Breast cancer is widely regarded as a disease that affects only women. But can men get it too? According to foreign media reports, Robert Fleghart, 62, of the United Kingdom discovered a small lump just beside his nipple after more than a week of chest pain that began when a friend playfully pinched it. Convinced that men could not develop breast cancer, he initially brushed off his concern — but the discomfort persisted and he eventually went to a doctor. At a nurse's suggestion, he underwent a mammogram, an X-ray examination used to detect lumps and calcifications in breast tissue. The results confirmed breast cancer, and the disease had already spread to one lymph node.
Breast cancer is not confined to women. Men can develop it too. Male breast cancer accounts for less than 1 percent of all breast cancer cases, and because public awareness is low and lumps are often mistaken for simple gynecomastia — a benign enlargement of male breast tissue — diagnosis is frequently delayed, making careful attention essential.
According to the US National Institutes of Health, male breast cancer represents less than 1 percent of all breast cancer diagnoses. Because awareness is low, it is often caught at an advanced stage. The average age at diagnosis is between 60 and 70, though the disease can occur at any age. Hormonal imbalances and mutations in the BRCA genes — which help repair damaged DNA and whose mutations are known to raise the risk of breast and ovarian cancer — are believed to be contributing factors.
Both men and women are born with the same basic breast structure. After puberty, female hormones drive the development of mammary glands and fatty tissue in women. In men, that development is comparatively limited, but the underlying glandular tissue, including the milk ducts, is still present.
"Breast cancer is a malignant tumor that arises from glandular tissue, and in men it tends to be diagnosed relatively late — typically in their 60s or 70s," said Chae Su-min, a professor in the breast surgery department at Kyung Hee University Hospital. "Beyond age, a family history of breast cancer, BRCA2 gene mutations, radiation exposure, obesity and changes in sex hormone levels can all serve as major risk factors."
The most common symptom of male breast cancer is a lump in the chest, and it must be distinguished from benign conditions. Gynecomastia typically develops as the glandular tissue beneath the nipple and areola enlarges; the lump usually feels soft or elastic and is tender when pressed. It most often appears symmetrically in both breasts, though it can occasionally affect only one side.
Male breast cancer, by contrast, typically presents as a firm, poorly mobile lump in one breast — most often beneath or around the nipple — and is frequently painless. "However, it is difficult to determine on your own whether a lump is cancerous based solely on how it feels or whether it hurts," Chae said. "If the lump is accompanied by bloody nipple discharge, nipple retraction, skin changes resembling orange peel, or enlarged lymph nodes in the armpit, the possibility of breast cancer should be investigated." He added that because men have less breast tissue than women, cancer can more easily invade surrounding structures such as the nipple, skin and chest wall. "If you notice any new change in the chest area, do not put off getting examined," he said.
Surgery is the primary treatment for male breast cancer, and a total mastectomy is the most common procedure. Depending on the location and extent of the tumor, breast-conserving surgery combined with radiation therapy may be considered for some patients. Chemotherapy, radiation, endocrine therapy and targeted therapy can also be used in combination, depending on the stage and biological characteristics of the tumor.
"Male breast cancer has a high rate of hormone receptor positivity, meaning cancer cells proliferate under the influence of female hormones," Chae said. "Adjuvant endocrine therapy after surgery — which minimizes hormonal stimulation — plays a key role in reducing the risk of recurrence, and tamoxifen is the representative drug recommended for this purpose."
When caught early, male breast cancer generally carries a favorable prognosis. If diagnosis is delayed, however, the risk of the cancer spreading to nearby lymph nodes and other organs increases significantly. "Men over 60, or those with risk factors such as a family history of breast cancer or known gene mutations, should monitor their chest area closely and consult a specialist if they notice anything unusual," Chae said. "In particular, men who carry high-risk genetic variants are advised to undergo genetic counseling, pursue genetic testing, and develop a tailored screening plan based on the results."
kty@heraldcorp.com
