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Definition  

Breast cancer is a disease in which cancer cells grow in the breast tissue. Although male breasts do not fully develop, they do contain most of the same basic breast structures as women. Male breasts include small glands called lobules, ducts, and the nipple. These structures are also surrounded by fatty tissue. All of these structures are susceptible to developing breast cancer.

Breast cancer in men is rare, accounting for about 1% of all breast cancer. Unfortunately, awareness of it is also rare. Because of this, the cancer is often diagnosed in advanced stages. Like all other cancers, early diagnosis and treatment are important for the most favorable outcome.

Types of breast cancer found in men are:

  • Infiltrating ductal carcinoma—Cancer starts in the ducts of the breast and spreads into surrounding tissues. This is the most common type of breast cancer in men.
  • Ductal carcinoma situ—Early stage cancer confined to the ducts. This type has the highest cure rate.
  • Infiltrating lobular carcinoma—A rare cancer that starts in the lobules of the breast and spreads into surrounding tissues.
  • Paget’s disease—A very rare cancer that starts in the ducts and spreads to the nipple and areola.
  • Inflammatory—A very rare, but aggressive cancer that occurs with visible changes in the skin around the breast and nipple.
Lymph Nodes and Vessels  

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Causes  

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body. The lymph nodes associated with breast cancer are in the armpit, above the collarbone, and in the chest.

It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

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Risk Factors  

Factors that may increase your risk of developing breast cancer include:

  • Advancing age
  • Family history of breast cancer
  • Genetic mutations, such as BRCA1, BRCA2, and others
  • Exposure to radiation, especially in the chest
  • Exposure to increased levels of estrogen, which may occur with:
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Symptoms  

When breast cancer first develops, there may be no symptoms at all. As the cancer grows, it can cause the following changes:

  • One or more lumps in the breast, which may or may not be painful
  • One or more lumps in lymph nodes near the breast, under your arm, or collarbone that which may or may not be painful
  • Changes in the skin or nipple, such as dimpling, puckering, or nipple retraction
  • Redness, irritation, or ulceration of the skin in the breast area
  • Discharge from the nipple, which may be clear or bloody
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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical exam will be done. This includes a thorough manual breast exam and blood tests.

In most cases, diagnosis can be confirmed with a biopsy. A sample of the suspicious tissue will be removed and sent to a lab to look for cancer cells.

Types of biopsies include:

  • Fine-needle aspiration—A thin needle is used to extract fluid or cells from the suspicious tissue.
  • Core needle—Removal of a small cylinder of suspicious tissue.
  • Surgical—Removal of a sample of the lump, or the entire lump with surrounding healthy tissue.
  • Samples of lymph tissue and nipple discharge.

Imaging tests can help with diagnosis and determine the extent of cancer. These may include:

If cancer is present, your doctor may order other tests to learn more about the type of cancer. These may include:

  • Blood tests—To look for tumor markers and genetic mutations.
  • Tissue evaluation—To look for estrogen or progesterone receptors, and the presence of HER2/neu and Oncotype DX. These are used to help plan therapy.

The physical exam, combined with all of your test results, will help to determine the type and stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, breast cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

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Treatment  

Cancer treatment varies depending on the stage and type of cancer.

A combination of therapies is most effective. For example, radiation may be used before surgery to shrink the tumor or after to make sure all the cancer has been removed.

Treatment options include:

Surgery  

The goal of surgery is to remove the tumors and any affected tissue.

Surgical procedures include:

  • Modified radical mastectomy—Removal of the whole breast, the lymph nodes under the arm and, often, the lining over the chest muscles. This is the most common procedure.
  • Radical mastecto