Breast cancer may not be common among men but the mortality rate is higher than in women. Medical student Yimeng Zhang points out that these patients often do not receive enough physical, emotional and psychological support.

The most common symptom for men with breast cancer is a lump in the breast area.

Breast cancer is often associated with women; however, men can also be affected, even though this is less common. Often, people do not realise that men can get breast cancer as they do not consider men as having breasts. Nonetheless, both men and women have breast tissue, with men having a much smaller amount than women.

Only about one in a 1,000 men develops breast cancer in their lifetime. As the disease is rare in men, there is less knowledge regarding their experiences with breast cancer and less research is carried out regarding its outcome and treatment. This also means that most of the support and information available is aimed at women. However, much of the information regarding men with breast cancer is the same as for females, including the symptoms, diagnosis and treatments.

There are some differences in the risks between the two genders and in some areas men may require different information to women, such as the type of breast surgery that might be required.

There are various types of breast cancer, with the most common one in both men and women being invasive ductal carcinoma, which can spread to other areas of the body. Sometimes the breast tissue of men can also become enlarged due to a non-cancerous condition called gynaecomastia.

The exact causes of breast cancer in men are not fully understood but certain factors may increase the risk. Similar to breast cancer in women, the most important risk factor is advancing age. Most men who get breast cancer are over 60 years of age, although younger men can also be affected. Other risk factors include:

• Radiation: Repeated exposure to radiation over a long period of time increases the risk of developing breast cancer due to its effects on normal healthy tissue.

• Significant family history of blood relatives over several generations: men who have female relatives with breast cancer have an increased risk, especially if the women are close relatives or diagnosed at a young age. They may inherit an altered gene, most commonly the BRCA2 (Breast Cancer 2) gene. In fact, 10-20 per cent of diagnoses of men with breast cancers are due to inherited faulty genes. If you are concerned about your family history, speak to your GP for guidance.

• High oestrogen levels: although oestrogen is the main female hormone, it is normal for all men to produce some oestrogen. However, high oestrogen levels can stimulate the development of breast cancer. Increased oestrogen levels can occur in men because of long-term liver damage, obesity as well as some genetic conditions such as Klinefelter’s syndrome (a very rare disorder which can increase a man’s risk of breast cancer by 20 times).

The most common symptom for men with breast cancer is a lump in the breast area. This is nearly always painless and it is usually near the centre, close to the nipple. This is because most of the breast tissue in men is beneath the nipple. Other symptoms can include: oozing from the nipple (a discharge) that may be blood, swelling or ulceration of the breast area, a tender (hurts when pressure is applied) or drawn in (inverted) nipple and occasionally, the lymph nodes (glands) under the arm may also be swollen, forming lumps. The sooner the breast cancer is diagnosed and treated, the better the outcome may be. Consequently, it is important to get any symptoms checked out as quickly as possible.

The same tests and treatments are used for breast cancer in both men and women. The most common tests used for detecting breast cancer are ultrasound and breast X-ray (mammogram). This can be followed by a biopsy, where a sample of tissue is taken for further examination under a microscope. If these tests show that indeed breast cancer is present, other tests may be conducted to check whether it has already spread.

Treatments will depend on the stage of the cancer, its type and characteristics. These can include radiotherapy, chemotherapy, hormone therapy and surgery, with the most common being the removal of the whole breast tissue (mastectomy).

When men are diagnosed with breast cancer, they are normally of an older age and more likely to have lymph node involvement than women. This could be related to the lack of awareness of the disease among the patients as well as healthcare professionals, in addition to the lack of routine screening.

Men with breast cancer have a lower survival rate than women. However, this is not always due to the cancer itself but rather because men generally have shorter life-spans with more additional health problems such as heart disease.

The exact causes of breast cancer in men are not fully understood but certain factors may increase the risk

Often men who are diagnosed with breast cancer undergo different experiences than their female counterparts. Women are often provided with larger amounts of information and support, whereas men are left with less reassurance.

Sometimes men also have to deal with the issues of masculinity and stigmatism that come along with having breast cancer as it is considered to be a feminine issue. This, in addition to the other physical and emotional concerns, explains why almost a quarter of men experience traumatic stress symptoms specific to breast cancer. Likely risk factors for distress include negative body image, the use of avoidant coping strategies, fear and uncertainty in relation to breast cancer and unmet information needs.

The risk of getting breast cancer can be reduced by decreasing alcohol intake and maintaining a healthy lifestyle and weight through regular exercise and a balanced diet packed with fruits and vegetables. By knowing the symptoms of breast cancer, men can seek help from a physician earlier, which would lead to a better outcome.

Male breast cancer is a serious issue and it is crucial that its awareness is raised to provide men with better physical, emotional and psychological support.