Breast cancer in men

Men also have mammary glands, which are somewhat different from women's, but they can also develop malignant tumors.

Breast cancer is not often diagnosed in men, it was previously believed that this type of cancer is worse for men, but recent studies have shown the opposite and, as it turned out, both sexes have equal chances of recovery. In ICD 10, breast cancer is listed under the code C50 (malignant neoplasms of the mammary gland).

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Causes of breast cancer in men

The true causes of tumors in the mammary glands in men remain unclear, but experts identify the following risk factors that contribute to the development of cancer. Breast cancer in men, as in women, depends on hormones. Age also affects the development of oncology - the older a person is, the greater the risk of developing cancer (usually cancer is detected in patients over 68 years old).

At risk are patients with a "heavy heredity" - every 5th patient diagnosed with breast cancer had a close relative suffering from a similar disease. In addition, specialists have found that with mutations in the BRCA2 gene, the risk of developing cancer is significantly higher.

Another risk factor is considered to be a rather rare hereditary disease – Klinefelter syndrome, which is characterized by an excess of female sex hormones, enlarged mammary glands, sometimes infertility, and small testicles.

Risk factors also include:

• radiation emission
• alcohol abuse
• liver diseases
• taking hormonal drugs (especially female sex hormones)
• excess weight
• testicular removal
• work in hazardous production

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Pathogenesis

Typically, breast cancer in men begins to develop in old age, usually against the background of gynecomastia.

Male mammary glands are considered to be vestigial organs, i.e. they have lost their purpose during evolutionary development. Sometimes lifestyle or taking certain medications can disrupt the balance of hormones in a man's body and lead to an increase in the level of female hormones, which causes the growth of the mammary gland (one or both).

The cancer process begins to develop in men after the onset of male menopause (andropause), with the location of the testicles outside the scrotum (undescended, absent, etc.), androgen deficiency, testicular atrophy, hormonal imbalance. In the pathogenesis of oncology development in men, a hereditary factor, frequent injuries, and metabolic disorders are also noted.

Since men have small breasts, the tumor grows quickly and spreads to adjacent tissues, metastasizing to the lymph nodes.

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Symptoms of breast cancer in men

The development of cancer in a man may be indicated by the appearance of a tumor in the chest area that is easily palpated, soreness, retraction or wrinkled skin of the nipple, ulcers, peeling, redness on the skin in the area of the areola, nipple, compaction of the axillary lymph nodes on the side of the tumor.

If there is a suspicion of breast cancer in men, additional tests are prescribed to confirm the diagnosis.

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First signs

The first sign of cancer may be the appearance of a lump in the breast that is easily palpable. Men have much smaller mammary glands than women, so the tumor in most cases develops close to the skin and can be detected at the initial stages.

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Forms

The following types of cancer are detected in men:

• non-invasive ductal carcinoma - affects the ducts of the mammary gland, does not extend beyond the gland and does not affect fatty tissue, this type of cancer is treated surgically, in most cases a positive effect is achieved.
• infiltrating ductal carcinoma - the tumor grows into adipose tissue and metastasizes.
• infiltrative lobular cancer - affects the lobules of the mammary gland, fatty tissue, and is detected extremely rarely.
• Paget's disease - the tumor affects the ducts, nipples, or areola.
• Edematous-infiltrative cancer is a very aggressive form of cancer that is extremely rare in men.

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Complications and consequences

Breast cancer in men can metastasize to the liver, lungs, bone marrow and brain. Cancer intoxication of the body and progression of the disease itself can lead to death in a short time.

The main treatment for breast cancer is surgical removal of not only the mammary gland with the tumor, but also the adjacent lymph nodes. Removal of the lymph nodes leads to disruption of lymph flow, which can cause swelling and limited mobility of the arm, but by performing a certain set of exercises, you can fully restore mobility.

After radiation or chemotherapy, the skin may become flaky, red, and inflamed. After such treatment, you should avoid direct sunlight, limit contact with household chemicals, cosmetics (gels, lotions, deodorants) as much as possible, and wear clothes made of natural fabrics to avoid further irritation.

The main complication of this treatment is baldness, but after the end of the course of treatment, the hair gradually grows back.

Breast cancer in men, as well as in women, requires long-term treatment, and complications after it almost always occur. But with the right approach and adherence to the doctor's recommendations, the appearance after the course of therapy is quickly restored, and the patient's condition is normalized.

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Diagnostics of breast cancer in men

During the examination of the patient, the specialist assumes the development of breast cancer and prescribes additional examinations to confirm the diagnosis - mammography, ultrasound, biopsy, etc., which allows to establish the malignancy of the process and the stage of the disease.

Mammography is an examination of the breast using X-ray images, after studying which a specialist can confirm the suspicion of cancer.

Ultrasound is a widely used diagnostic procedure that is used to detect many diseases. The method is relatively inexpensive, simple and safe, based on the passage of ultrasound waves through the body's tissues and the creation of an image on a computer, which is used to assess the condition of organs and tissue structure.

If mammography or palpation reveals the presence of a tumor, ultrasound shows the nature of the neoplasm - a cyst or a solid formation. But this method does not allow determining the malignancy of the process.

Nipple discharge is sent for laboratory testing, which may reveal atypical cells.

A biopsy allows you to accurately determine the cancer process. A tumor sample is taken for examination. There are several diagnostic methods that are used depending on the case:

• needle biopsy – using a syringe, the contents are “pumped out” of the tumor, which is then sent to the lab to identify atypical cells. If the tumor is not palpable, the syringe is inserted under ultrasound or X-ray control.
• Stereotactic biopsy – involves examining several areas of the tumor; if the tumor is not palpable, the analysis is carried out under ultrasound or X-ray control.
• Incisional biopsy is a surgical procedure to some extent. A fairly large piece of tissue is taken for examination, usually this method is prescribed if a needle biopsy is not informative enough or the tumor is quite large. The purpose of this method is to establish a diagnosis, but not a treatment, since only part of the tumor is excised. After confirming the diagnosis, surgery is prescribed to remove the tumor.
• excisional biopsy is also a diagnostic operation, in which the tumor is completely removed from the mammary gland and sent for laboratory testing. The diagnosis is extremely accurate, but is not therapeutic; after confirmation of the cancerous process, an operation to remove the mammary gland is prescribed.

Magnetic resonance imaging is prescribed to determine the relationship of the tumor to deeper tissues. MRI results help the surgeon decide on the choice of surgical intervention and facilitate the process of tumor removal.

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Tests

Breast cancer in men can also be confirmed by a blood test.

To confirm the diagnosis, a specialist may order a genetic blood test to identify mutations in the genes responsible for normal cell division.

Usually, for this form of cancer, a blood test is prescribed for tumor markers Ca-15-3, BRCA, CEA.

A genetic blood test for BRCA is prescribed if the patient's relatives have suffered from breast cancer. The test allows determining the degree of risk of developing an oncological process. But it does not diagnose the disease.

Blood analysis for tumor markers Ca-15-3 is used to diagnose breast cancer. A high level of Ca-15-3 in the blood serum indicates the development of a pathological process, and, usually, metastasis.

This analysis is quite important and is also used to determine the effectiveness of treatment and relapses.

CEA (determination of the level of cancer embryonic antigen) allows to determine the cancer process of any localization, this analysis is the most common. An insignificant level of antigen is present in the cells of the pancreas, liver, gastrointestinal tract.

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Instrumental diagnostics

Instrumental diagnostics of breast cancer can be invasive and non-invasive.

Invasive methods, i.e. those requiring damage to the integrity of the skin and tissues, include various biopsy methods, while non-invasive methods (those that do not damage the skin and tissues of the body) include ultrasound, MRI, CT, etc.

At early stages, a modern diagnostic method can also be prescribed – positron emission tomography, which allows detecting the disease at an early stage, as well as suggesting where the cancer is metastasizing. This diagnostics allows preventing metastasis and starting a course of treatment in a timely manner.

If the patient is at risk (for example, genetically predisposed to cancer), the doctor may recommend a relatively new diagnostic method - using radioisotopes. This procedure allows you to detect the disease before the first symptoms appear, as well as determine metastases in any organs (even the smallest).

Differential diagnosis

It is relatively easy to detect breast cancer in men; by palpation, a doctor can distinguish cancer from other types of tumors (fibroadenoma, sarcoma, cyst, etc.). Cancerous nodes are harder to the touch, develop singly, and are connected to the skin and tissues.

In some cases, with deep-seated cysts, fat necrosis, inflammatory processes, and abscesses, additional examination is required to confirm cancer.

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Treatment of breast cancer in men

Treatment for breast cancer in men involves the same procedures as for women.

Treatment depends on the stage at which the disease is diagnosed (determined by the size of the tumor and its prevalence).

The treatment is chosen by the doctor, taking into account the type of cancer, stage and condition of the patient.

Most often, surgical removal of the mammary gland (including the nipple) is prescribed.

For invasive cancer, lymph nodes from the armpit are also removed.

Chemotherapy is prescribed after surgery to reduce the risk of recurrence of the disease. This type of therapy can be used when cancer cells are detected in the removed lymph nodes, the tumor size is more than 2 cm, in young patients, in the late stages of the cancer process.

Radiation therapy is given after chemotherapy and helps reduce the risk of cancer cells spreading throughout the body.

Hormonal therapy is prescribed to block estrogen and prevent the growth of abnormal cells. Taking hormonal drugs can reduce the likelihood of relapse.

Medicines

A course of chemotherapy may include such drugs as cyclophosphamide (intravenously, intramuscularly, the dosage is selected by the doctor individually, adjusted over time taking into account the clinical effect), methotrexate (tablets are taken at 15-50 mg for 5 days, usually several courses are required), fluorouracil (intravenously every other day, at the rate of 15 mg per 1 kg of weight).

Folk remedies

Cancer is treated mainly by surgery or the strongest chemotherapy drugs. In some cases, treatment can be supplemented with folk remedies that will help strengthen the general condition, which is important during chemotherapy and postoperative recovery of the body.

Traditional medicine recommends treating male breast cancer with burdock juice. To prepare the medicinal mixture, you will need 300-400 ml of burdock juice, 25 g of dark honey, and the juice of 3 lemons. Place all components in a dark glass bottle.

Before starting treatment, it is recommended not to eat meat for a week and do a cleansing enema. The mixture should be taken before bedtime, 15 ml for 12 days.

For breast cancer, it is recommended to take propolis - 5 g before meals. To get the maximum benefit from this substance, you need to chew it like gum.

Also, according to some data, propolis oil helps to get rid of breast cancer. You can prepare such oil yourself: bring 1 kg of butter to a boil, add 200 g of propolis, simmer for 30 minutes over low heat, after the contents settle, cool and take 15-20 g 3 times a day.

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Herbal treatment

Now in pharmacies you can find tinctures of medicinal herbs that will help the body resist cancer. Herbs can also be used for taking a bath, which significantly improves well-being. For a bath you can use celandine, burnet, bergenia, calendula, dill.

To strengthen the general condition and better resistance to the disease, you can prepare a medicinal collection of burnet, motherwort, dandelion, plantain, St. John's wort, oregano, string, birch, coltsfoot, thyme, celandine, immortelle, yarrow, immortelle, valerian roots, fennel, sage, nettle, angelica, eucalyptus, linden, chamomile, centaury, calendula, pine. All components are taken in equal quantities and 1 tbsp. of the mixture is brewed with 200 ml of boiling water, after 30 minutes the infusion is strained and drunk (can be divided into several doses).

The course of treatment is 3 months; after 2 weeks, if necessary, the treatment can be repeated.

Traditional medicine recommends treating male breast cancer with poisons - aconite dzungarian, red fly agaric, knyazhik sibirica. But it should be remembered that the dosage must be carefully observed, otherwise there may be disastrous consequences and you cannot combine poisonous plants, it is better to drink them in courses of 3 months with a 2-week break.

Tincture of aconite dzhungarian: 20 g of roots, 500 ml of alcohol (vodka), leave for 14 days and strain. Take strictly according to the scheme: 1 day - 1 drop, 2 day - 2 drops, 3 day - 2 drops (increase to 10), then also return back to 1 drop (i.e. 11 day - 10 drops, 12 day -9 drops, 13 day - 8 drops, etc.). Drink the tincture before meals 3 times a day. Dilute in 100 ml of water. Several courses may be needed until complete recovery.

Homeopathy

Homeopathy involves treating not a specific disease, but the body as a whole, strengthening and restoring its normal functioning so that the patient can overcome the disease on his own.

Homeopathic doctors use an individual approach to the treatment of each patient; in each case, specific drugs and dosages are selected, taking into account concomitant diseases, the patient’s condition, and the stage of the oncological process.

Homeopathic treatment for male breast cancer may include taking Arsenicum Album (a well-known remedy among homeopaths). The drug has antibacterial, analgesic, and antiseptic effects.

Even in the later stages, Arsenicum helps to significantly reduce pain and improve the quality of life of cancer patients.

Surgical treatment

Breast removal surgery is the most common treatment for breast cancer in both women and men.

Removal of the mammary gland (mastectomy) can be performed in several ways:

• Madden's method is the simplest and most gentle operation, which allows preserving the pectoral muscles and axillary lymph nodes. The operation is prescribed at the initial stages of the disease, and Madden's mammary gland removal can also be performed for preventive purposes (for example, in case of genetic predisposition).
• The Patey method involves removing the breast, the pectoralis minor muscle, and the axillary lymph nodes. If the surgery is performed early in the cancer's development, surgeons may remove one lymph node and send it for laboratory testing; if it turns out to be diseased, another surgery will be performed to remove the remaining lymph nodes.
• Halsted's method - removal of the mammary gland, pectoral muscles, lymph nodes, and adjacent tissue. Currently, such an operation is performed extremely rarely, since after such an intervention, a number of serious complications are observed, in particular, deformation of the chest, decreased mobility of the arm.
• Double mastectomy – removal of both breasts. This surgery is usually performed to prevent cancer from developing in the other breast.
• subcutaneous mastectomy - the operation is prescribed mainly to women, since after it it is easier to perform plastic surgery to restore the breast. This method is prescribed after histology.

Prevention

Since the exact causes of breast cancer are not known, experts recommend avoiding any risk factors that may trigger tumor growth.

First of all, it is important to eat right – do not abuse unhealthy food (fried, smoked, pickled), eat more fresh fruits and vegetables, greens. It is recommended to include in the diet products that neutralize the action of free radicals – tomatoes, onions, carrots, cabbage.

In the vast majority of cases, breast cancer in men develops against the background of gynecomastia (enlargement of the mammary glands), which can be caused by taking certain medications (especially hormonal ones), endocrine diseases, drug addiction, etc.

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Forecast

Breast cancer in men has a better chance of being treated if the disease is detected at an early stage (cure rate up to 95% of cases).

If the disease is diagnosed at a later stage, treatment is usually aimed at relieving symptoms (reducing pain) and improving the patient's quality of life. Therapy in this case involves prolonging the patient's life for as long as possible.

Breast cancer in men is most often diagnosed at later stages, when tumor removal and chemotherapy will not help to cope with the disease.

Usually, late diagnosis is associated with a man’s attitude towards his health, since most men believe that breast cancer is a purely female disease and do not pay attention to the appearance of the first symptoms of cancer.

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