Time to speak of breast cancer in men

Doctors say it is equally important to discuss the same among men, adding that with most men being diagnosed late and the social stigma associated with it, it is imperative to spread awareness. 

Dr Anitha Ramesh, Professor and Head Medical Oncology, Saveetha Medical College and Hospital, has seen close to a dozen cases of breast cancer in men. What binds the cases together is the delay in approaching doctors. The symptoms are similar to that of women. An abnormal lump in the breast region, rashes, bleeding from the nipple etc. are signs of breast cancer. But, a lot of men do not identify these abnormalities at an early stage and they often go in for medical check-up when the symptoms become more severe and they realise that there is something wrong with their body. By then, the cancer may have spread fully. 

Dr Anitha says, “Many of them came in at advanced stages and this is largely due to lack of awareness. The lump is easily visible and can be noticed fast. As the tissues are fewer, it breaks the skin and bleeds . When it penetrates the chest wall and causes pain, the tumour becomes inoperable and results in advanced stage of cancer. However, such a situation can be easily avoided,” she says In many of the cases, there is considerable social stigma. “They either withdraw from the treatment or don’t want to get it addressed when they realise it is breast cancer. However, they must understand that it can be cured when treated on time. Time is the key here,” she adds. 

The survival rate depend on the detection of cancer at various stages, points out Dr Balaji R, Consultant Surgical Oncologist, Apollo Speciality Hospital, Vanagaram. “There is a survival rate of 90-95% in stage 1, 75%-85% in stage 2, 55%-65% in stage 3 and about 30% in stage 4. However, these survival rates may vary, as per the sub-type of the breast cancer,” he says. 

There are a number of reasons for the condition to surface in men. These include family history- if the individual’s sister/mother has breast cancer, then there are chances for the men to develop this form of cancer. The presence of excessive female sex hormones increases the chances for breast cancer. The consumption of alcohol and smoking affect the liver causing liver diseases which in turn increases the level of oestrogens (female sex hormones). Obesity is another factor that leads to more number of fat tissues in that region.   

Age is another major factor, as men above the age of 50 start facing the symptoms. “While men above 50 years of age are affected by it, those in their 40s, who account for 20% of the cases, are also showing signs of it, says Dr Balaji.” 

Diagnosis involves triple assessment- clinical examination, fine-needle aspiration cytology (FNAC), or biopsy and imaging , mammogram, ultrasound, MRI, PET CT scan etc. The treatment options include surgery - breast conservation with sentinel node biopsy and oncoplastic surgery, mastectomy, radiation – apart from accelerated Partial Breast Irradiation (APBI) and Intraoperative Radiation therapy. The treatment also involves chemotherapy, hormone therapy and targeted therapy, which includes precision therapy, say experts.