Causes of Breast cancer in Men



A breast cancer is a malignant tumor that starts from cells of the breast. Amalignant tumoris a group of cancer cells that may grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer.
Normal breast structure
To understand breast cancer, it helps to have some basic knowledge about the normal structure of the breasts.
The breast is made up mainly of lobules (glands that can produce milk if the right hormones are present), ducts (tiny tubes that carry the milk from the lobules to the nipple), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, blood vessels, and lymphatic vessels).

Until puberty (on average around age 9 or 10), young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola (area around the nipple). At puberty, a girl’s ovaries make female hormones, causing breast ducts to grow, lobules to form at the ends of ducts, and the amount of stroma to increase. Even after puberty, men and boys normally have low levels of female hormones, and breast tissue doesn’t grow much. Men’s breast tissue has ducts, but only a few if any lobules. Like all cells of the body, a man’s breast duct cells can undergo cancerous changes. But breast cancer is less common in men because their breast duct cells are less developed than those of women and because they normally have lower levels of female hormones that affect the growth of breast cells.

Although the breast tissue in men differs somewhat from that in women, breast cells in men are susceptible to cancer growth, even though the chances of breast cancer developing in men is much less than it is for women. While breast cancer will affect 1 in every 8 women over their lifetime, it impacts only 1 in every 1,000 men.

Up until the beginning of puberty, males and females each have a few ducts (tube-like structures) in the breast tissue located in the area of the nipple. Once a female’s ovaries begin to produce hormones, her breast ducts grow and develop lobules, which make milk. In males, however, male hormones manufactured by the testicles prevent further development of breast tissue, ducts, and lobules.

However, the breast tissue in men can undergo changes that lead to cancer, even though men have much lower levels of the hormones that affect breast cancer growth.

Risk Factors For Breast Cancer in Men

Scientists do not completely understand the causes of breast cancer in men, but a number of risk factors have been identified.

Age: As in women, the risk of breast cancer in men goes up with age, with 68 being the average age a man is diagnosed with the disease
Gene mutations: Men who have inherited a mutation of the BRCA2 or BRCA1 genes, which are breast cancer genes, have an increased risk of the disease.
Family history: About 20% of men with breast cancer have a close male or female relative with the disease
Exposure to radiation: Prior radiation to the chest may increase risk.
Klinefelter syndrome: This rare congenital condition affects about 1 in 1,000 men and is characterized by men who have higher than normal levels of female hormones and lower than normal male hormones.
Alcohol: Excessive alcohol use increases the risk of breast cancer in men.
Liver disease: Because the liver has a key role in the metabolism of sex hormones, liver disease can lead to abnormally high estrogen levels in men.
Obesity: Fat cells transform male hormones into estrogens, and so men who are obese have higher levels of estrogens, which in turn may increase their risk of breast cancer.
Testicular conditions: Men who develops mumps as an adult, have an undescended testicle, or who have had their testicles removed may be at increased risk of breast cancer.
Types of Breast Cancer in Men

Breast cancer in mencan develop in a number of different ways. The most common type of breast cancer is called invasive ductal carcinoma, which means the breast cancer spreads beyond the duct and develops in the fatty tissue of the breast. This type of breast cancer can then spread (metastasize) to other parts of the body. About 80% of male breast cancer cases are invasive.

About 10% of male breast cancer cases are called ductal carcinoma in situ, which means the cancer stays in the breast ducts and does not spread outside the duct walls. Nearly all cases of ductal carcinoma in situ can be cured with surgery.

The remaining 10% of male breast cancer cases include various rare forms of the disease, including invasive lobular carcinoma (which starts in lobules, which are uncommon in men), Paget disease of the nipple, and inflammatory breast.

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Detecting Breast Cancer in Men

Because breast cancer in men is not common, most men don’t even think about it. However, if you notice any breast lumps or growths, you should have them checked by your healthcare provider. Don’t be embarrassed; while the lump may be just an infection or be related to some other noncancerous cause (e.g., gynecomastia; see below), checking any unusual growths is important. Breast cancers in men tend to be smaller than they are in women, but because men have little breast tissue, cancer can spread more extensively.

Signs of Breast Cancer in Men

Possible signs of breast cancer men should watch out for include the following:

Appearance of a lump or swelling in the breast, which may or may not be painful
Puckering or dimpling of the skin on the breast
Scaly or red nipple or breast skin
Discharge from the nipple
Retracted nipple (nipple that turns inward)
Treatment of Breast Cancer in Men

Treatment of breast cancer in men includes methods also used in women: surgery, radiation, chemotherapy, hormone therapy, and targeted therapy (drugs designed to target gene changes). Most men undergo some type of surgery, or a mastectomy, that may or may not also require the removal of lymph nodes under the arm and/or the chest wall muscles under the chest if the cancer has spread that far. Radiation, chemotherapy, hormone therapy, and targeted therapy may be given either before or after surgery to help reduce the risk the cancer will recur after surgery, or they may be given after surgery to treat cancer that has come back.

Some men with breast cancer are also treated with bisphosphonates, which are drugs that help reduce bone pain associated with metastatic breast cancer, as well as strengthen bones and reduce the risk of fractures. Zoledronic acid (Zometa) and pamidronate (Aredia) are examples of bisphosphonates. Another drug called denosumab (Prolia) also reduces the risk of fractures and other problems associated with treatment of breast cancer, but it is not in the same drug class and seems to provide better results.


The most common operation for men with breast cancer is removal of the whole breast (mastectomy) including the nipple. There is not very much breast tissue in men, so it isn’t usually possible to leave any behind. Sometimes the surgeon also removes part of the underlying muscle if it is close to the cancer.

For men diagnosed with invasive breast cancer the surgeon may remove some of the lymph nodes from the armpit. They send the nodes to the laboratory to see if they contain cancer cells. Or the surgeon may check the lymph nodes closest to the breast using a procedure called sentinel node biopsy.

For men, implants currently available don’t recreate the correct shape of a man’s breast so it is not usual to have breast reconstruction. But sometimes your surgeon may be able to improve the appearance of the chest with more surgery after mastectomy.

Diet and Breast Cancer:

Some people being treated for breast cancer may experience weight loss due to side effects like nausea. However, weight gain is more common in people being treated for breast cancer. This weight gain, in addition to carrying extra body weight, may lead to poor outcomes from treatment. Maintaining bone health is also very important for people being treated for breast cancer. Also, breast cancer and its treatment can bring about metabolic changes that cause or aggravate symptoms of diabetes.

Dietary fats and breast cancer:

Fats include oils, butter and margarine as well as the fat in meats, fish and nuts. Remember there are also hidden fats in sweets, biscuits, cakes and other foods that you buy ready made.

An overview study (meta analysis) of 45 studies reported that after the menopause women who had more fats in their diet had an increased risk of breast cancer. The EPIC study has shown that women who ate higher levels of saturated fats had double the risk of breast cancer compared to those eating the least.

Foods high in saturated fat include

*Fatty cuts of meat
*Meat products, including sausages and pies
*Butter, ghee and lard
*Cheese, especially hard cheese
*Cream, soured cream and ice cream
*Some savoury snacks and chocolate products
Biscuits, cakes and pastries

Based on the evidence, it appears that saturated fat does play a role in increasing breast cancer risk. But it is probably a combination of this as well as other things that causes breast cancer.

People who eat a lot of foods containing fish oils (marine omega-3 polyunsaturated fatty acids) seem to have a lower breast cancer risk than people who only eat small amounts.

Sugars, carbohydrates and breast cancer:

There is no strong evidence of a direct link between sugars and carbohydrates and breast cancer. But a large study of Chinese women in the USA reported in 2009 that for women younger than 50 a high carbohydrate diet slightly increased the risk of developing breast cancer. And the EPIC study showed that high carbohydrate diets are linked to an increased risk of a type of breast cancer called oestrogen receptor negative breast cancer.

Eating too much sugar can make you put on weight and we know that being overweight increases the risk of breast cancer in post menopausal women.

Dairy foods and breast cancer:

Dairy products have been studied for their effect on breast cancer risk. Some recent studies have shown that women with a high intake of dairy products have a lower risk of breast cancer, but we need results from more studies before we can be sure about this. Dairy products are high in calcium, and several studies show a lower risk of breast cancer for women with high calcium intakes or calcium blood levels.
Fibre and breast cancer:

Fibre is found mostly in fruit, vegetables and whole meal cereals (including flour and all kinds of bread, particularly whole grain). There is some evidence that diets containing more than 25g of fibre per day reduce the risk of breast cancer in pre menopausal women.

Eating wheat bran fibre has been found to lower the levels of oestrogen in the blood in women who have not yet had their menopause. Lower levels of oestrogen may help to reduce the risk of breast cancer. Researchers aren’t quite clear about why wheat fibre reduces oestrogen levels. It may not be an effect of the fibre itself. Instead it may be that high fibre diets contain less fat and more antioxidants than low fibre diets.
Fruit and breast cancer:

An overview study found that women who ate more fruit had a lower risk of breast cancer. This may be due to the fibre and antioxidants that they contain. Anti oxidants are molecules that prevent a chemical process called oxidation, which occurs when oxygen molecules join with another chemical. Oxidation can cause gene damage in cells that may lead to cancer. Antioxidants include vitamins A, C and E and selenium.

If you change your diet to include more fruit and vegetables, as well as more starchy carbohydrates, you will almost certainly eat less fat. So you will be more likely to keep your weight within a healthy range. This helps to reduce your risk of breast cancer.
Soya foods and other phyto oestrogens:

Because of the difference in breast cancer rates in different parts of the world, scientists have been looking into whether eating phyto oestrogens, could affect the risk of getting breast cancer.

Phyto oestrogens are chemicals found in plants (phyto means plant). So they can also be called plant oestrogens. They have a similar structure to the female sex hormone oestrogen. There are different types of phyto oestrogens. Some are found in soya bean products (isoflavones). Others are found in the fibre of whole grains, fruit, vegetables and flax seed (lignans). Milk may also contain phyto oestrogens, but this depends on what the cows have been eating.

Lignans are the main type of phyto oestrogens in the Western diet. Research into the effect of lignans on breast cancer risk was conflicting. So in 2009 researchers looked at all the studies that had been done. They found that in women who had had their menopause, high levels of lignin in the diet slightly reduced their breast cancer risk. It had no effect for premenopausal women though.

A joint study reported in July 2002, produced by Cancer Research UK, the National Cancer Institute of the USA, and the National University of Singapore. It found that women with a diet high in soya had less dense breast tissue than women with low soya diets. Higher density of breast tissue has been linked to a higher risk of breast cancer. This is the first study to directly link eating soya with an effect on breast tissue. Combining the results of lots of separate studies (a meta analysis) showed that Asian women who eat the highest amounts of soy foods had a lower risk of breast cancer. In other parts of the world, most women do not eat enough soy to reduce their risk of breast cancer.

In some studies, eating phyto oestrogens (soya flour and linseed supplements) regularly over several weeks reduced oestrogen levels. One of the active ingredients in soya is isoflalavone. This chemical is similar to oestrogen and reduces the effect of human oestrogen in the body. High levels of human oestrogen can increase breast cancer risk.


Carotenoids are organic colourings (pigments) found in some plants. Foods that are good sources of carotenoids include carrots, sweet potatoes, spinach, kale, greens, papaya, bell peppers, and tomatoes. A summary of published studies has shown that women with higher levels of carotenoids in blood samples may have a lower risk of breast cancer.
Flavonols and flavones:

Flavonols and flavones are substance found in plants and are also called flavonoids or bioflavonoids. Flavonols are found in high levels in

*Black tea, green tea and oolong tea

Flavones are found in

*Aromatic herbs (such as parsley)
*Camomile tea

Studies have shown that people who have high levels of flavonoids in their diet have a lower risk of breast cancer than people with lower levels.
Coffee and breast cancer:

We have included information about coffee because it is often in the news. A lot of research has looked into coffee drinking and cancer risk. Breast cancer is one of the cancers investigated. But there is no research evidence to show that coffee increases breast cancer risk.
Gynecomastia Is Not Breast Cancer

Perhaps you’ve experienced or know men who have had a common male breast disorder calledgynecomastia. Sometimes referred to as “man breasts” or “man boobs,” gynecomastia often appears as a small mass of tissue under the nipple and areola that can be felt when applying slight pressure. In some men gynecomastia is more severe and causes the breasts to grow somewhat larger.

Gynecomastia is usually caused by an imbalance of hormones. That’s one reason why men who take steroids can develop gynecomastia. Other causes of gynecomastia include liver disease, obesity, use of some medications (e.g., those for treatment of ulcers, high blood pressure, heart failure, heartburn), or a rare genetic condition called Klinefelter syndrome, which can also increase a man’s risk of getting breast cancer.

Breast cancer in men is rare, but it is a serious, even deadly disease. If you experience any of the signs of breast cancer, see your healthcare provider as soon as possible.

– See more at:

Lisa Attebery, D.O., breast surgeon, assistant professor of surgery, Dept. of Surgery, Cooper University Hospital, The Cancer Institute of Surgery

Jennifer Harned Adams, Ph.D., Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas

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