Male Breast Cancer Diagnosis & Treatment

Diagnosing male breast cancer involves a series of tests and examinations.  Here’s what to expect.:

1. Clinical Examination: A healthcare provider will perform a physical examination, checking for breast lumps, nipple changes and any other abnormalities. 

2. Imaging: Mammography and breast ultrasound are commonly used imaging techniques to visualize the breast tissue and any potential abnormalities.  

3. Biopsy: If an abnormality is detected, a tissue sample (biopsy) is taken from the suspicious area for laboratory analysis to confirm the presence of cancer and determine its type and stage. 

4. Staging: Once diagnosed, further tests like CT scans, MRI or bone scans may be conducted to determine the extent (stage) of the cancer and whether it has spread to other parts of the body. 

What is Staging?

Staging describes the severity of a person's cancer based on the size and/or extent (reach) of the original (primary) tumor and whether or not cancer has spread in the body. Staging is important for several reasons:

• Staging helps the doctor plan the appropriate treatment.

• Cancer stage can be used in estimating a person's prognosis.

• Knowing the stage of cancer is important in identifying clinical trials that may be a suitable treatment option for a patient.

• Staging helps healthcare providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials.

Staging is based on knowledge of the way cancer progresses. Cancer cells grow and divide without control or order, and they do not die when they should. As a result, they often form a mass of tissue called a tumor. As a tumor grows, it can invade nearby tissues and organs. Cancer cells can also break away from a tumor and enter the bloodstream or the lymphatic system. By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors. The spread of cancer is called metastasis.

All cancers are staged when they are first diagnosed. This stage classification, which is typically assigned before treatment, is called the clinical stage. A cancer may be further staged after surgery or biopsy, when the extent of the cancer is better known. This stage designation (called the pathologic stage) combines the results of the clinical staging with the surgical results.

A cancer is always referred to by the stage it was given at diagnosis, even if it gets worse or spreads. New information about how a cancer changes over time simply gets added onto the original stage designation. The cancer stage designation doesn't change (even though the cancer itself might) because survival statistics and information on treatment by stage for specific cancer types are based on the original cancer stage at diagnosis.

TNM system

The TNM system is one of the most widely used cancer staging systems. This system has been accepted by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC). Most medical facilities use the TNM system as their main method for cancer reporting.

The TNM system is based on the size and/or extent (reach) of the primary tumor (T), the amount of spread to nearby lymph nodes (N), and the presence of metastasis (M) or secondary tumors formed by the spread of cancer cells to other parts of the body. A number is added to each letter to indicate the size and/or extent of the primary tumor and the degree of cancer spread.

Primary Tumor (T)

TX: Primary tumor cannot be evaluated

T0: No evidence of primary tumor

Tis: Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and is sometimes called preinvasive cancer)

T1, T2, T3, T4: Size and/or extent of the primary tumor

Regional Lymph Nodes (N)

NX: Regional lymph nodes cannot be evaluated

N0: No regional lymph node involvement

N1, N2, N3: Degree of regional lymph node involvement (number and location of lymph nodes)

Distant Metastasis (M)

MX: Distant metastasis cannot be evaluated

M0: No distant metastasis

M1: Distant metastasis is present

For example, breast cancer classified as T3 N2 M0 refers to a large tumor that has spread outside the breast to nearby lymph nodes but not to other parts of the body. Prostate cancer T2 N0 M0 means that the tumor is located only in the prostate and has not spread to the lymph nodes or any other part of the body.

For many cancers, TNM combinations correspond to one of five stages. Criteria for stages differ for different types of cancer. For example, bladder cancer T3 N0 M0 is stage III, whereas colon cancer T3 N0 M0 is stage II.

• Stage 0: Carcinoma in situ

• Stage I, Stage II, and Stage III: Higher numbers indicate more extensive disease: Larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or tissues or organs adjacent to the location of the primary tumor

• Stage IV: The cancer has spread to distant tissues or organs

Source: Oncology Nurse Advisor

Treatment Options

The treatment approach for male breast cancer is similar to that for female breast cancer and depends on factors such as the stage of cancer, type of cancer, and overall health of the patient.

Common treatment options include:

• Surgery: The primary treatment for male breast cancer involves surgical removal of the tumor. This can range from a lumpectomy (removing the lump) to a mastectomy (removing the entire breast).

• Radiation Therapy: Radiation may be recommended after surgery to target any remaining cancer cells in the breast.

• Chemotherapy: Chemotherapy is used to kill cancer cells or shrink tumors and is typically recommended for advanced or aggressive cancers.

• Hormone Therapy: Since male breast cancer is often hormone-receptor positive, hormone therapy may be used to block the effects of hormones like estrogen that can fuel the growth of cancer cells.

• Targeted Therapy: Some advanced cases may benefit from targeted therapies that specifically target the proteins involved in cancer growth.

• Clinical Trials: Participation in clinical trials may be an option, especially for individuals with advanced or hard-to-treat cancers.

Prognosis

The prognosis for male breast cancer varies depending on the stage at diagnosis and the effectiveness of treatment. When detected early and treated promptly, the outlook for many men with breast cancer can be quite favorable. However, advanced stages of the disease may present more challenges.

While male breast cancer is rare, it’s essential to be aware of the symptoms, risk factors and available treatments. Early detection through regular self-examination and medical check-ups can significantly improve outcomes. Men should not hesitate to seek medical attention if they notice any changes in their breast tissue or experience any concerning symptoms. Knowledge is a powerful tool in the fight against male breast cancer, and understanding its symptoms is the first step towards early diagnosis and effective treatment.