Male breast cancer

The fear of cancer hangs like a Damocles' sword over humankind and the only ones who are probably spared are those who are ignorant of the dimensions of the disease and the impact it can have on people. The illness is enervating not just physically and mentally but financially too. In India where there are fewer support groups than in foreign countries, it can be a drain on a family's finances.

We have come across different types of cancers, the most common among women being the cancer of the breast. However, though infrequently, breast cancer can affect men as well.

To a layperson like me, this fact, to which I was introduced while surfing the Net, came as a shock. Firm in my belief that I did not belong to the class of 'medically challenged', I had prided myself on my knowledge of human physiology and the numerous diseases that attack it. Not any longer. Here are some details I discovered about male breast cancer.

The disease is apparently in many ways similar in the two cases. However, the fact that it is uncommon in men has made data gathering difficult. Men tend to be older than women at the time of diagnosis, with the result that the disease is at a more advanced state. One difference is that men are more unlikely to develop cancer in the other breast. Rather, they are prone to go in for a different type of cancer.

A painless lump, usually discovered by the man himself, is the first sign. It appears beneath the areola where the breast tissue is concentrated. However, most male breast cancers are not large. It does not follow that the small size of the male breast makes early detection possible. In fact, often it is the reverse - the cancer is found spread locally before diagnosis. And for this, the size of the breast could itself be a causative factor.

Lacking in bulk, the cancer can invade the tissues of the chest wall beneath it.

Almost all breast cancers in men are carcinomas. The most common is the ductal carcinoma but various sarcomas do occur too, though they are more rare.

Risk factors

The incidence of male breast cancer increases with age. It is rare before the age of 35. The average age is around 65, five years older than the average age for women. Abnormal hormonal activity, a factor linked to female breast cancer, could play a role in male breast cancer too.

Radiation exposure, which is associated with an increased incidence of breast cancer in women, is thought to play a role in the development of breast cancer in men.

Several cases were linked to childhood radiation for benign disorders of the chest and neck. However, an earlier theory that a history of trauma to the breast preceded diagnosis of male breast cancer was found to be more of a coincidence.

The same procedures used to diagnose breast cancer in women can be used in men - medical history, physical examination and mammography.

The prognosis for a man, as for a woman, depends on the extent and stage at the time of diagnosis. Features such as large tumour size, positive auxiliary nodes or ulceration are signs that the disease is likely to have spread.

Treatment and Rehabilitation

Treatment is generally similar in both male and female breast cancer. Mastectomy or surgical removal of the breast is the standard treatment, but in men a skin graft is often needed to close the wound.

This is followed by radiation and chemotherapy, the dosages of which will vary from individual to individual.

How do men cope with the illness? The rarity of the condition could leave them feeling lonely and helpless. Besides, afflicted by a disease that is predominantly associated with women the patient could take it as a threat to his masculinity.

And the loss of strength in the arm could incapacitate a man whose work involves physical activity.

Incidence

In the United States, male breast cancer accounted for one out of 100 cases of cancer in 1984. According to American Cancer Society, it is estimated that 1,400 men developed breast cancer in 1995.

However, it has been said in certain parts of the world the incidence of male breast cancer is more common than in the US.

What is the situation in India?

Chennaionline invites doctors, researchers and those afflicted with the illness to throw light on the subject and share their views -  editor@chennaionline.com 

Links:

http://interact.withus.com/interact/mbc/

http://breastdoctor.com/breast/men/cancer.htm

Sethulakshmy Nayar

Published on 29th May 2002

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