COLUMBUS, Ohio – Yes, men get it, too – breast cancer, that is – and even though the numbers are small, the incidence of the disease among men has risen significantly in recent years. It’s a phenomenon that has clinicians scratching their heads.
The American Cancer Society estimates that about 180,000 women in the United States will develop breast cancer this year, compared to about 1,600 men. A recent review of data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results database found that over the 25 years spanning 1973-1998, the incidence of breast cancer in men rose roughly 25 percent.
“We really don’t know why we are seeing more of it, but we suspect that several factors might be at play,” says Dr. Charles Shapiro, director of breast medical oncology at The Ohio State University Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
Shapiro, who has treated several men with breast cancer, says heightened public awareness about the disease, coupled with better screening methods, might be two reasons why we’re seeing higher numbers, but adds that increased obesity rates and alcohol consumption may be factors, too.
For the most part, breast cancer in men is a lot like breast cancer in women, but there are some important differences. “Men don’t seem to be as attentive as women to changes in their bodies, so they often overlook or ignore something like a lump or a change in their skin texture,” says Shapiro. As a result, men are more likely than women to have more advanced disease the first time they see a doctor.
Like women, men see their risk of breast cancer increase with age. Their tumors also tend to be estrogen positive, which means their tumors tend to act more like the breast cancer found in older, postmenopausal women than the estrogen negative forms of the disease, which occur more frequently in younger women.
“About 6 percent of all male breast cancer is related to irregularities in the BRCA2 gene, one of a small number of genes that, when malfunctioning, greatly increase a person’s chance of developing breast and other cancers,” says Shapiro.
Shapiro notes that while it’s well-known that increased obesity in women – especially older women – is a risk for breast cancer, it is not clear that increased fat in men leaves them equally vulnerable. “We really haven’t had the numbers to study that fully,” he says. Interestingly, however, he says that studies show that men with a greater degree of breast tissue do not have a higher risk of breast cancer than other men.
As for alcohol’s role in heightening any risk in men – Shapiro notes there has been little research in the area, noting only one small study suggesting that men, just like women, may increase their risk of breast cancer by consuming as few as two alcoholic drinks per day.
Treatment for breast cancer is the same for men or women, and may include any single approach or combination of surgery, radiation and chemotherapy.
“Breast cancer is no means at the top of most men’s health checklists,” says Shapiro. “But the increased incidence of the disease means that men – and their doctors, who may not be attuned to it, either – need to be aware of its signs and symptoms." They include:
· Any lump that may or may not be painful to touch
· Any change or thickening in breast tissue
· Any discharge from the nipple.
As for that special set of women who are daughters of men who have had breast cancer – they need to know that when a nurse or a doctor asks them if they have a family history of breast cancer, they can’t overlook dad.
“Fathers count, too," says Shapiro, adding that both mothers and fathers can have BRCA2 mutations and that children of mutation carriers stand a 50-50 chance of inheriting the same mutation.
The Arthur G. James Cancer Hospital and Richard J. Solove Institute at The Ohio State University is a founding member of the National Comprehensive Cancer Network and consistently ranked by U.S. News & World Report as one of America’s best cancer hospitals. # # #
Medical Center Communications