Hello, Warriors! How are you feeling? With a new day comes another opportunity to stay active and live your best life. We hope you’re taking advantage of the outdoors to catch a bit of fresh air (sans humidity). Thank you for taking time out of your active schedule to visit The Breast Place blog. Welcome! We cover a range of topics here, including breast cancer management, anti-aging skin treatments, and tips for overall health and wellness. The Breast Place is committed to sharing the best health practices and treatment options with you! Check out our previous posts about how the water you’re using may be affecting your skin and the importance of genetic testing! And, of course, be sure to return here for further tips on how to improve and prioritize your health!
Today we want to provide you with a comprehensive resource full of information concerning male breast cancer. Many people aren’t aware men can develop breast cancer. This misconception, combined with a lack of general medical knowledge, can contribute to later diagnoses for men with breast cancer. We hope to bring awareness to the reality of breast cancer for men, as well as detail potential differences in symptoms and treatment. We’ll discuss risk factors which might leave a man predisposed to developing breast cancer and quote survival rates among men. We hope this article is helpful!
Men and women are both born with breast tissue and milk-producing glands within the breast. Women, unlike men, continue to develop breast tissue during puberty. For this reason, breast cancer among men is relatively rare. About one in one-hundred—or one-percent—of breast cancer cases are diagnosed within men. Men develop the same types of breast cancer as women. The first and most common type is invasive ductal carcinoma, which occurs when cancer develops in the milk duct. The second most common type is invasive lobular carcinoma, which occurs when cancer develops in the milk-producing glands. Men have less lobules within their breast tissue, which accounts for the decreased rate of this type of cancer within men.
Finally, there are a few other types of cancers (or diseases which can lead to cancer). Ductal Carcinoma in situ (DCIS) is an early, noninvasive stage of the invasive ductal carcinoma. Inflammatory breast cancer is a rare form of breast cancer, only affecting one to five percent of all breast cancer patients, and is characterized by redness and swelling. This inflammation is the result of cancer cells blocking the lymph vessels in the skin of the breast. There’s also Paget’s disease, which is another rare form of breast cancer. Paget’s disease, when of the breast, begins in the nipple and expands outward to the edge of the areola. The disease can often be mistaken for a skin condition, such as dermatitis.
There are plenty of risk factors which can contribute to (or indicate an increased chance of) breast cancer development. The first risk factor is age. The likelihood of developing breast cancer increases with age and most breast cancer within men is diagnosed after the age of sixty. Another key risk factor is exposure to the hormone estrogen. This increased exposure could come from hormone therapy (often used to treat prostate cancer). Klinefelter syndrome, a genetic syndrome resulting from males being born with an extra copy of the X chromosome, can lead to abnormal development of the testicles and increased production of estrogen. Liver disease or conditions which affect the liver (like cirrhosis) can increase production of estrogen. Obesity, or being significantly overweight, is linked to higher levels of estrogen within the body. Any disease of surgery which impairs or prevents the function of the testicles can result in an increased risk of developing breast cancer for men. As well, radiation therapy which has targeted the chest area can increase risk.
Another major risk factor is a family history of cancer. Especially if the common type in your family is breast cancer and the affected relative is immediate. Our last article, The Importance of Genetic Testing, covers the implications of a family history rife with cancer diagnoses. If this is your situation, your doctor may recommend you undergo genetic testing. This testing will expose the presence of inherited genetic mutations which might leave you at an increased risk of developing breast cancer. The primary genetic mutations which contribute to breast cancer development are BRCA1 and BRCA2.
Men are more likely to have a lump which can be felt as a symptom of their breast cancer. This lump will, most often, be painless to the touch. Other than this, most men's breast cancer symptoms lineup with women’s’. You should look for a lump or thickening of the breast tissue. There may be alterations to one’s nipple, such as puckering, dimpling, redness, and scaling. As well, there may be discharge coming from one or both nipples. Since men aren’t taught to check themselves for breast cancer, breast cancer is often diagnosed at a later stage than women. This is why it’s important to visually and physically assess your body for sudden changes.
The process for diagnosing breast cancer is the same among both men and women. After an initial physical examination, a mammogram will be ordered. After the mammogram, typically an ultrasound is next. This is followed by an MRI and blood tests. Then, usually, a biopsy. From here, treatment paths can diverge widely depending on the results of these tests, the type of cancer, and whether the cancer has spread. Further tests will be required to determine where the cancer has spread, if so. Then, further testing will determine when the cancer cells have certain receptors (i.e. estrogen, progesterone, human epidermal growth factor type two). Based on the results of these tests, your doctor may recommend a variety of treatment options, including surgery, chemotherapy, radiation therapy, hormone therapy, or another targeted therapy.
Survival rates are relative and based on the overall population. Instead of being grouped into the AJCC TNM stages (i.e. stage one, stage two, etc.), survival rates based on the SEER database classify patients into three types. The first type is localized and refers to cancer which has not spread outside of its original formation spot. The second type is regional and refers to cancer which has spread to the area surrounding the formation spot. The third type is distant and refers to cancer which has spread throughout the body. These rates are relative because an eighty-percent five-year survival rate means a patient is eighty percent likely, on average, to live another five years as someone who does not have the same type of cancer. These numbers apply to when the cancer is first diagnosed and do not take into account circumstantial factors (e.g. age and lifestyle), nor certain genetic and protein-based mutations within someone’s cancer. Therefore, it's best you review these numbers with your healthcare provider to have a better understanding of your survival rate.
The five-year survival rate for cancer diagnoses in the localized stage is ninety-seven percent. The five-year survival rate for cancer diagnoses in the regional stage is eighty-three percent. And the five-year survival rate for cancer diagnoses in the distant stage is twenty-two percent. These numbers are comparative to women’s survival rates, as well. Given the vast differences in survival rates between the localized and distant stages, early diagnosis is the most significant determining factor in survival rate. As we mentioned above, men are often diagnosed in later stages than women because they are unaware they need to be checking themselves for breast cancer. This is why male breast cancer awareness is so important.
Providing support and resources to our male Warriors is of the utmost importance to us. Dealing with breast cancer is difficult enough and men who have been diagnosed can feel as though they do not have a community to turn to. We’re here to tell you that’s not true! You have us! We are here to provide both the information and treatment you need to face your diagnosis. The Breast Place offers several breast imaging services, including: mammograms, ultrasounds, and MRIs. We also offer family history and genetic testing services. We specialize in both malignant and benign tumors and will assist you with determining the best course of action following your test results. Reach out today if you have any questions or concerns! Until next time, thanks for reading!
Hello, Warriors! How are you? We hope you’re living your best life and staying active. Late summer is a wonderful time to enjoy the outdoors and catch a little fresh air. Thank you for visiting The Breast Place blog and welcome! We cover a range of topics here, from breast cancer management to skin care treatments to women’s overall health and wellness. The Breast Place is committed to sharing the best health practices and treatment options with you! Check out our previous posts about teaching your daughters how to perform a self-exam and how the water you’re using may be affecting your skin! And, of course, be sure to return here for further rips on how to improve and prioritize your health!
Today, we want to give you an in-depth look at what exactly genetic testing entails. We’ll go over who is best suited for genetic testing, as well as its ramifications on breast cancer treatment. If genetic testing is something you’ve been considering for a while, then this article is definitely for you. Likewise, if genetic testing is simply something you’d like to be better informed about, read on!
What is Genetic Testing?
Genetic testing began in the 1950s when scientists discovered a replication of chromosome 21 causes Down’s syndrome. The staining of chromosomes, referred to as karyotyping, allowed scientists to count the number of chromosomes present in DNA. Since then, advancements have afforded scientists the ability to isolate individual chromosomes and identify structural mutations. Various mutations in genes can expose us to increased risk for certain diseases, illnesses, and cancers. Often, these genetic mutations are inherited. Genetic testing offers individuals the option to be aware of which illnesses they are genetically predisposed to developing, as well as alter their lifestyles in order to decrease their risk of developing these illnesses.
Known Harmful Genetic Mutations
The most significantly harmful genetic mutations which increase the likelihood of developing breast cancer are the BRCA1 and BRCA2 genes. The capability to test for these specific genes was only acquired as recently as 1996. Individuals, both men and women, who carry one or both of these genetic mutations are determined to have Hereditary Breast and Ovarian Cancer Syndrome (HBOC). This syndrome increases women’s risk of developing breast, ovarian, pancreatic, and other forms of cancer. Similarly, this syndrome increases men’s chances of developing breast, prostate, pancreatic, and other forms of cancer.
The BRCA genetic mutations are not the only genetic mutations which can increase an individual’s likelihood of developing breast cancer. The other genes which can harbor harmful mutations are the PALB2, CHEK2, ATM, PTEN, and TP53 genes. Not all genetic tests check for inherited mutations associated with these genes. If a family member of yours has a genetic mutation associated with one of these genes, you should discuss being tested for these mutations with your genetic counselor.
According to research, an estimated five to ten percent of breast cancers are the result of an inherited genetic mutation. Further, between fifty-five and seventy-two percent of females with the harmful BRCA1 mutation variation, and forty-five to sixty-nine percent of females with the harmful BRCA2 mutation variation, are likely to develop breast cancer before the age of eighty. These staggering statistics provide a strong basis for early genetic testing, especially for those with a family history of multiple cancers.
Who Should Be Tested
It is not recommended that everyone be tested for genetic mutations associated with breast cancer. If you or a close family member were diagnosed with breast cancer at a young age, or triple negative breast cancer (which tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein), then you should be tested. The number of family members diagnosed with breast cancer, the age they were when they were diagnosed, and how close they are in relation to you, all affect your chances of having a harmful genetic mutation. If you have a family member who has tested positive for one of the harmful BRCA mutations, then you should be tested. If you are of Ashkenazi Jewish descent or have been diagnosed with breast cancer a second time (not a recurrence of the first cancer), then you might be more likely to have a harmful genetic mutation.
The Process of Genetic Testing
To begin with, you should consult a genetic counselor or genetic specialist. This professional will be able to, using your family history, estimate your risk for certain genetic mutations. They will be able to put together a panel of genes to test for and answer any questions you may have about the potential results. Testing can target a specific mutation or a range of different mutations, depending on your situation. Once you’ve determined which genetic mutations to test for, a medical professional will collect a sample of your blood or saliva (by cheek swab). This sample will then be sent off to a lab to be reviewed.
You can expect your results to be returned within two to four weeks, allotting extra time for more extensive testing panels. When analyzing the reported results of your genetic testing, you may be confused by the answer. You can receive a positive result, which means you do indeed have a harmful genetic mutation and there are steps which you can subsequently take to decrease your risk of developing breast cancers (and other cancers). You can receive a negative result, however this doesn’t necessarily ensure you do not have a harmful genetic mutation. There is a chance you were not tested for the full range of genetic mutations and a harmful genetic mutation predisposing you to breast cancer has been missed. In this case, further testing would be required. You can also receive an inconclusive result, which means the tests were not able to determine whether you do or do not have harmful genetic mutations. Finally, you can receive a positive for a variant of unknown significance (VOS) result, which means you’ve tested positive for a genetic mutation which science hasn’t yet connected to an increased or decreased risk.
There is still much work to be done in genetic testing research. For this reason, you must take any results from genetic testing with a grain of salt. Genetic testing is, on the whole, incredibly accurate. Still, you’ll want to have your results interpreted and explained by a genetic counselor who can give you a plan for the immediate future regardless of your results.
There are at-home genetic testing kits available and approved by the FDA. However, these kits usually only test for a handful of the BRCA mutations, and not the over one-thousand variations which exist. Therefore, they cannot provide much by way of comfort or relief, even with a negative result.
Impact on Treatment
If you have been diagnosed with breast cancer, or diagnosed with breast cancer for a second time, undergoing genetic testing and being determined positive for a harmful genetic mutation can affect your treatment plan. According to research comparing breast cancer patients who tested positive for BRCA mutations and breast cancer patients who tested negative for BRCA mutations, BRCA-positive patients underwent double-mastectomy surgeries much more often than BRCA-negative patients (66% > 24%). Conversely, BRCA-positive patients were less likely to undergo radiation treatment than patients who tested negative for BRCA (51% < 82%). Finally, BRCA-positive patients underwent chemotherapy at a slightly higher rate than BRCA-negative patients (38% > 30%). This data suggests breast cancer patients who tested positive for the BRCA mutation and their physicians are more aggressive in preventative measures such as mastectomies and treatments such as chemotherapy, but less aggressive in treatment measures such as radiation (perhaps because patients are planning to undergo mastectomies in the future or fear the effects of radiation). As well, BRCA-positive patients having an increased likelihood of developing breast cancer multiple times may explain the vastly higher rate of double-mastectomy.
Positive and Negative Considerations
Even if you have not currently been diagnosed with breast cancer, being aware of the presence of a harmful genetic mutation can affect how you live and thus affect your chances of developing cancer later in life. If you do test positive for harmful genetic mutation, you can make lifestyle changes such as being more physically active and lessening your alcohol consumption. You could also opt for preventative surgery, such as a double-mastectomy, or chemoprevention medication to lessen your risk.
If the results of your genetic testing are negative, this can be a great relief to many. Of course, a negative result doesn’t erase the possibility of developing breast cancer, but it can be comforting to know you aren’t any more likely than someone else.
On the other hand, some individuals aren’t adequately equipped to handle the mental and emotional stress of a positive result. If this is the case, you might opt out of genetic testing or seek professional help with coping with your results, whatever they might entail.
Genetic testing can be expensive, ranging from three-hundred to five thousand dollars depending on the facility you choose. There are insurance providers who will cover the cost if the testing is medically necessary. Check with your insurance provider and verify their guidelines before ordering tests.
If you fall under the scope of individuals who should be tested for genetic mutations—the sooner you seek answers, the better. We offer genetic testing and family history evaluations here at The Breast Place. You’ll meet with one of our qualified, highly-trained medical professionals to determine your inherent risk and be tested for a panel of harmful genetic mutations. Take your future into your own hands and schedule a consultation today. We’ll assist you with determining the best course of action following your test results. The Breast Place also offers several breast imaging services, including: mammograms, ultrasounds, and MRIs. We’re here to help!