Causes
Some risk factors for breast cancer have been discovered to date that promote the disease in men, but they do not explain all cases that have occurred. In some patients, it is simply not known what the cause is. One group of risk factors that are known are genetic factors.
One possibility is the hereditary form of breast cancer via the BRCA (Breast cancer gene). Some patients have this gene, which is a mutation that occurs in the DNA of all body cells and is therefore inherited. Affected patients should therefore be tested for this gene, especially if there are other cases of breast cancer in the family.
Another cause of breast cancer in men can be the so-called Klinefelter syndrome. Here the man has an additional X chromosome and thus a 20-60 times higher risk of developing breast cancer. Furthermore, radiation exposure can be a cause.
Men who have already been irradiated on the upper body during childhood, for example, due to another form of cancer, are particularly affected. Increased production of the hormone oestrogen can also be a factor. Normally, men produce only little of this hormone. However, overweight men, especially those who have abused alcohol, may produce more oestrogen.
Diagnosis
On the one hand, there is the possibility of early detection in patients who already have a high risk. This is the case, for example, in a family history of BRCA gene mutation or in patients with Klinefelter’s syndrome. If the cancer is already present, it is usually recognised by the classic lumps in the area of the nipple and possible skin changes on the breast.
If such changes are present, an ultrasound can be made to confirm the suspicion. In addition, every man should have a mammography. This diagnostic tool describes an X-ray of the breast.
Since both the ultrasound image and the mammography are somewhat less reliable in men than in women due to the different structure of the breast, the final diagnosis must be made by a biopsy. In a biopsy, a tissue sample is taken and examined by a pathologist. He determines the growth pattern of the possible tumour and carries out specific tests to detect hormone receptors (oestrogen receptor, progesterone receptor, androgen receptor, etc.) Subsequently, the lymph nodes are examined to see whether metastasis has already occurred. This topic might be of interest to you: Tumor markers in breast cancer
Forecast
The chances of recovery are somewhat worse for men than for women. The survival rate after 5 years for men is 78%, the 10 year survival rate is 65%. This is probably mainly due to the fact that tumours in men are often detected later, as there are no screening programmes for men and both doctors and patients in men often do not think of breast cancer first.
Therefore, many men have metastases in the lymph nodes at diagnosis, which worsens the prognosis. However, because the majority of men have tumours that have hormone receptors, a targeted therapy can be carried out that can considerably prolong and improve the lives of many patients, even if they cannot be cured.
