Explainer: From family history to lifestyle; understanding your risk factors for male breast cancer
Thought only women get breast cancer? You are wrong, here's what every Kenyan man needs to know.
What you need to know:
- Male breast cancer, though rare globally, shows higher prevalence among African and African American men at 4.2 per cent and 1.4 per cent respectively.
- The condition typically affects men around age 68 - about 20 years older than the median age for women with breast cancer in Kenya.
According to cancer experts, male breast cancer is a rare condition, making up less than one per cent of all breast cancer cases. However, the incidence of male breast cancer is notably higher in African American and African populations, with rates of 1.4 per cent and 4.2 per cent, respectively.
A study published in 2023 by the Department of Surgery at The Aga Khan University Hospital in Nairobi, titled Characteristics and Treatment of Breast Cancer in Men: A 12-Year Single-Institution Review, reveals that the diagnostic process for male breast cancer closely mirrors that of female breast cancer.
“For men over the age of 25 presenting with a breast lump, a mammogram should be the first step in evaluation. If the mammogram results are inconclusive or suggest cancer, an ultrasound is recommended. In men under 25, ultrasound is the preferred initial imaging technique,” the study indicated.
Based on the publication, if any suspicious masses are identified during imaging, a core biopsy is necessary to confirm the diagnosis and evaluate hormonal receptor and HER2 status.
The staging for male breast cancer follows the same protocols as for female breast cancer, and the treatment for male breast cancer is primarily informed by studies on female patients, as the rarity of male breast cancer makes randomised controlled trials difficult because of limited participation. Notably, male patients are more likely to undergo mastectomy, even for early-stage tumours.
In the study, the median age at diagnosis was 68, which aligns with the global median age of 67 for male breast cancer. “This is approximately 20 years older than the median age for breast cancer diagnosis in women in Kenya,” explains the study.
This difference may stem from the biological similarities between male breast cancer and late-onset female breast cancer, as well as associations with non-hormonal risk factors.
The exact causes of male breast cancer are not fully understood. It typically begins when breast tissue cells develop abnormal DNA changes, leading to uncontrolled growth and the formation of tumours. Factors influencing this process include:
Where breast cancer begins in men
Experts explain that everyone is born with a small amount of breast tissue, which includes milk-producing glands, ducts that transport milk to the nipples, and fat. During puberty, individuals assigned female at birth typically experience significant growth of breast tissue, while those assigned male at birth usually do not. However, since all individuals have some breast tissue, breast cancer can potentially develop in anyone.
According to Dr Miriam Mutebi, a breast cancer oncologist and assistant professor in the Department of Surgery at Aga Khan University Hospital, several factors can increase the risk of male breast cancer.
“Older age is a significant risk factor, with most diagnoses occurring in men in their 60s.”
Additionally, experts say that hormone therapy for prostate cancer or medications that contain oestrogen can elevate the risk, whereby men undergoing such treatments are more susceptible to developing breast cancer.
A family history, according to cancer experts, also plays a crucial role. If a man has a blood relative diagnosed with the disease, his likelihood of developing it increases. Furthermore, inherited DNA changes, such as those associated with the BRCA1 and BRCA2 genes, can heighten the risk, as these mutations are passed down from parents to their children.
Another contributing factor, according to cancer experts, is Klinefelter syndrome, a genetic condition where males are born with an extra X chromosome. This syndrome affects testicular development and disrupts hormonal balance, leading to a higher risk of breast cancer. Similarly, liver diseases like cirrhosis can alter hormone levels, further increasing susceptibility.
Obesity is also linked to male breast cancer, as it often results in higher oestrogen levels in the body. Lastly, conditions affecting the testicles, such as orchitis (inflammation) or surgeries like orchiectomy (removal of a testicle), can contribute to a greater risk of breast cancer in men.
According to Dr Mutebi, male breast cancer can present with several signs and symptoms. “The signs of male breast cancer are often similar to those in females, typically starting with a painless lump or thickening in the chest area, changes to the skin over the chest such as dimpling, puckering, scaling, or alterations in skin colour.”
Additionally, she adds that men may notice changes in the nipple, including colour changes, scaling, or an inward-turning nipple, as well as discharge or bleeding from the nipple.
Dr Mutebi terms it crucial for men not to dismiss these signs, as many mistakenly believe that breast cancer only occurs in women. “Early recognition of these symptoms is vital for effective treatment. Therefore, it is important for men to closely monitor any changes and not ignore potential symptoms, as breast cancer can affect them as well.”
