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Breast cancer in men is rare, accounting for less than 1% of all
breast cancer cases. Although breast cancer in men occurs less
frequently than breast cancer in women, the diseases are similar in many
ways. Cancer begins when normal cells in the breast begin to change and
grow uncontrollably, forming a mass called a tumor. A tumor can be
benign (noncancerous) or malignant (cancerous, meaning it can spread to
other parts of the body).
The breast is mainly composed of fatty tissue. Within this tissue is a
network of lobes, which are made up of tiny, tube-like structures
called lobules that contain milk glands. Tiny ducts connect the glands,
lobules, and lobes to the nipple, located in the middle of the areola
(darker area that surrounds the nipple of the breast). Blood and lymph
vessels run throughout the breast; blood nourishes the cells, and the
lymph system drains bodily waste products. The lymph vessels connect to
lymph nodes, which are tiny, bean-shaped organs that normally help fight
infection.
The main types of breast cancer are the same for men and women. Most
breast cancer cases start in the ducts or lobes. Almost 75% of all
breast cancers begin in the cells lining the milk ducts and are called
ductal carcinomas. Approximately 25% of male breast cancers are lobular
carcinoma (cancer that begins in the lobules).
A type of breast cancer that has spread outside of the duct and into
the surrounding tissue is called invasive or infiltrating carcinoma. The
majority of male breast cancer cases are infiltrating ductal carcinomas
(IDC).
Disease that has not spread is called in situ, meaning "in place."
Ductal carcinoma in situ (DCIS) is the most common type of in situ
breast cancer, but it is uncommon in men.
Inflammatory breast cancer
makes up about 1% to 5% of all breast cancers. Paget's disease of the
nipple begins in the ducts, but spreads to the skin of the nipple.
Paget's disease is more common in men than in women. Other, less common
subtypes of breast cancer include medullary, mucinous, tubular, or
papillary.
Cancer may begin as a single, genetically abnormal cell. As this one
cell divides, it eventually becomes a tumor and develops a blood supply
to nourish its continued growth. At some point, cells may break off from
the primary mass and move to other parts of the body in a process
called metastasis.
Breast cancer spreads when breast cancer cells move to other sites in
the body through the blood vessels and/or lymph vessels. A common site
of spread is the regional lymph nodes. The lymph nodes can be axillary
(located under the arm), mediastinal (under the sternum or breast bone),
or supraclavicular (located just above the collarbone). The most common
sites of distant metastasis are the bones, lungs, and liver. Less
commonly, breast cancer may spread to the brain. The cancer can also
recur (come back after treatment) locally in the skin, in the same
breast (if it was not removed as part of treatment), other tissues of
the chest, or elsewhere in the body.
Breast cancer in men is detected the same way as breast cancer in
women is—through self-examination, clinical examination, or
mammography (x-ray of the breast). Changes in the breast may be easier
to detect because men have less breast tissue. However, the awareness of
breast cancer in men is much lower than it is in women; therefore, men
may not perform regular breast self-examinations or talk with their
doctor about the disease.
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