Rwanda: Breast Cancer Month - Men Urged on Early Screening

12 October 2019

October is breast cancer awareness month. And whereas the spotlight is commonly put on breast cancer in women, male breast cancer is a concern that needs immediate attention.

Male breast cancer is rare cancer that forms in the breast tissue of men. So far, information indicates that male breast cancer accounts for just 1% of all breast cancer cases.

However, regardless of the fact that this ailment is a relatively rare cancer, oncologists point out that it is as aggressive as that in women.

Dr. Archille Manirakiza, a Clinical and Radiation Oncologist says male breast cancer numbers vary differently from one area to another. While in some countries like the US, the numbers span between 0.5-1% of all breast cancers, they tend to be high in other countries and get at least 6% of all breast cancers (female included).

He explains that breast cancer in men is as dangerous as it is with women, however, in men, it tends to be aggressive and has poor survival rates when compared to women.

Risk factors

As with other cancers, breast cancer has no known cause so far but medics understand that male breast cancer occurs when some breast cells divide more rapidly than healthy cells do.

The accumulating cells form a tumor that spreads (metastasize) to nearby tissue, to the lymph nodes or to other parts of the body. There are risk factors however that increase the chances of a man getting breast cancer.

Dr. Manirakiza says the risk of getting breast cancer increases with age, having at least one close family member (first degree) with a history of breast cancer, obesity, substance or drug use such as marijuana, and hormonal disturbances (excessive estrogen or any primary testicular disease).

"There is also literature suggesting hormonal disturbances (hyperestrogenism) that comes secondary to hepatic dysfunction," he says.

Where does breast cancer begin in men

Data from the Mayo Clinic website shows that everyone is born with a small amount of breast tissue. Breast tissue consists of milk-producing glands (lobules), ducts that carry milk to the nipples and fat.

During puberty, women begin developing more breast tissue, and men do not. But because men are born with a small amount of breast tissue, they can develop breast cancer.

With men, there is cancer that begins in the milk ducts (ductal carcinoma). Nearly all male breast cancer is ductal carcinoma, data shows.

There is also cancer that begins in the milk-producing glands (lobular carcinoma). This type is rare in men because they have few lobules in their breast tissue.

Other types of cancer (rarer types of breast cancer that can occur in men) include Paget's disease of the nipple and inflammatory breast

cancer.

Signs of breast cancer

Dr. Fidel Rubagumya, a Clinical Oncologist says that the signs and symptoms are mostly like those of breast cancer in women noting that for men, they are more visible because the male breast is small.

"One of the signs is a lump, mostly a painless lump, and also there could be thickening in your breast tissue," he said.

He added that changes to the skin covering the breast, such as dimpling, puckering, redness or scaling as some of the signs and

symptoms.

Changes to your nipple, such as redness or scaling, or a nipple that begins to turn inward and discharge from your nipple are signs as well, he noted.

How is it treated?

Dr. Rubagumya says doctors use the same treatment used in managing female breast cancer. He explains that diagnosis for breast cancer is done by biopsy and then laboratory testing.

Biopsy involves removing a sample of breast cells for testing. This involves a medic using a specialized needle device guided by an X-ray or another imaging test to extract a core of tissue from the suspicious area.

Dr. Manirakiza also highlights that the treatment of male breast cancer does not differ much from the usual treatment of female breast cancer.

It consists of a combination of surgery, chemotherapy and radiation therapy in a sequential way and inter-changeably.

The difference comes in with surgery, this difference lies primarily in the tissue difference between males and females.

This at times allows some women in their earlier stages of infection to be able to retain their breast in the procedure, this is called breast-conserving surgery and this cannot be done in males ( they usually get a mastectomy).

Every other treatment modality is adapted according to the disease stage, he explains.

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