Risk factors, symptoms the same as women

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• Early diagnosis key to surviving male breast cancer

October is breast cancer awareness month, a disease normally viewed as being only suffered by women.

But while it's considerably less common, men can, and do, suffer from breast cancer as well.

"It's almost a misunderstanding that men cannot get breast cancer," says Dr. Wey Leong, a surgical oncologist at Princess Margaret Hospital, who specializes in breast cancer treatment.

"And it's not common if you compare it to other breast cancers. We basically have to see 100 women to see one male (case)."

Unlike prostate and testicular cancers which area viewed as "more of a man thing", Dr. Leong says when it comes to breast cancer, men are less likely to see a doctor because they're too embarrassed to talk about it.

"In those rare cases it happens, most of the time the men don't even come to see the doctor until much later," he said.

Symptoms men can watch for include a painless lump in the breast and redness of the nipple or some type of discharge.

"If they see anything that's a-symmetrical, like one side is more red and scaly, that's one of the presentations of it, or a lump that is larger on one side than the other," he said.

Keep in mind, he said, it's natural that men form a little more breast tissue when they get older and often it does happen on one side first.

"During that time when there is only side...as doctors we know sometimes that it will be okay, but we'll monitor it," he said.

Typically, Leong said, breast cancer occurs in men ages 60 and older, but it can happen to younger men, especially if their family carries the BRCA2 gene.

"It's a genetic syndrome that inherits from one generation to another; that's why the family would have a lot of cancers," he said.

Besides family history, other risk factors include having previous exposure to estrogen, either through a sex change procedure, being obese at one time in their life or even alcohol abuse.

"Because liver processes the estrogen in the body, if you have a problem with the liver caused by drinking, then the level of estrogen in the body may be higher than usual," Leong said. "We think that the estrogen is the main factor for men to develop breast cancer..."

To give them an accurate diagnosis, patients are given a mammogram and an ultrasound. Unlike women, who in Canada get mammograms at 50 or younger if there is a family history of breast cancer, Leong said there is no regular checkup for men. So, it's imperative that men know what symptoms to look for and relay them to their family doctor.

When women get cysts and lumps due to estrogen a series of tests need to be done to confirm it's breast cancer. But Leong says when a man finds a lump in his breast, the suspicion that it's cancer is much higher.

Once a breast cancer diagnosis has been made there are two courses of action: remove the tumour or have a mastectomy.

"But because men have small breasts, it's almost always that they require to have the whole breast removed, unlike in women, we often try to save the breast," he said. "In men it's usually difficult to do because the tumour is usually under the nipple so the nipple will have to be removed as well."

Afterwards, patients may still have to get radiation or hormone blocking treatment, but it varies from patient to patient.

The survival rate is about the same as women with the difference that men seem to present their symptoms much later and are usually already in stage 2 or 3 which gives them an 80 to 60 per cent survival rate.

With such a small percentage of men who get the disease, Leong said it's unrealistic to expect men to do a monthly self-exam. But for those who are at risk, Leong says, they should take the time to do the self-exam.

"But for those who never have any of these, if they find something unusual bear in mind it can still happen even if it's a rare condition, it can still happen to men who have no risk factors."