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Male Breast Cancer

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Although most people who get breast cancer are women, men can get it, too. Breast cancer in men is rare — less than one percent of all breast cancers occur in men. The most common type of breast cancer in men is invasive ductal carcinoma (IDC).

Both men and women have breast tissue. Since men's bodies don't make much of the breast-stimulating hormones, their breast tissue is minimal. But, sometimes men can develop more breast glandular tissue due to hormone imbalances or certain medicines.

Factors that can increase a man's risk of getting breast cancer include:

  • Age: Risk increases as you get older. The average age of men when they’re diagnosed is about 72.
  • High estrogen levels: Men can have high estrogen levels due to medicines, being overweight, estrogens in the environment, heavy alcohol use, liver disease, or testicular conditions.
  • Klinefelter syndrome: Men with this condition have lower levels of androgens (male hormones) and higher levels of estrogen (female hormones).
  • Radiation exposure: Radiation therapy to the chest, such as during cancer treatment, increases the risk of breast cancer.
  • Family and genetics: A strong family history of breast cancer or genetic mutations (particularly BRCA2 gene mutation) increases risk.

The treatment of male breast cancer is similar to female breast cancer, and we follow the same treatment guidelines. In some instances, your doctor may recommend chemotherapy, hormonal therapy, or another treatment before or after surgery. Your doctor will talk to you about all your options.

Tests

Mammograms
Mammograms are the fastest, most accurate way of detecting an abnormal growth in your breast. With tomosynthesis, or 3-D mammography, radiology technologists can get breast images from multiple angles, enhancing the accuracy of a reading and reducing the potential need for repeat scans.

Breast Ultrasound and Magnetic Resonance Imaging (MRI)
Your doctor may request a noninvasive imaging exam, such as breast ultrasound or breast MRI, if you have dense breasts and you’re at a higher risk of breast cancer — especially for those with a 20 percent or higher lifetime risk for breast cancer.

Ductoscopy
More than 80 percent of breast cancer growths arise in milk ducts. If your symptoms include a watery, blood-tinged discharge from the nipple, your surgeon will use ductoscopy to find the lesion to sample or remove it. It uses a fiber-optic scope less than a millimeter thick inserted into the milk duct at the nipple to send images to a computer monitor.

Biopsies
A biopsy is a small sample of the suspicious breast tissue that’s removed and tested. Biopsies can be performed in several ways, depending on the circumstances: fine needle aspiration (minimally invasive biopsy), image-guided core needle biopsy, cyst aspiration, ductoscopy (milk ducts), and surgical biopsy (excisional or incisional biopsy).

Estrogen and Progesterone Receptor Test
This test looks for estrogen and progesterone (hormone) receptors in your cancer tissue. If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. The test tells your doctor whether treatment to block estrogen and progesterone will be effective.

Human Epidermal Growth Factor Type 2 (HER2/neu) Receptor Test
This test measures how many HER2/neu breast cancer genes there are and how much HER2/neu protein is made in a sample of breast tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow or spread more quickly.

Multigene Tests
Because no tumor has a single mutation, genomic profiling allows the pathologist (cellular expert) to identify groups of mutations in your tumor tissue sample. We then can create a tumor profile for you. That profile helps us determine what type of treatment would be the most effective and how long you should have treatment.

Treatments

Modified Radical Mastectomy
The most common surgery in men is called a modified radical mastectomy, in which the nipple, areola and all of the breast tissue is removed and the underlying muscle is left intact. Usually, a breast-sparing lumpectomy isn't possible because men's breasts are so small.

Sentinel Lymph Node Biopsy
Doctors use this minor surgery to determine if cancer has spread beyond a primary tumor into your lymphatic system. A sentinel lymph node is the first place cancer cells may move to when they begin to spread. During the biopsy, your doctor injects a special dye (tracer) to locate the nodes and remove them to look for cancer cells. If they're free of cancer, it means it's unlikely that cancer has spread and it's not necessary to remove more lymph nodes.

Sylvester offers a novel treatment that prevents taking more lymph nodes, even if the sentinel node is suspicious. Before surgery, an ultrasound scan of the armpit can highlight which lymph nodes are involved (they will appear enlarged or swollen). When chemotherapy is used before surgery (neoadjuvant chemotherapy), it can convert a previously positive lymph node to negative when biopsied, which means more lymph nodes don't need to be removed.

Radiation Therapy
Radiation therapy is often used after a mastectomy for men with large cancers (tumors 5 centimeters or larger) or cancer that has spread to the lymphatic system or blood vessels.

Hormone Therapy
Hormone therapy is an effective treatment for men with hormone-receptor-positive cancer. If the cancer returns or grows during hormonal therapy, your doctor may include chemotherapy as part of your treatment.

Chemotherapy
Chemotherapy is cancer-fighting medicine that's administered intravenously or by a pill. Chemotherapy also might be recommended before surgery, called neoadjuvant chemotherapy, to help reduce the size of the tumor and improve surgical results. Often, more than one chemotherapy medicines are used at the same time or one after the other to destroy different kinds of cancer cells that come from the same breast cancer.

Locations:If you need intravenous (infusion) chemotherapy, you can have it at the Comprehensive Treatment Unit (CTU) at Sylvester’s main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables and Deerfield Beach locations.

Cold Cap Therapy to Minimize Hair Loss
Sylvester offers FDA-cleared cold cap therapy to reduce hair loss during chemotherapy. This therapy works by cooling the scalp during treatment.

Targeted Therapy
Targeted therapies are treatments designed to attack the molecular changes that make the cancer cells grow and spread. The FDA has approved several targeted therapies. Herceptin, a common type of targeted therapy, treats HER2-positive breast cancers. In these breast cancers, the cancer cells have a gene mutation that creates too much HER2 protein, which stimulates cancer cell growth. Herceptin targets and blocks the receptors, so the signals to grow and spread can't be delivered. Herceptin also marks the cancer cells so the immune system can destroy them.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Renowned Braman Family Breast Cancer Institute at Sylvester. We offer treatments customized to your individual needs at one of the nation's best breast cancer diagnosis and care programs.

Breast Imaging Center of Excellence designation by the American College of Radiology. Thanks to imaging excellence, you receive a more precise diagnosis, which then guides a more effective treatment plan.

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