Breast cancer is often entirely associated with women, but breast cancer is a disease that can affect anyone regardless of their gender. Better Healthcare explains how breast cancer can affect all of us.
Despite beliefs to the contrary, breast cancer is a disease that can affect any of us. While women are far more likely to be diagnosed than men, with up to 62,000 women diagnosed in the UK annually, it’s understood that just under 400 men are diagnosed with breast cancer in the UK every year too. This is because we are all born with breast tissue and, as such, this makes breast cancer possible in everyone. Because diagnosis in men is so rare when compared to women, it doesn’t receive anywhere near the same level of attention.
However, there are definitely risk factors that increase the chances of men being diagnosed with breast cancer. In this article, Better Healthcare is going to walk through some of these risk factors, the signs of breast cancer in men, and what treatments and services are available for men who are diagnosed with breast cancer.
Risk factors and causes
While the exact cause of breast cancer in men is not entirely known, a number of risk factors have been identified. We discuss them below.
Being over the age of 60
There is a relationship between breast cancer in men and getting older. This is because the majority of men diagnosed with breast cancer are between the ages of 60 and 70.
Elevated oestrogen levels
Oestrogen is the primary hormone that can drive the development of breast cancer. While it is often associated with the development of female characteristics, oestrogen is produced in everyone’s body; in the same way that testosterone, the hormone primarily associated with the development of male characteristics, is also present in everyone’s body. While men tend to produce less oestrogen than women, there are a number of conditions or factors that could affect that balance.
Men who are obese or overweight may produce more oestrogen. Certain conditions may also affect the production of oestrogen. Men with Klinefelter syndrome (when a male is born with an extra X chromosome) can result in lower testosterone levels and, as such, an increase in gonadotrophin levels (which can lead to an overproduction of oestrogen). Additionally, men living with chronic liver damage, such as cirrhosis (scarring of the liver), may produce more oestrogen too.
Transgender people who identify as men, masculine or non-binary may also have higher levels of oestrogen and breast cancer risk factors than cisgender (people who identify with their sex assigned at birth) men and, as such, it may be worth discussing the possibility of these breast cancer risks with a doctor. However, if they are undergoing hormone therapy, these risks are still lower than cisgender women. Trans women or transfeminine people assigned male at birth who later transition, or are transitioning, may also be at a higher risk of breast cancer due to higher oestrogen levels that come from taking hormone replacement therapy (HRT). While one 2019 study in the Netherlands showed that the risk of breast cancer in trans women is approximately 47 times that of men, mostly due to HRT, the risk of breast cancer still isn’t as high as it is for cisgender women. The NHS is currently reviewing how to proceed with breast cancer screening for transgender people. These risks may also be present for some intersex people who take hormones that can increase the risk of developing breast cancer.
Men who have been exposed to radiation over time have an increased risk of developing male breast cancer, particularly if radiotherapy has directed towards the chest (as is the case during treatment of Hodgkin’s lymphoma). Often this risk is more pronounced if the exposure took place when the person was younger.
Genes, racial factors and family history
Family history may indicate whether or not a man is more at risk of developing breast cancer. If a close female relative, such as a mother or sisters, have developed breast cancer, then they may be at more risk – particularly if the family member(s) was diagnosed with the disease while under the age of 40. It’s thought that approximately 10% to 20% of breast cancer in men is as a result of inherited altered genes. The most common of these genes are BRCA1 and BRCA2 (with BRCA being derived from BReast CAncer), with the latter more likely to cause men to develop breast cancer. It is worth noting that children of a person with these genes has a 50% chance of also inheriting them.
Some studies have also noted that certain racial groups may be more at risk than others, with both men of sub-Saharan African and Ashkenazi Jewish descent thought to be more at risk of developing breast cancer.
What are the signs?
Many of the signs and symptoms of breast cancer in men are similar to that of breast cancer in women. Invasive breast carcinoma (no special type or NST) is the most common of breast cancers in both men and women. However, men who develop breast cancer may also be diagnosed with more rare forms of cancer, such as ductal carcinoma in situ (DCIS) or Paget’s disease of the breast.
The most common symptom is a painless, hard and fixed lump in the breast region, often by the nipple due to most men’s breast tissue being underneath the nipple. Other symptoms may include:
- An inverted nipple (when the nipple turns inwards, may be tender)
- A rash or ulcer sore surrounding the nipple that does not go away (even with topical treatment)
- Nipple discharge (fluid or liquid that oozes from the nipple and may contain blood)
- Swollen chest and armpit glands (bumps in the armpit)
- Swollen, discoloured or hard nipples (often red)
It is worth noting that men’s breast tissue can become enlarged as a result of a rare, benign condition known as gynaecomastia. If you identify any of these symptoms, it is best to talk to your GP as soon as possible. While it is unlikely that the cause is breast cancer, treatment for breast cancer is more successful if it has been identified early enough.
Treatments for breast cancer in men
Treatment depends on how far the cancer has spread, the type of breast cancer and how the cells appear under a microscope. You may be offered multiple treatment plans, along with the full information surrounding each treatment plan, to allow you to make an informed decision about the way forward. Treatment for breast cancer in men comes in the form of either chemotherapy, radiotherapy, targeted drug therapy, hormone therapy or surgery. You may only need one of these treatments, or you may need a combination of these treatments.
The most common form of treatment for breast cancer is surgery. This is often done to remove the whole breast, including the nipple, affected by breast cancer. This is known as a mastectomy. Additional surgery may be performed to help create a new nipple, however, this is optional and usually occurs some months after the mastectomy to allow for healing. For more information on breast cancer surgery, please read our previous blog on ‘What to expect after a breast cancer surgery‘.
Often performed after surgery, this can help reduce the chances of the cancer coming back or spreading any further. Chemotherapy is often performed if you are young, if the cancer is of a high grade, if the tumour is large and if there are cancerous cells present in the lymph nodes under the armpit(s). In some rare instances, chemotherapy may be performed before the surgery to help shrink cancer that has grown larger, making surgery easier to perform.
Irrespective of when chemotherapy is utilised, you will receive several sessions, lasting a few hours each time, where medication is injected directly into your vein. Each session is usually followed by a break from treatment for a couple of weeks to allow the body to recover. It can lead to many symptoms, such as feeling tired, sick or experiencing hair loss, but these symptoms are almost always temporary.
Like chemotherapy, this is often performed after the surgery to reduce the chances of the cancer coming back or spreading any further. Lasting for 3 to 6 weeks, you’ll either be given 10 or so minutes of radiotherapy every day from Monday to Friday, or on alternate days. While it isn’t as painful as chemotherapy, you may still experience some side effects such as feeling tired, sick or having sore skin.
Targeted drug therapy
If doctors find that you have a lot of HER2 receptors, you may be prescribed for targeted drug therapy. Most often, this comes in the form of a drug known as trastuzumab (with the brand name Herceptin) and it is commonly used after completing chemotherapy or radiotherapy. Treatments tend to last up to a year, with injections taking place in the hospital every 3 or so weeks. It can lead to a number of side effects including tiredness, diarrhoea or constipation, and an increased risk of infection.
If breast cancer cells are being encouraged to grow by the hormones oestrogen or progesterone, you may be prescribed hormone therapy. This is often a long-term treatment using the drug tamoxifen that can last upwards of 5 years. Side effects may be present, such as a lower libido (sex drive), erectile dysfunction, weight gains, insomnia, depression, nausea or hot flushes.
Coping with a breast cancer diagnosis
It’s not uncommon for men to be shocked, upset, confused or even feel embarrassed as a result of a breast cancer diagnosis. This is not only due to the misconception of breast cancer being a disease that only really affects women, but because much of the advertising and discourse surrounding breast cancer is quite feminine-coded (such as the usage of the colour pink which, in recent times, has been associated with femininity).
As such, it isn’t uncommon for men to feel isolated as a result of their diagnosis. Often this is due to the literature surrounding breast cancer being almost always associated with women. If you find that you are struggling to cope with the diagnosis, speak to your GP or your care team to see if there is additional advice and support available to you.
Additionally, support groups do exist to help men with the condition. Breast Cancer Now and Cancer Research UK’s Cancer Chat are great resources to not only allow you to chat with other people affected by cancer, but in helping to get in touch with other men also affected by breast cancer.
Getting through the treatment process with Better Healthcare
Going through treatment for breast cancer can be a difficult and sometimes lonely journey. No matter the treatment, there can be a number of side effects that make everyday living difficult – both mentally and physically. Day-to-day tasks can become really strenuous and, sometimes, even getting out of bed can be a challenge.
At Better Healthcare Services, our care team support people every day as they face the challenges of living with temporary or permanent conditions – including cancer. Our qualified, professional carers can come into the home and not only help you with the physical tasks that can take their toll – such as cooking and cleaning – but can grab what you need from the shops, head down to the pharmacy to get your prescription and can even offer you an ear to listen to your thoughts and concerns.
Our service is tailored to the needs of our clients, meaning that we can be there for as long or as little as you’d like us or need us to be there.