Introduction
A large part of the population considers breast cancer (malignant alteration of the breast gland tissue) to be a typical women’s disease. In fact, it is predominantly women who develop breast cancer – about 70,000 per year. However, men can also be affected by breast cancer, although much less frequently (about 650 new cases per year).
Breast cancer is often diagnosed much later in men because, unlike for women, there is no regular screening programme (such as mammography). For this reason, the prognosis for men with breast cancer appears to be significantly worse than for women. A late diagnosis in an already very advanced cancer stage drastically reduces the probability of a complete cure.
For affected men, a change in their breast tissue is usually only noticed by chance at a relatively late stage of the disease. This can be a palpable lump, or an unusual secretion of fluid from the nipple. Small, non-healing wounds or inflammations as well as retractions of the skin can also provide an indication.
If this is the case, a doctor should be consulted as soon as possible, who can initiate a more detailed diagnosis. After all, even in a man suffering from breast cancer, the earlier the diagnosis is made, the better the prognosis. The treatment plan for men is very similar to that for women.
First and foremost, and therefore most importantly, is surgery, in which as much of the tissue affected by cancer cells as possible is removed. This is usually followed by radiation, chemo- or hormone therapy, because most breast cancer cells in male patients grow hormone-dependently. If the hormones necessary for growth are removed or the corresponding hormone receptors are blocked, tumour growth can be significantly slowed down or even stopped.
Diagnosis
The diagnosis of breast cancer in men is similar to that of women. First, the doctor thoroughly scans the breast tissue for structural changes. In this way, an initial assessment can be made as to whether the tumour is benign or malignant.
Benign tumours of the breast are usually smoothly limited and movable. Malignant tumours, on the other hand, grow deep into the tissue, are therefore immobile and can even cause the nipple to retract. The next step in the diagnosis includes imaging, which begins with an ultrasound examination.
With this method, the size and location of the altered area of the breast tissue can already be estimated (see: Ultrasound examination of the breast). The most important form of imaging, however, is mammography, i.e. X-ray examination of the breast. Due to the higher density of breast tissue in men, however, all imaging procedures are less meaningful than in women.
In order to be able to actually diagnose breast cancer, it is therefore necessary to take a tissue biopsy from the breast, which is examined microscopically (see: Tissue samples in breast cancer). Another possible method of diagnosing breast cancer is MRI (magnetic resonance imaging or magnetic resonance tomography). Here a strong magnetic field is generated which acts on the atomic nuclei of the hydrogen atoms in the body.
Depending on the tissue, the human body has different amounts of water or hydrogen, which means that the MRI image shows different shades of grey. This form of imaging takes about 15 to 30 minutes and does not produce any radiation exposure (unlike e.g. X-rays). The MRI can make both longitudinal and cross-sectional views of the body visible, thus enabling optimal calculation of the tumor position and size.
In addition, benign tumours have a different hydrogen content than malignant ones, which means that an MRI image can be used to make an initial assessment of malignancy. If the findings in mammography are not clear, this procedure offers a good opportunity for more precise information. Due to the different sectional image planes, almost every angle of the body can be viewed precisely and displayed independently of the tissue density.
A painless, palpable lump is typical for breast cancer. Should there be pain in the breast, this is therefore not a typical sign of breast cancer. Only after advanced metastasis (scattering of the tumour cells) can pain occur, depending on the organ involvement.
As a rule, breast cancer first spreads into the lymph vessels of the armpit, but this does not cause pain. It can then spread to bones, lungs, liver and brain. In particular, metastases in the bones can be accompanied by stress pain. However, this is not an early symptom.
