Male breast cancer is on the rise, say medics

Breast cancer, although predominantly a woman’s disease, can attack men too. According to medical literature, a one out of 100 breast cancer patient is a man.

However, city-based oncologists say that this number is gradually increasing, and now about 1.5% to 2% of all breast cancer patients are men.

Due to lack of awareness, this disease is often diagnosed late or misdiagnosed among men, leading to severe consequences, said doctors.

Men with mutation of the BRCA gene are more prone to developing breast cancer. These men also are likely to develop prostate cancer, explained Dr S Krishnamurthy, professor and senior surgical oncologist, Kidwai Institute of Oncology.

“Breast cancer is seen among older men, generally 70 years of age and above. As men get older, their testosterone level dips down and oestrogen levels become higher, leading to mutation of the BRCA gene,” explained Dr Krishnamurthy.

Unlike breast cancer in women, there is not much screening programme for men. “However, similar to breast cancer in women, this disease is genetic and thus the next generation is more prone to this disease if father, uncle or any man in the family has this disease. Unlike breast cancer in women, in men the cancer is easily visible. So one should consult a doctor immediately on viewing a lump or tumour in the breast,” said Dr Krishnamurthy.
Doctors feel that the main challenge in male breast cancer cases is an early detection.

“Usually, male breast cancer is diagnosed only at stage three and four when the disease has advanced much,” said Dr Radheshyam Nayak, medical oncologist, HCG. In his entire career, he has seen around 12 to 13 similar cases. But why is breast cancer in men diagnosed late? “The disease spreads quickly,” explained the doctor. “Since there is no fat in the male breast, the disease evades the chest wall and chest muscle fast,” he said.

Sometimes, they are also misdiagnosed with gynecomastia, a condition that leads to enlargement of male breasts. “By the time male breast cancer is detected, it already reaches an advanced stage. However, the disease is very much treatable,” said Dr Krishnamurthy. Treatment parameters are similar in men and women, including surgery, chemotherapy and radiation. However, in men since breast cancer is hormone-dependent, sometimes the removal of testes helps in managing the disease, he added.
However, early detection can only be possible with adequate awareness about the subject, said Dr Neelesh Reddy, medical oncologist, Columbia Asia Hospital. “Most of the male population today is unaware of male breast cancer. Thus, any swelling in the armpit or breast area is not taken seriously by them,” he said.
Who should take precaution? Men with family history of breast cancer in men should undergo a gene test to check the BRCA gene mutation, said Dr Krishnamurthy. Also, men with gynecomastia should check the BRCA gene mutation and should be extra careful, as gynecomastia is considered as a pre-cancer state, said Dr Radheshyam. These men are more prone to developing breast cancer, he added.     m_soumita@dnaindia.net