An article published in the Lancet on 18 February 2006 looks at some of the risk factors and treatment trends in male breast cancer over the past few decades as well as some specific issues that are relevant to men suffering from what is a reasonably uncommon condition for them. The analysis was based on a review of over 140 articles published about male breast cancer from as far back as the 1940s up until 2005.
Breast cancer is far less common in men than in women.According to Australian Institute of Health and Welfare figures, there were 113 new cases of male breast cancer diagnosed in Australia in 2008 -- the most recent year for which incidence figures are available. This is about 1 in every 100 000 men, similar to the European prevalence figures quoted in the Lancet article.
It appears that family history may account for more breast cancers in men than in women. Inherited mutations in genes that can predispose people to breast cancer are estimated to be the cause of breast cancer in between 4% and 40% of cases in men compared with between 5 and 10% of cases in women. Other possible risk factors for male breast cancer include obesity and exposure to high levels of oestrogen which can be brought about by testicular or liver failure.
Early detection is as important in men as in women
An important point raised in the article is that because breast cancer is relatively uncommon in men, its diagnosis tends to be delayed and therefore the cancer is frequently more advanced at the time of diagnosis in men compared with women. This can lead to poorer outcomes for men than women. It is important that men who notice breast lumps or other changes in their breasts have them investigated promptly.
Treatment of early male breast cancer
As with women, standard treatment for early (localised) male breast cancer includes surgery, radiotherapy and hormonal therapy. Hormonal therapy generally includes Tamoxifen as about 90% of male breast cancer is hormone-receptor-positive.
The role of aromatase inhibitors and Herceptin in the treatment of male breast cancer has not been determined and the benefits of chemotherapy are less well established for men than women. However, given the benefits of these treatments in women, the authors recommend that these be considered as options for treating male breast cancer where appropriate.
Treatment of secondary male breast cancer
Hormonal therapy or chemotherapy are recommended for treatment of secondary breast cancer in men.
More support is needed for men with breast cancer
The authors make a final recommendation that more resources be dedicated to providing support for and research into male breast cancer.