Male Breast Cancer (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Male breast cancer facts
- What is male breast cancer?
- How common is male breast cancer?
- What are causes and risk factors of male breast cancer?
- What are the different types of male breast cancer?
- What are male breast cancer symptoms and signs?
- How is male breast cancer diagnosed?
- What is staging of male breast cancer?
- What is the medical treatment options for male breast cancer?
- What health care specialists treat male breast cancer?
- What is the outcome (prognosis) of male breast cancer? What is the survival rate for male breast cancer?
- Is it possible to prevent male breast cancer?
- Find a local Oncologist in your town
How is male breast cancer diagnosed?
Diagnosis of breast cancer requires identifying cancer cells in tissue specimens obtained by taking a sample of the growth - also called a "mass" or "tumor" - by the technique of biopsy. Since men have little breast tissue, cancers in male breasts are easily palpable (located by feel) and, therefore, are easily accessible to biopsy. Fine needle aspiration or needle biopsy of a suspicious mass can usually establish a diagnosis. A doctor inserts a needle into the mass to withdraw tissue from the suspicious area. Microscopic examination of the tissue by a pathologist establishes the diagnosis.
Other techniques that may be used to diagnose breast cancer in men include incisional (removing a portion of the suspicious tissue) or excisional (removing the mass in its entirety) biopsy of a breast mass. If nipple discharge is present, microscopic examination of a smear of the discharge can sometimes establish the diagnosis.
What is staging of male breast cancer?
Doctors carry out staging to determine the extent to which a cancer has spread within the body. Staging of breast cancer in men is carried out identically to the staging of breast cancer in women. Imaging studies such as X-rays, CT scans, magnetic resonance imaging (MRI), ultrasound, and bone scans may be performed to evaluate the presence and extent of metastatic disease once the initial diagnosis of breast cancer had been made. The American Joint Committee on Cancer (AJCC) TNM staging system takes into account the tumor size, lymph node involvement by cancer, and presence of metastasis. For 2018, a new edition of the AJCC staging system also takes into account biologic characteristics of the tumor including estrogen receptor (ER) and progesterone receptor (PR) status, tumor grade (the appearance of the cells under a microscope and their similarity to normal cells), and the presence of the HER-2 protein on the cancer cells.
- T: tumor size and extent of local spread
- N: extent of tumor involvement of lymph nodes in the axillary (underarm) region. Since the nipple area is rich in lymphatic vessels, male breast cancer commonly spreads via the lymphatic channels to the axillary lymph nodes. (When the tumor has spread to the lymph nodes, doctors sometimes use the term "lymph node-positive" cancer.)
- M: presence of distant metastases (spread to other parts of the body through the bloodstream or lymphatic vessels)
Stage 0 refers to intraductal carcinoma or ductal cancer in situ, in which the cancer cells have not spread beyond the boundaries of the ducts themselves.
In Stage I breast cancer, the tumor is 2 cm or less in greatest diameter and has not spread to the lymph nodes or to other sites in the body.
Stage II cancers are divided into two groups. Stage IIA cancer is either less than 2 cm in diameter with spread to the axillary lymph nodes, or the tumor is between 2 cm-5 cm but has not spread to the axillary lymph nodes. Stage IIB tumors are either larger than 5 cm without spread to the lymph nodes or are between 2 cm-5 cm in size and have spread to the axillary lymph nodes.
Stage III is considered to be locally advanced cancer. Stage IIIA means the tumor is smaller than 5 cm but has spread to the axillary lymph nodes, and the axillary lymph nodes are attached to each other or to other structures; or the tumor is greater than 5 cm in diameter with spread to the axillary lymph nodes, which may be attached to each other or to other structures. Stage IIIB tumors have spread to surrounding tissues such as skin, chest wall, or to the lymph nodes inside the chest wall.
Stage IV cancer refers to metastatic cancer, meaning it has spread to other parts of the body. With breast cancer, metastases (sites of tumor elsewhere in the body) are most often found in the bones, lungs, liver, or brain. It may also reoccur in and spread to involve areas of the chest wall, skin, and muscles, as well as more distant lymph nodes.
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