Not just women: What you may not know about breast cancer in men

Every October marks breast cancer awareness month. And with almost one in 13 women likely to get breast cancer, according to Singapore Cancer Society, much emphasis is usually given to encourage women, especially those who are older to go for regular mammograms to detect the possibility of breast cancer. 

But breast cancer is not exclusive to women; men can get it too. 

According to Dr Tan Chuan Chien, head, division of breast and endocrine surgery at Ng Teng Fong General Hospital, "breast cancer in men accounts for about one per cent of all diagnosed breast cancer patients".

Men with breast cancer

While only five to 10 per cent of breast cancer in women can be attributed to genes, up to two-thirds of males with breast cancer are found to have a hereditary cancer gene and usually have a strong family history of breast cancer, says Mount Elizabeth Hospital breast surgeon, Dr Tan Yah Yuen. 

Male breast cancer tends to be diagnosed at a later stage of the disease, where the tumour size is larger and the cancer has potentially spread to the lymph nodes and distant organs by the time it is discovered, she adds. 

Like in women, breast cancer tends to develop in the later years in life for men. 

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"Essentially cancer develops due to mutation in breast cells, and such mutations are more common as a person grows older," says Dr Tan Yah Yuen. 

"Also, the natural defences of a person to fight abnormal cells decreases as a person ages, especially when there are also other premorbid co-existing diseases," adds Dr Tan Chuan Chien.

The symptoms are also similar in both sexes — a lump that can be felt in the breast, abnormal bloody nipple discharge or nipple retraction. For Dr Tan Chuan Chien, most of the male breast cancer patients he has treated had a breast lump in the retroareolar region, behind the nipple. 

"However, because there is usually not much breast tissue in men, there is a tendency for the tumour to have infiltrated to the chest wall or even skin before it is discovered, especially since men are often not on the active lookout for breast symptoms," says Dr Tan Yah Yuen.  

"Hence, men are also more likely to have skin changes from the tumour, such as puckering of overlying skin."  

Treatment and recovery options

Treatment options don't vary between men and women, and whether surgery, chemotherapy, radiotherapy or endocrine therapy is advised is dependent on the stage of cancer. However, "surgeons tend to recommend removal of the entire breast (mastectomy) for men as preservation of breasts is not usually an issue for men," shares Dr Tan Chuan Chien. 

The nipple is also always completely removed during surgery for men, adds Dr Tan Yah Yuen. Men are also more likely to be somewhat embarrassed by the removal of their breast, rather than feel upset about losing their breast compared to women, she adds. 

And while men seem to have a "lower unadjusted rate of overall survival than women with breast cancer", this is primarily due to the "later advanced stage of presentation for men as compared to women", shares Dr Tan Chuan Chien. 

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Breast Cancer Awareness Month takes place every October. As breast cancer is the number one cancer affecting women in Singapore and early detection can save lives, women are encouraged to do a mammogram screening for just $25 for Singapore citizens. Visit pinkribbonsingapore.org for more information on the various activities taking place to raise awareness for breast cancer.

kailun@asiaone.com