Male breast cancer
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Male breast cancer is exceptionally rare and only accounts for less than 0.25% of male malignancies and ~0.5-1% of all breast cancer (both genders). The diagnosis is sometimes delayed due to the patient's hesitancy to seek advice. Workup from a radiological point of view is the same as for women, including the use of needle biopsy to confirm the diagnosis.
The average age of diagnosis of male breast cancer is 60-70 years, which is later than female breast cancer.
Most commonly, men present with a painless subareolar mass. Male breast cancer is also reported to present at a relatively advanced stage compared with female breast cancer 8.
Recognized risk factors include 9:
exposure to ionizing radiation: especially to the chest wall
testicular injury / infectious orchitis
increased levels of estradiol
consider this risk in transgender patients
liver dysfunction: cirrhosis
family history: ~30% of cases can have a positive family history
certain racial groups: may have a comparatively higher incidence
BRCA2 gene mutation 2
Please note gynecomastia is not a risk factor per se.
can occur anywhere within the breast but favors the subareolar area or the upper outer quadrant
favors a slightly eccentric location relative to the nipple 7
The genetic predisposition for breast cancer can be inherited from both mother and father. First line family history includes both genders.
Typically seen as a subareolar mass (often round, oval, or lobulated) and at times can be masked by the presence of concurrent gynecomastia 3. Calcifications tend to be fewer in number and coarser than in female breast cancer 1.
Treatment and prognosis
The overall prognosis tends to be worse than for female breast cancer, possibly due to the fact that men seek medical attention for the mass at later stages (i.e. when the mass has already become palpable).
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