Archive for the ‘ Breast Cancer ’ Category
When you think of breast cancer, what comes to mind? Many people picture women, sometimes wearing pink, or a pink ribbon. Although breast cancer very commonly seen in women, men can also develop breast cancer and it’s important to raise awareness and support men breast cancer thrivers or survivors as well.
The following are key facts about breast cancer in men:
- The ratio of male-to-female breast cancer diagnoses is 1 man to every 120 women.
- Male breast cancer rates are on the rise, which may be related to the hormonal effects of obesity.
- Men are often diagnosed with breast cancer at later stages than women (because routine screening is not recommended for men).
- Male breast cancer is usually estrogen receptor positive (ER+).
Specific risk factors for male breast cancer include the following:
- A family history of breast cancer, especially in other male relatives
- Certain genetic syndromes
- BRCA gene mutation and other genetic mutations.
- Klinefelter’s syndrome (sex chromosome combination of XXY), which carries a 50-fold increase in risk
How Is Breast Cancer in Men Diagnosed?
Usually, a man will discover the breast mass himself and seek medical attention. His physician will then take a careful history, perform a physical exam, and often order breast imaging, including mammography and breast ultrasound. If the imaging is suspicious, the patient will need a biopsy for a tissue sample.
How Is Breast Cancer in Men Treated?
Surgical treatment options for men diagnosed with breast cancer are the same as those for women. Male breast cancer can be successfully treated with lumpectomy and radiation therapy (also called breast conservation therapy). The current breast conservation rate for male breast cancer in the United States is 13%. This means that many men with breast cancer are being treated with mastectomy.
Chemotherapy and/or endocrine therapy treatment recommendations are similar for men and women, and are dependent on the stage and biology of the patient’s cancer. For estrogen receptor–positive breast cancers in men, tamoxifen is the drug of choice.
The risk of developing a new breast cancer in the opposite breast for a male breast cancer patient is about 1% to 2%. Due to this very small risk, preventive mastectomy, also called prophylactic mastectomy, for the opposite breast is not recommended.
Other Considerations for Men with Breast Cancer:
- Genetic testing—8% of all male breast cancer patients will carry a BRCA2 gene defect. This information is especially important for their female relatives. Genetic counseling for family members can be lifesaving.
- Risk of another type of cancer—12.5% of men with breast cancer will develop a second type of cancer. The most common associated cancers are prostate cancer, pancreatic cancer, stomach cancer and colon cancer. Appropriate cancer screening guidelines are recommended.
Are Survival Rates Different for Men and Women?
Breast cancer survival for men and women is the same when the stage and biology of the breast cancer is similar. As with women, the earlier a breast cancer is detected and treated in a man, the better the chances are of taking care of the breast cancer and improving long-term survival.
-Dr. Ann Chuang
At the Premier Surgical Network, we are proud to offer both genetic testing and counseling services to our patients to support them throughout their breast health journey. Our team of surgeons are here to help you every step of the way when making informed decisions about your health.
What is genetic testing?
Genetic testing is done for individuals who have a genetic predisposition for developing breast cancer in the future, such as a family history. The BRCA gene test utilizes DNA analysis to identify changes in certain genes. These mutations can signal one of the two most common breast cancer genes, BRCA1 and BRCA2; Angelina Jolie and Christina Applegate raised public awareness regarding these genes. Both BRCA mutations are uncommon and make up only 5% to 10% of total breast cancer cases. One of the genetic panels that we use is made by INVITAE, which tests for 47 genes, not just BRCA1 and BRCA2. When patients have multiple gene mutations present, their risk for breast cancer increases significantly. If you test positive for a mutation, our team of specialists can better evaluate the potential benefits of surgery and other forms of preventive treatment.
To learn more about genetic testing and to see if you may be a candidate for genetic testing, click here.
What counseling services are offered?
Upon finding out results from genetic testing, a patient may experience many different emotions if they receive a positive BRCA test result. Feeling scared, overwhelmed or upset is completely normal and your surgeon will be able to discuss all your options with you. Additionally, finding that the BRCA testing result is negative can also bring on feelings of uncertainty, or a feeling of “survivors’ guilt” if their family members either tested positive for the gene, or have been diagnosed with breast cancer.
Our surgeons know how extremely difficult these emotions can be to deal with, and are here not only as your doctor, but as someone you can talk to while navigating your choices.
A patient of Dr. Anjeanette Brown recently underwent prophylactic mastectomies and a hysterectomy after discovering that she tested positive for a BRCA 1 mutation. Upon this discovery, she opted to have bilateral nipple sparing mastectomies and a hysterectomy to decrease her risk of developing cancer.
Many patients elect to have prophylactic, or preventative procedures for a number of reasons, the first reason being testing positive for the BRCA gene after going over their family history with their healthcare provider. Other patients choose to remove their second breast if they’ve already had cancer in the other breast, as a preventative measure for future cancers. Only after referral to the genetic counselor with an in-depth analysis, do our surgeons perform surgery. They also work with fertility doctors if the given patient is at a reproductive age.
Prophylactic mastectomies reduce the risk of developing cancer by 90 to 95% for patients with the BRCA1 or BRCA 2 mutation, so it is a great choice for patients who test positive for the gene. It also helps them reduce their anxiety or fear of developing breast cancer, so it has many psychological benefits as well.
However, our surgeons understand the psychological and emotional impact that mastectomies, prophylactic or not, can have on a patient. It is a huge decision to make and comes bearing other decisions as well, such as whether or not to undergo breast reconstruction. Our team is here for each patient throughout their breast care journey.
To schedule a consultation, please contact or office at (844)-973-0002 or visit our website premiersurgicalnetwork.com