Out of all patients diagnosed with breast cancer, only 1% are men. The classical presentation of male breast cancer consists of a painless and hard tumour that appears behind the areola – the circular area around the nipple. This is different from breast cancer in women, who can present a tumour in different parts of the breast. In some cases, however, male breast cancer can manifest at the same time as gynecomastia. Read More
This condition involves the enlargement of a man’s ‘breasts’ due to hormone imbalances or the intake of female hormones. The combination simulates the pattern of cancer in females, where the cancer can occur in variable locations. As male breast cancer is rare, and these presentations make up only a portion of breast cancer cases, very few studies have investigated them. Better understanding of the pattern will facilitate prompt diagnosis and more effective therapeutic strategies.
Professor Dorothy Ibifuro Makanjuola of Women’s Health Hospital at King Abdulaziz Medical City Riyadh recently carried out a study to better understand the clinical implications of rare male breast cancer occurring in conjunction with gynecomastia.
As part of their study, Professor Makanjuola and her colleagues analysed the clinical data of 17 male patients who were diagnosed with breast cancer from 2011 to 2021. This data included the age of the patients, information outlining how the disease manifested, risk factors, other diseases or conditions, scans, and detailed pathology reports.
Out of the 17 male patients that were examined as part of the study, 9 exhibited classical presentations of male breast cancer, while 8 also had gynecomastia and thus showed female-like presentations of the disease.
Some of the patients with gynecomastia had tumour masses far from the nipple, sometimes diffused to other functional tissues, along with leukaemia or lymphoma, and enlarged lymph nodes in the armpit. The study showed that those with female-type presentation were not diagnosed as early as the others with classical presentation of breast cancer.
Importantly, Professor Makanjuola’s team found that these female-type presentations of breast cancer were successfully detected via a mammography – an imaging technique that utilizes x-rays to look inside the breasts.
Their study thus highlights the importance of prescribing a mammography to male patients with gynecomastia who present possible symptoms of breast cancer as early as possible, so that they can promptly start investigation and treatments as needed.
The team’s insights could guide the practices of oncologists and other healthcare workers, encouraging them to recommend a mammography to male patients presenting a breast mass, gynecomastia, or swollen breasts, to rule out the possibility of breast cancer.