Whenever one talks about breast cancer, it is presumed to be a woman affected. But it also affects men is a lesser known fact. In the UK, about 350 men are diagnosed with breast cancer as against 50,000 women. This shows that though rare but it does exist. The problem is men are not aware of it. Even when an affected person is told, he is not ready to accept it. Thus diagnosis and treatment is delayed thus hampering the quality of life and even survival. Exposure to radiation particularly at a young age is one of the common causes for breast cancer in men. Men with liver disorders like cirrhosis are also susceptible to develop breast cancer. It can occur due to genetic mutation or chromosomal abnormalities. Regular alcohol consumption is a risk factor for developing breast cancer as well. This happens because alcohol breaks down in the body into acetaldehyde which can cause genetic mutation. It also disrupts hormonal balance of body, causing increased level of estrogens in men and causing breast cancer. The symptoms are the same as for women. One may feel a hard, painless lump in the breast or below nipple or in the underarm of that side. It is easy to feel this lump in a man due to scanty fatty tissue in the breast. The overlying skin may look scarred, tight and inflamed. There may be a bloody or dirty milky discharge from the nipple. If the cancer has spread to other body parts, symptoms depend on part affected. One gets cough or dyspnoea if lungs are affected, its spread can cause deranged liver functions with or without jaundice. Spread of cancer to the backbone manifests as backache and pathological fractures. Diagnosis is suspected clinically in a man, if he has any one of the features suggestive of breast cancer. Imaging techniques like mammography, CT scan and other scans help to localise the tumor and its extent. Presence of malignancy is confirmed by a biopsy and histopathological examination. Treatment is as for a woman. Depending on age of patient, size of tumor and whether it has spread to distant parts or not the decision is taken to choose one or more treatment options. The options being surgery, radiation therapy to kill cancer cells or chemotherapy to kill growing cancer cells by drugs. After treatment, regular follow up is important to see whether the cancer is destroyed totally or is there any residual part remaining. If there is a recurrence or if there is spread of the cancer to other body part/parts, that can also be detected on follow up. Further treatment varies as per the follow up findings. It is important that awareness should be generated among men also about breast cancer. If a man notices a hard lump in his breast, any part of breast getting swollen with or without skin changes, any discharge from a nipple, he should take it seriously and get himself screened for cancer at the first opportunity. A healthy lifestyle builds the resistance of the body for not only against infections but also against cancer as well. Alcohol has multiple health hazards including being a risk factor for cancer, hence should be avoided. Lastly it is important to understand that breast cancer is a cancer like that of any other body part and a man should not delay treatment because he feels ashamed about it. Dr Rachna Pande is a specialist in internal medicine at Butaro Hospital.
