Men ’s health While the average age of a breast cancer diagnosis in Australian men is 69, the risk of a man being diagnosed with breast cancer before the age of 75 is one in 1,258. This compares well to the risk of a woman being diagnosed with breast cancer, which is one in eight before the age of 85; however, age is not the only risk, and as is the case in women, men of all ages can be affected. Men who carry an inherited BRCA1 or BRCA2 gene mutation, or who have a strong family history of breast cancer are at an increased risk of developing breast cancer. Not all men who have these genes will go on to develop cancer; however if a man is proven to be a BRCA carrier it is advisable to have a check by their GP. All men’s bodies produce a small amount of the female hormone oestrogen, as well as male hormones such as testosterone. Men who have higher than normal levels of oestrogen may be at an increased risk of developing breast cancer. Being overweight or obese (because fat cells produce oestrogen), long-term liver conditions such as cirrhosis, and genetic conditions, such as Klinefelter’s syndrome levels can all contribute to higher oestrogen levels in men. Research suggests that men who have had previous radiotherapy treatment, particularly of the chest area for conditions like lymphoma, may also have an increased risk of developing breast cancer. The good news is that most men in Australia survive breast cancer – 85% of men diagnosed are alive five years later and the breast cancer does not return. This is because we have effective treatments for breast cancer, giving good results whether male or female. There are many different breast cancer cancers and many different treatments. The recommended treatment will depend on a number of factors that are unique to the patient and the type of cancer they have. Most breast cancers in men are ductal carcinomas however, similar to women, men may present with other types such as lobular or in situ carcinomas. The treatment of male breast cancer is similar to the treatment for women. Surgical excision is usually the primary treatment. A mastectomy is the most common procedure for men. This involves removing the whole breast (including the nipple and area around the nipple) with the aim to remove all the cancer cells from the breast. To prevent spread beyond the breast, systemic treatments are often utilised. Chemotherapy involves a regime of one or more drugs given cyclically over several months. The majority of male breast cancers will be hormone sensitive. That is, they carry oestrogen receptors that help them grow and spread. Hormone therapy drugs such as Tamoxifen can also be used to treat hormone receptor positive breast cancer while targeted therapy drugs can be used to treat men with HER2-positive breast cancer. Radiotherapy (also called radiation treatment) can be used to kill any cancer cells that may be left after surgery. Sessions last around 20 minutes and are usually given five days a week for around six to seven weeks. For a man diagnosed with breast cancer, the journey through treatment can represent a double jeopardy. Widely recognised as a ‘women’s cancer’ a breast cancer diagnosis may leave a man feeling emasculated, embarrassed, isolated and alone. Friendships and family relationships can be affected by their diagnosis, creating another layer of emotional duress. It is important that a man diagnosed with breast cancer does not retreat into his ‘man cave’, but rather seeks advice and/or professional counselling to support him as he journeys through treatment. pm The most comm on risk factors are • getting older • having a strong family history of female or male breast cancer or ovarian cancer Ot her factors/ associations: • high oestrogen levels • Klinefelter’s syndrome (this is a chromosomal a bnormality that is quite rare) • obesity, alcohol, liver disease Some studies suggest there is a link between the risk of male breast cancer and the following: • some testicular disorders • radiation exposure The most common symptom of breast cancer in men is a painless lump in the breast close to the nipple. Ot her possible symptoms include: • a discharge from the nipple • a change in the shape or appearance of the nipple • a change in the shape or appearance of the breast, such as swelling or dimpling pain • swollen lymph nodes (glands) under the arm Screening for breast cancer in men is not practice. Breast cancer in men is only detected through being breast aware for the above symptoms. It is important to see a doctor as soon as possible if you notice any new or unusual breast changes. If the changes are due to cancer, finding it early will mean a better chance of effective treatment. Breast reconstruction, although not usually taken up by men is available, as it is for women. A breast surgeon may be able to perform a breast reconstruction using tissue from the back, abdomen or buttock. A nipple reconstruction that involves rebuilding of the nipple and the areola (the area around the nipple), which can then be tattooed to match the colour of the other nipple may be an option for some men. Alternatively, a nipple and areola tattoo can be performed by itself. “All men’s bodies produce a small amount of the female hormone oestrogen, as well as male hormones such as testosterone. Men who have higher than normal levels of oestrogen may be at an increased risk of developing breast cancer.” 36 Pindara Magazine Autumn - Winter | 2014
Pindara Private Hospital Magazine - Issue Two
To see the actual publication please follow the link above