Data supporting the efficacy of regular screenings have undergone intensive debate during the past decade. The treatment options for male breast cancer have evolved in a way that mirrors female breast cancer treatment. In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop. The National institutes of Health, the National Cancer Institute, and the United Sates Preventive Services Task Force (USPSTF) has all published guideline
for screening women for breast cancer. Right now there is limited information present for screening male patients at high risk. Memorial Sloan-Kettering physicians have treated large numbers of male breast cancer patients over several decades, and are now planning a national registry for men who have undergone treatment for breast cancer.
There is no sure way to prevent breast cancer. Prevention is better than cure. Utilizing evidence based studies shows that a new treatment is better than the one currently being used. Hopefully, this awareness will encourage men to seek timely medical intervention, thus providing evidence for future research and recommendation.
References
American Cancer Society.
The National Cancer Institutes. (2006).
