Breast cancer in men

Men also have mammary glands that are somewhat different from females, but they can also develop a malignant tumor.

Breast cancer in men is not diagnosed often, it was previously believed that this type of cancer is tolerated to men worse, but recent studies have shown the opposite and, as it turned out, both sexes have equal chances of recovery. In ICD 10 breast cancer is under the code C50 (malignant neoplasms of the breast).

[1], [2],

Causes of the breast cancer in men

The true causes that cause the appearance of a tumor in the mammary glands of men remain unclear, but experts identify the following risk factors that contribute to the development of cancer. Breast cancer in men, as well as in women, depends on hormones. Also on the development of oncology affects age - the older a person, the greater the risk of developing cancer (usually cancer is detected in patients older than 68 years).

At risk are patients with "severe heredity", every fifth patient who has breast cancer diagnosed has a close relative suffering from a similar disease. In addition, specialists found that with the mutations of the BRCA2 gene, the risk of oncology is much higher.

Another risk factor is a fairly rare hereditary disease - Kleinfelter syndrome, which is characterized by an excess of female sex hormones, an increase in the mammary glands, sometimes - infertility, small testicles.

Also, risk factors include:

• radiation
• alcohol abuse
• liver disease
• taking hormonal drugs (especially female sex hormones)
• excess weight
• removal of testicles
• work in harmful production

[3], [4], [5]

Pathogenesis

Usually breast cancer in men begins to develop in old age, usually against the background of gynecomastia.

Men's mammary glands are considered a rudimentary organ, i.e. Lost their appointment in the course of evolutionary development. Sometimes the lifestyle or intake of certain drugs can disrupt the balance of hormones in the body of a man and lead to an increase in the level of female hormones, which causes the growth of the breast (one or both).

The cancerous process begins to develop in men after the onset of male menopause (andropause), with the testicles outside the scrotum (non-admission, absence, etc.), androgen deficiency, testicular atrophy, hormonal imbalance. In the pathogenesis of oncology, men also have a hereditary factor, frequent trauma, metabolic disturbances.

Since the size of the mammary gland is small in men, the tumor grows rapidly and spreads to the adjacent tissues, metastasizes to the lymph nodes.

[6], [7], [8], [9], [10], [11], [12]

Symptoms of the breast cancer in men

The development of cancer in a man can indicate the appearance of a tumor in the chest that is well palpated, soreness, retraction or puckered skin of the nipple, sores, flaking, redness on the skin, in the areola, nipple, compaction of the axillary lymph nodes from the tumor.

If there is a suspicion of breast cancer in men, additional tests are being performed to confirm the diagnosis.

[13], [14], [15]

First signs

The first sign of cancer can be the appearance of a tumor in the chest, which is well palpated. In men, the mammary glands are much smaller than in women, so the tumor in most cases develops close to the skin and can be detected in the initial stages.

[16]

Forms

In men, the following types of cancer are identified:

• non-invasive protocol cancer - affects the ducts of the breast, does not go beyond the gland and does not affect fatty tissue, this type of cancer is treated surgically, in most cases a positive effect is achieved.
• infiltrative ductal carcinoma - the tumor sprouts into adipose tissue, metastasizes.
• infiltrative lobular cancer - affects the lobules of the breast, fatty tissue, is extremely rare.
• Paget's disease - the tumor affects the ducts, nipples or areola.
• edematous-infiltrative cancer is a very aggressive form of cancer, extremely rare in men.

[17]

Complications and consequences

Breast cancer in men can metastasize to the liver, lungs, bone and brain. Cancer intoxication of the body and the progression of the disease itself in a short time can lead to death.

The main treatment for breast cancer is the surgical removal of not only the breast with the tumor, but also the adjacent lymph nodes. Removal of lymph nodes leads to impaired lymph flow, which can cause swelling and limited mobility of the hand, but performing a certain set of exercises, you can completely restore mobility.

After radiation or chemotherapy, skin may appear peeling, redness, inflammation. After such treatment, direct sunlight should be avoided, contact with household chemicals, cosmetics (gels, lotions, deodorants) should be minimized, clothes made of natural fabrics should be worn so as not to provoke even more irritation.

The main complication of this treatment is alopecia, but after the end of the treatment the hair gradually grows.

Breast cancer in men, as well as in women, requires long-term treatment, and complications after it occur almost always. But with the right approach and observance of the doctor's recommendations, the appearance after the course of therapy is quickly restored, and the patient's condition is normalized.

[18], [19], [20], [21]

Diagnostics of the breast cancer in men

During the examination of the patient, the specialist assumes the development of breast cancer and, to confirm the diagnosis, appoints an additional examination - mammography, ultrasound, biopsy, etc., which allows to establish the malignancy of the process and the stage of the disease.

Mammography is a study of the mammary gland with the help of X-ray images, after which the expert can confirm the suspicion of cancer.

Ultrasound is a widely used diagnostic procedure that is used to detect many diseases. The method is relatively inexpensive, simple and safe, it is based on the passage of ultrasound waves through the tissues of the body and the creation on the computer of an image by which the state of organs and the tissue structure are assessed.

If a mammogram or palpation revealed the presence of a tumor, ultrasound shows the nature of the neoplasm - cyst or solid formation. But this method does not allow to determine the malignancy of the process.

Discharges from the nipples are sent to a laboratory study, in which atypical cells can be detected.

A biopsy can accurately establish the cancer process. For the study takes a sample of the tumor. There are several diagnostic methods that are used, depending on the case:

• needle biopsy - using a syringe from the tumor and "pumped out" content, which is then sent to the laboratory to identify atypical cells. If the tumor is not probed, the syringe is administered under the supervision of an ultrasound or an X-ray.
• stereotactic biopsy - suggests the study of several tumor sites, with a non-palpable tumor, the analysis is performed under the supervision of ultrasound or X-ray.
• Incisional biopsy is in some ways a surgical intervention. A rather large area of tissue is taken for the study, usually this method is prescribed if the needle biopsy is not sufficiently informative or a tumor of a rather large size. The purpose of this method is to establish a diagnosis, but not treatment, since only a part of the tumor is excised. Once the diagnosis is confirmed, an operation is performed to remove the tumor.
• Excisional biopsy is also a diagnostic operation, in which the tumor is completely removed from the breast and sent to a laboratory study. Diagnosis is as accurate as possible, but is not therapeutic, after confirmation of the cancer process, an operation is performed to remove the breast.

Magnetic resonance imaging is assigned to determine the ratio of the tumor to deeper tissues. The results of MRI help the surgeon determine the choice of surgery and facilitate the process of removing the tumor.

[22], [23], [24], [25], [26]

Analyzes

Breast cancer in men can also be confirmed by a blood test.

To confirm the diagnosis, a specialist can prescribe a genetic blood test that identifies mutations in the genes responsible for normal cell division.

Usually, with this form of cancer, a blood test is done for the cancer markers Sa-15-3, BRCA, CEA.

Genetic analysis of blood on the BRCA is prescribed if the patient's relatives have had breast cancer. The analysis allows to determine the degree of risk of development of the oncological process. But do not diagnose the disease.

The blood test for the on-markers Sa-15-3 is used to diagnose breast cancer. A high level of Ca-15-3 in the serum means the development of the pathological process, and, usually, metastasis.

This analysis is important enough and it is also used to determine the effectiveness of treatment, relapse.

REA (determination of the level of cancer embryonic antigen) allows to determine the cancer process of any localization, this analysis is the most common. An insignificant level of antigen is present in the cells of the pancreas, liver, GIT.

[27], [28], [29]

Instrumental diagnostics

Instrumental diagnosis of breast cancer can be invasive and non-invasive.

To invasive methods, i.e. Requiring the violation of the integrity of the skin and tissues, include various methods of biopsy, to non-invasive (not damaging skin integuments and body tissues) ultrasound, MRI, CT, etc.

In the early stages, a modern diagnostic method can also be assigned - positron emission tomography, which allows to identify the disease at the initial stage, and also to suggest where the cancer metastasizes. This diagnosis can prevent metastasis and start treatment in a timely manner.

If the patient is at risk (eg, genetically predisposed to cancer), the doctor can recommend a relatively new method of diagnosis - using radioisotopes. This procedure allows you to identify the disease before the appearance of the first symptoms, as well as determine the metastases in any organs (even the smallest).

Differential diagnosis

To identify breast cancer in men is relatively easy, with palpation, a doctor can determine the cancer from other types of tumors (fibroadenomas, sarcomas, cysts, etc.). Cancer nodes are more firm to the touch, develop singly, have a connection with the skin and tissues.

In some cases, with deep located cysts, fatty necrosis, inflammatory processes, abscesses to confirm the cancer requires additional examination.

[30], [31], [32], [33], [34], [35]

Treatment of the breast cancer in men

Therapy for breast cancer in men involves the same procedures as in women.

Treatment depends on the stage at which the disease is diagnosed (determined by the size of the tumor and its prevalence).

Treatment is chosen by the doctor, taking into account the form of cancer, stage and condition of the patient.

Most often, surgical removal of the mammary gland (including the nipple) is prescribed.

In case of invasive cancer, lymph nodes from the axillary basin are also removed.

Chemotherapy is prescribed after the operation, in order to reduce the risk of re-development of the disease. This type of therapy can be used to detect cancer cells in distant lymph nodes, tumor size more than 2 cm, patients at a young age, in the late stages of the cancer process.

Radiation therapy is prescribed after chemotherapy and reduces the risk of cancer cells spreading throughout the body.

Hormonal therapy is prescribed to block estrogen and prevent the growth of atypical cells. The intake of hormonal drugs reduces the likelihood of relapse.

Medications

The course of chemotherapy may include such drugs as cyclophosphamide (intravenously, intramuscularly, the dosage is chosen by the doctor individually, with time correcting for the clinical effect), methotrexate (tablets take 15-50 mg for 5 days, usually several courses are required), fluorouracil (intravenously in a day, at the rate of 15 mg per 1 kg of weight).

Alternative treatment

Cancer is treated mostly quickly or with the strongest chemotherapy. In some cases, treatment can be supplemented with alternative medicine that will help to strengthen the general condition, which is important during chemotherapy and postoperative recovery of the body.

Breast cancer in men alternative medicine is recommended to treat the juice of burdock. To make a medicinal mixture, 300-400ml of burdock juice, 25g of dark honey, 3 lemons juice will be needed. Put all components in a bottle of dark glass.

Before starting treatment it is recommended not to eat meat for a week and make a cleansing enema. Take the mixture before going to bed 15ml for 12 days.

When breast cancer is recommended to take propolis - 5 grams before meals. To get the most benefit from this substance, you need to chew it as a cud.

Also propolis oil, according to some data, helps to get rid of breast cancer. Prepare this oil yourself: 1kg of butter to bring to a boil, add 200g of propolis, for 30 minutes, protrude on low heat, after the contents osyadet cool and take 15-20g 3 times a day.

[36], [37]

Herbal Treatment

Now in pharmacies you can find a tincture of herbs that will help the body resist cancer. Also, herbs can be used to take a bath, which significantly improves well-being. For the bath you can use celandine, a bugle, bianco, calendula, dill.

To strengthen the general condition and better resistance to the disease, it is possible to prepare a medicinal collection from a blood-grouse, motherwort, dandelion, plantain, St. John's wort, oregano, string, birch, mother-and-stepmother, thyme, celandine, cudweed, yarrow, immortelle, valerian roots, fennel , sage, nettle, angelica, eucalyptus, linden, chamomile, centaury, marigold, pine. All components are taken in equal amounts and 1 tbsp. Mixture is brewed 200ml boiling water, after 30 minutes infusion strain and drink (can be divided into several receptions).

The course of treatment is 3 months, after 2 weeks if necessary, treatment can be repeated.

Breast cancer in men, alternative medicine recommends treatment with poisons - aconite Dzhungar, red fly agaric, prince of Siberia. But it should be remembered that the dosage must be carefully observed, otherwise there may be deplorable consequences and it is impossible to combine poisonous plants, it is better to drink them by courses for 3 months with a 2-week break.

Tincture aconite Dzungarian: 20g roots, 500ml alcohol (vodka), insist 14 days and strain. Take strictly according to the scheme: 1 day - 1 drop, 2 days - 2 drops, 3 day - 2 drops (increase to 10), then also go back to 1 drop (ie 11 days - 10 drops, 12 day -9 drops, day 13 - 8 drops, etc.). Drink tincture before meals 3 times a day. Dilute to 100ml of water. Until full recovery, several courses may be necessary.

Homeopathy

Homeopathy involves treating not a specific disease, but the body as a whole, strengthening and restoring its normal functioning, so that the patient can defeat the disease on his own.

Doctors - homeopaths use an individual approach to the treatment of each patient, in each case, selected drugs and dosage, taking into account the concomitant diseases, the patient's condition, the stage of the oncological process.

Breast cancer in men with homeopathic treatment can include taking Arsenicum Albumum (known among homeopaths remedy). The drug has antibacterial, analgesic, antiseptic effect.

Even in the later stages Arsenicum helps to significantly reduce the pain and improve the quality of life of cancer patients.

Operative treatment

The operation to remove the breast is the most common treatment for breast cancer, both in women and men.

Breast removal (mastectomy) can be carried out in several ways:

• The method of Madden is the most simple and sparing operation, which allows to preserve pectoral muscles and axillary lymph nodes. The operation is prescribed in the initial stages of the disease, also the removal of the mammary gland according to Madden can be carried out for preventive purposes (for example, with genetic predisposition).
• The Peyti method involves the removal of the breast, small pectoral muscle and axillary lymph nodes. If the operation is performed in the early stages of cancer, surgeons can remove one lymph node and send it to a laboratory test, if it is affected, another operation will be performed to remove the remaining lymph nodes.
• method Halsted - removal of the breast, pectoral muscles, lymph nodes, adjacent fiber. Currently, such an operation is extremely rare, since after such intervention a number of serious complications are observed, in particular, deformation of the chest, a decrease in the mobility of the hand.
• double mastectomy - removal of both mammary glands. This operation is usually prescribed in order to prevent the development of a cancerous tumor in another mammary gland.
• subcutaneous mastectomy - the operation is prescribed mainly to women, because after it is easier to perform a plastic surgery to restore the breast. This method is prescribed after histology.

Prevention

Since the exact causes of breast cancer are not established, experts recommend avoiding any risk factors that can trigger tumor growth.

First and foremost, it is important to eat right - do not abuse harmful food (fried, smoked foods, pickles), consume more fresh fruits and vegetables, greens. It is recommended to include in the diet products that neutralize the effect of free radicals - tomatoes, onions, carrots, cabbage.

Breast cancer in men in the vast majority of cases develops against the background of gynecomastia (an increase in mammary glands), which can be caused by the use of certain medications (especially hormonal), endocrine diseases, drug dependence, etc.

[38], [39], [40], [41], [42]

Forecast

Breast cancer in men is more likely to be treated if the disease was detected at an early stage (recovery to 95% of cases).

If the disease was diagnosed at a later stage, the treatment is usually aimed at alleviating the symptoms (reducing pain) and improving the patient's quality of life. Therapy in this case provides for the extension of the patient's life for the maximum possible period.

Breast cancer in men is most often diagnosed at later stages, when removal of the tumor and a course of chemotherapy will not help cope with the disease.

Usually late diagnosis is associated with the attitude of a man to his health, since most men believe that breast cancer is a purely female disease, and does not pay attention to the appearance of the first symptoms of attention cancer.

[43], [44]