Male Breast Cancer

Diagnosis

Male breast cancer is diagnosed using a combination of physical examinations and diagnostic tests. The process helps confirm the presence of cancer and provides details needed to plan treatment.

Tests and procedures may include:

• Clinical breast exam, where a healthcare professional checks the breasts and nearby areas for lumps or changes and assesses their size, texture and relationship to surrounding skin and muscles

• Imaging tests that create detailed pictures of breast tissue, such as mammography, ultrasound or MRI scans

• Biopsy, which involves removing a small sample of breast cells using a needle guided by imaging tests and examining the cells in a laboratory

In the lab, specialists analyze the biopsy sample to determine whether cancer is present. Additional testing may identify hormone receptors or specific DNA changes in the cancer cells. These results guide treatment decisions. Depending on individual circumstances, further tests may also be required.

Staging

Once male breast cancer is confirmed, the healthcare team determines how far the cancer has spread. This process, called staging, helps estimate prognosis and select appropriate treatment options.

Staging often involves imaging tests, which may include:

• Bone scan

• CT scan

• Positron emission tomography scan

Laboratory tests on the cancer cells also provide staging information, including the cancer grade, which indicates how fast the cancer is growing. Testing is also done to check for receptors such as estrogen, progesterone and HER2.

Breast cancer stages range from 0 to 4. Stage 0 means the cancer is confined within the milk ducts and has not invaded breast tissue. As the cancer grows or spreads to surrounding tissues or distant organs, the stage increases. Stage 4 indicates that the cancer has spread to other parts of the body.

Treatment

Treatment for male breast cancer usually begins with surgery. Additional treatments may include chemotherapy, hormone therapy, radiation therapy and targeted therapy. The choice of treatment depends on the cancer stage, overall health and personal preferences.

Surgery

Surgery aims to remove the cancer along with some healthy surrounding tissue. Surgical options may include:

• Mastectomy, which removes all breast tissue from one side of the chest, including the nipple and areola, and is the most common surgery for male breast cancer

• Lumpectomy, which removes the cancer and a margin of healthy tissue while preserving most of the breast, often followed by radiation therapy

• Sentinel lymph node biopsy, where the first lymph nodes likely to be affected are removed and tested to check whether cancer has spread

If cancer is found in the sentinel lymph nodes, additional lymph nodes may be removed for further evaluation.

Radiation Therapy

Radiation therapy uses high-energy beams to destroy cancer cells. Treatment is delivered by a machine that targets specific areas of the body, usually the chest and armpit. Radiation therapy is commonly used after surgery to eliminate any remaining cancer cells.

Hormone Therapy

Many male breast cancers are hormone sensitive and rely on hormones to grow. Hormone therapy may be used to reduce the risk of recurrence after surgery or to slow cancer growth if it has spread. Tamoxifen is commonly used, though other hormone-blocking medicines may be options if tamoxifen is not suitable.

Chemotherapy

Chemotherapy uses powerful medicines, given through a vein or as pills, to destroy cancer cells. It may be recommended after surgery to eliminate remaining cancer cells or used to treat cancer that has spread to other parts of the body.

Targeted Therapy

Targeted therapy focuses on specific chemical changes in cancer cells. By blocking these changes, targeted treatments can cause cancer cells to die. This therapy may be used after surgery or for cancer that has spread beyond the breast.