Have you ever wondered why you keep hearing of women suffering from breast cancer, but rarely of men doing so? Why is it that less than one percent of patients reporting breast cancer are men? It means that fewer than one in a thousand men are likely to develop breast cancer. Breast cancer received global focus in 2013 when Angelina Jolie underwent double mastectomy (complete removal of both the breasts) as a preventive measure since she had a family history of breast cancer.
The common factor in both men and women is that genetic factors place them at high risk of developing breast cancer. It is vital to get a genetic screening if anyone in your family with whom you have blood relationship has ever suffered cancer. Mutations of BRCA1, BRCA2; TP53, the Li-Fraumeni syndrome causing mutations; PTEN, the tumor suppressor gene which causes Cowden’s syndrome; STK11; PALB2; MSH2, and MLH1 genes predispose a person to developing breast cancer.
It is vital to analyze what causes the disparities between the men and women in their predisposition to get breast cancer. Compare the immunohistochemical profile of male breast cancers with that of stage-matched female breast cancers. The immunophenotypic differences in men from those occurring in women, imply a different pathogenesis in the evolution and progression of the disease in men.
Men who exhibit defective BRCA1 and BRCA2 genes are likeliest to develop breast cancer. Since genetic conditioning is a critical factor in the likelihood of anyone getting cancer, the daughters of a man suffering from breast cancer are at a 40 to 80 percent higher chance of getting breast cancer at some stage of life. Unfortunately, women whose sister, mother, or grandmother/s, even daughter have suffered from breast cancer are at very high risk of getting it too. If a woman has suffered endometrial cancer, ovarian cancer, or uterine cancer; she has a higher susceptibility to getting breast cancer with or without metastasis.
The medical term for a breast is mammary gland. In women, its primary function is to secrete milk to nourish newborn children. However, men do not need to secrete milk. Therefore, male breasts don’t have the milk producing lobes; only the pectoral muscles of the chest. With women having more breast tissue, especially fatty and connective tissues between the lobules, their susceptibility is greater. The downside for men is fewer tissues means it is that much more difficult to identify the growth of any tumor in the first or even second stage. Net result is that the prognosis is very poor, and survival rates are heartbreaking — around 20 percent. Cystosarcoma phylloides, which is a cancer of the connective tissue in the breast is less likely to affect men than women, as women have more connective tissues in their breasts.
Some men suffer from enlarged breasts in a condition called gynecomastia caused by enlarged glandular tissue. Genetic predisposition; onset of puberty; hyperthyroidism; usage of herbs like lavender, dong quai, and tee tree oil which increase estrogen levels; faulty diet which relies on canned food, shrimps, beer, supermarket cheese or meat — especially red meats; or medication which causes a hormonal imbalance leading to lower testosterone levels could lie at the root of boys or men getting gynecomastia. Other causes of gynecomastia include aging, chronic kidney failure, cirrhosis of the liver, infection or trauma of the testes, and malnutrition. Breast reduction surgery is one option; though your doctor is likely to seek medicinal options first. Men suffering from gynecomastia are likelier to be susceptible to both breast cancer, and a rare cancer called Paget’s disease of the nipples which impacts the aureoles of the nipples.
Anyone trying to analyze and understand why women are naturally susceptible to breast cancer, should try and understand its structure. The breast is made of mostly fatty tissues overlying the pectoral tissues underneath, lymph glands, ligaments, and blood vessels. Note that there are no muscles in the breast itself. Each female breast is made up of 15-20 lobes. Milk is released from the breast via the nipple. Each nipple has 6-9 major ducts that open in its surface. Each major duct divides and re-divides into smaller ductules, which open into a small sac where milk is produced. The ductules are essentially modified sweat glands, and are also called Montgomery’s tubercles. Multiple such sacs form together to form a lobule, and multiple lobules join to form a lobe.
The primary reason women are more susceptible to breast cancer is because the female breast is made of mostly fatty tissues, also known as adipose tissues. 90 percent of breast cancer arises from the ducts or ductules, and 10 percent from the lobules (milk producing bulbs or sacs). Those arising from the ducts are called ductal carcinoma, and those arising from the lobules are called lobular carcinoma. Breast cancer first starts in the lining of the ducts or lobules. Once confined to the ducts or lobules, it is called cancer in situ — ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS). Ductal carcinoma is the more dangerous, and accounts for around 80 percent of all reported breast cancer cases.
Being overweight or obese is linked to a higher risk of 13 different types of cancer. It should be kept in mind that non-genetic risk factors for male breast cancer (MBC) have displayed higher hormone levels and obesity to be significant risk factors for the disease. Women with dense breasts, those who bore their first child after turning 30, or experienced onset of periods before turning 13 are all at risk of getting breast cancer. A sedentary lifestyle, alcohol abuse, drug abuse, and high dose radiation to the chest can cause breast cancer in both men and women.