Male Breast Cancer Archives - Page 2 of 4

22FebJune 11, 2023

Breast Cancer Infographic Breast cancer is the second-deadliest cancer among American women. Other than adopting a healthier lifestyle, early detection with regular mammograms remains the single most effective way for combating the disease. Women diagnosed with breast cancer that has not spread outside the breast have a 99 percent survival rate. Steady declines in mortality among women since 1989 have been attributed to a combination of early detection and improvements in treatment.

Statistics

In the U.S., one in eight women will be diagnosed with invasive breast cancer during her lifetime.

In the U.S. in 2018, 266,120 women and 2,550 men are expected to be diagnosed with invasive breast cancer.

In 2018, breast cancer is expected to claim the lives of 40,920 women and 480 men in the U.S.

In Texas in 2018, an estimated 17,566 new cases of female and male breast cancer are expected, with 3,175 deaths.

Risk Factors

Age: Most invasive breast cancers occur in women over age 55.

Family History: Women with an immediate family member (mother, sister, daughter) who has had breast cancer are nearly twice as likely to develop the disease. Close male relatives with the disease also raises risk. If you have a family history of cancer, genetic testing may help determine risk.

Diet and Exercise: Overweight and/or physically inactive women have a higher risk, especially after menopause.

Breast Conditions: Women with dense breast tissue and some benign breast conditions are at higher risk.

Menstrual Cycles: Starting menstruation early (before age 12) or completing menopause late (after age 55) raises risk.

Radiation: Radiation to the chest for another cancer have a higher risk of breast cancer.

DES Exposure: Women who were exposed or had mothers exposed to diethylstilbestrol have a slightly higher risk.

Symptoms and Signs

Women are encouraged to consult their physician immediately for evaluation if any of the following signs and symptoms are present. The signs for breast cancer are not the same for all women, and some women show no signs in early stages.

A lump in the breast, under the arm or around collarbone

Change in breast size or shape

Thickening of breast or underarm

Nipple retraction or nipple discharge

Dimpled skin or skin resembling orange peel

Tenderness or pain in breast or nipple

Irritation, redness, scaliness, or swelling on the breast, nipple, or skin near the nipple

Prevention

Breast cancer cannot be completely prevented, but women can take steps to decrease risk and/or improve early detection of the disease. Screening recommendations are for women with average risk. It is important to discuss with a physician your individual risk factors, including age, menopausal status, and family history to determine your screening needs.

Screening
- Women should understand their risk as some women with a family history of breast cancer or known to be of higher risk should start screening early and can take other preventative measures.
- Women should check their breasts monthly. Report any changes to a physician immediately.
- Women in their 20s and 30s should have a clinical breast exam every three years.
- Women in their 30s should discuss their breast cancer risk level with a physician to determine the most appropriate cancer screening options, including mammograms and MRI screenings.
- Women age 40 and older should discuss individual risk factors with a physician to determine recommended timing and most appropriate screenings, including annual mammogram, annual clinical breast exam, and annual MRI screening.
- Women age 50 and older should have a mammogram and a clinical breast exam at least every two years after discussion with her physician, and if recommended by a physician, an annual MRI screening.

Lifestyle
- Regular exercise, limiting alcohol intake, and maintaining a healthy body weight may reduce the risk of breast cancer.

Higher Risk
- Women with a family history of breast cancer should discuss genetic testing with their physicians. If genetic tests indicate a woman has a genetic disorder that will increase her risk of breast cancer, like BRCA, there are a number of risk reduction strategies to discuss with her physician.
- Women with a first degree relative who had breast cancer before age 50 should begin receiving mammograms 10 years before reaching that relative’s age at diagnosis.

Treatment Options

Anyone with breast cancer should consult with a medical oncologist to determine their specific treatment needs. Treatment options can include surgery, radiation therapy, chemotherapy, proton therapy, targeted therapy, bone-modifying therapy, or hormone therapy. A combination of treatments may be used to provide the best chance of disease control.

Sources: American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, and Texas Cancer Registry

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22FebJune 11, 2023

By MHN Author

ICD-10 Diagnosis Code C50.122 Malignant neoplasm of central portion of left male breast

Male Breast Cancer

Although breast cancer is much more common in women, men can get it too. It happens most often to men between the ages of 60 and 70.

Breast lumps usually aren’t cancer. However, most men with breast cancer have lumps. Other breast symptoms can include

Dimpled or puckered skin
A red, scaly nipple or skin
Fluid discharge

Risk factors for male breast cancer include exposure to radiation, a family history of breast cancer, and having high estrogen levels, which can happen with diseases like cirrhosis or Klinefelter’s syndrome.

Treatment for male breast cancer is usually a mastectomy, which is surgery to remove the breast. Other treatments include radiation, chemotherapy and/or hormone therapy.

NIH: National Cancer Institute

After chemotherapy – discharge (Medical Encyclopedia)
Breast cancer in men (Medical Encyclopedia)
Chest radiation – discharge (Medical Encyclopedia)
Understanding Chemotherapy – NIH – Easy-to-Read (National Cancer Institute)
What to Know about External Beam Radiation Therapy – NIH – Easy-to-Read (National Cancer Institute)

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22FebJune 11, 2023

By MHN Author

Are more men with breast cancer opting for prophylactic mastectomy?

STUDY AT A GLANCE

This study is about:

Trends and factors associated with the decision to undergo prophylactic double mastectomy among men with cancer in one breast.

Why is this study important?

Researchers have seen the rates of double mastectomy increase in women with breast cancer but they do not know if this increase is also true for men.

Key study findings:

The rate of prophylactic mastectomy doubled (from 3% to 6%), but the overall number is still very small, with only 106 of 1884 men with invasive cancer in one breast choosing to undergo double mastectomy.

The factors associated with a higher likelihood of double mastectomy include: younger age, white race, and having private insurance rather than Medicaid.

What does this mean for me?

This study indicates an increase in the rate of men choosing double mastectomy between 2004-2005 and 2010-2011. However, it is important to note that most men with breast cancer have a unilateral mastectomy (approximately 75% of men in 2004-2005 and 2010-2011 chose this option). The decision to undergo a single or double mastectomy should be a personal, individual one, made in consultation with your healthcare provider.

Questions to ask your health care provider:

What are the pros and cons of each type of surgery?

What are the costs and complications that can be associated with double mastectomy?

Is A lumpectomy is a surgery that is performed to remove a lump in the breast often to diagnose or treat breast cancer.  ”>lumpectomy an option?

As a man with breast cancer, should I consider genetic counseling and/or BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA testing?

A male blood relative has had breast cancer, should I be concerned that it is hereditary?

IN DEPTH REVIEW OF RESEARCH

Study background:

Researchers have noted increased rates of double mastectomy in women diagnosed with invasive cancer in one breast. This trend is especially true for younger women. Factors that researchers believe contribute to the increased rates of double mastectomy include:

increased BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA testing

use of Magnetic Resonance Imaging; a technique for looking for abnormalities such as cancer using magnetic fields. Breast MRI is typically recommended as a screening tool for breast cancer in high-risk women and is often used to follow up on a breast abnormality seen on mammogram. ”>MRI (some research suggests Magnetic Resonance Imaging; a technique for looking for abnormalities such as cancer using magnetic fields. Breast MRI is typically recommended as a screening tool for breast cancer in high-risk women and is often used to follow up on a breast abnormality seen on mammogram. ”>MRI findings cause patients to worry about cancer developing in the opposite breast)

the desire to achieve symmetry through reconstructive surgery

Although more women are opting to undergo double mastectomy – which comes with a risk of complications and costs – studies have not shown a survival benefit from the surgery. Unlike women, the double mastectomy rates among men with cancer in one breast and the various factors that contribute to their decisions are unknown.

Researchers of this study wanted to know:

Whether the double mastectomy rate in men has increased.

Population(s) looked at in the study:

6332 men who:

Were at least 20 years old

Had been diagnosed with Stage is a term used to describe how much a cancer has spread. Cancers are staged from stage 0 (preinvasive cancer) to stage 4. Although staging varies by cancer type, usually the lower the number, the less the cancer has spread. ”>stage I-III invasive breast cancer in one breast

Underwent surgery between 2004 and 2011

Study finding(s):

Comparing the double mastectomy rates during 2004-2005 to 2010-2011 indicates that the rate of this surgery increased from 3% to approximately 6%.
- 35 of 1166 men with invasive cancer in one breast chose to undergo double mastectomy in 2004-2005 while 106 of 1884 men with invasive cancer in one breast chose to undergo double mastectomy in 2010-2011

The factors that were associated with a higher likelihood of double mastectomy were:
- younger age
- white race
- having private insurance rather than Medicaid.

Limitations:

The researchers note that studies have found that increased BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA testing has increased prophylactic mastectomy rates in women with breast cancer. This research was not able to look at the BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA status of those in the study population. However, because 40% of male breast cancer is linked to BRCA2 is a gene found on chromosome 13. Mutations in BRCA2 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA2 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA2 mutations, it is possible that a sizable number of study participants may have been found to be BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA carriers.

Discussion:

According to study author Dr. Ahmedin Jemal, quoted in a Newsweek, article, “it’s important for male patients to ask a physician about their individual risk for Breast cancer in the other breast of patients who are already diagnosed with breast cancer.  ”>contralateral breast cancer before making any decisions about the surgery…It’s only the patients at high risk who are likely to benefit from the procedure.”

Although not as much research has been done on men with breast cancer, we do know that those with a BRCA2 is a gene found on chromosome 13. Mutations in BRCA2 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA2 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA2 mutation have a 7% risk of developing breast cancer by age 70. No studies, however, look at the risk of a second breast cancer diagnosis in men with BRCA2 is a gene found on chromosome 13. Mutations in BRCA2 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA2 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA2 mutations. By looking only at male survival rates and failing to also look at recurrence rates, researchers are unable to consider the possibility that double mastectomy may be decreasing the occurrence of a second cancer, helping these patients avoid further treatment.

In women without a BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA mutation, the chance of a second breast cancer diagnosis 10 years after the initial diagnosis is approximately 10%. The risk is 10%-30% for breast cancer survivors with a BRCA refers to two genes BRCA1 and BRCA2. Mutations in these genes cause an increased risk for breast, ovarian, prostate, pancreatic, and melanoma cancers. Although BRCA1 and BRCA2 are often referenced together, they are separate genes. Mutations in BRCA1 and BRCA2 cause slightly different risks for different cancers.  Also see BRCA1, BRCA2 and HBOC. ”>BRCA mutation.

Additionally, it is important to note that the researchers were able to see a significant difference in the rate of double mastectomy only between the years 2004-2005 and 2010-2011. They were unable to see any significant differences when comparing rates in 2004-2005 to those in 2006-2007 or in 2008-2009. Although the lack of a rate increase between 2006 and 2009 may strengthen the researchers’ argument that the increased rate of double mastectomy is, in fact, new, more data needs to be collected to ensure the trend is stable rather than something unique to 2010 and 2011.

Conclusions:

For both men and women, the decision to undergo a prophylactic mastectomy should be an individual, personal one, made by patients in consultation with their healthcare providers. Although the data from this study indicate the rates of this surgery in men with breast cancer have increased, more research is needed, both to understand why the rates have increased and to determine if there is a subset of men who will benefit from the procedure.

References:

Firger, J. “Rise Seen in Preventative Mastectomy for Male Breast Cancer Patients.” Newsweek. Published September 2, 2015.

Jemal A, Lin C, DeSantis C et al. “Temporal Trends in and Factors Associated with Contralateral Prophylatic Mastectomy Among US Men With Breast Cancer.” JAMA Surgery, Initially published online September 2, 2015.

Komen. “Inherited Gene Mutations,” updated 1/22/15

Schrag D, Kuntz KM, Garber JE, et al. “Life expectancy gains from cancer prevention strategies for women with breast cancer and BRCA1 is a gene found on chromosome 17. Mutations in BRCA1 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA1 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA1 or BRCA2 mutations.” JAMA. 283 (5): 617-24, February 2, 2000.

Tai YC, Domchek S, Parmigiani G, et al. “Breast cancer risk among male BRCA1 is a gene found on chromosome 17. Mutations in BRCA1 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA1 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA1 and BRCA2 is a gene found on chromosome 13. Mutations in BRCA2 increase the risk for cancers including breast, ovarian, pancreatic, prostate, melanoma and possibly other cancers. BRCA2 mutations are among the genes associated with Hereditary Breast and Ovarian Cancer Syndrome, also known as HBOC.  ”>BRCA2 mutation carriers.” J Natl Cancer Inst. 99(23): 1811-4, December 5, 2007.

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22FebJune 11, 2023

By MHN Author

NBCF Research | Stages, Types and Treatment of Breast Cancer

Breast cancer is a complex collection of many different subtypes, and there is no “one-size-fits-all” treatment. Health professionals may refer to a tumour by its size, grade or spread, as hormone receptive, invasive or metastatic.

“Staging” is a classification tool used by health professionals to describe:

the size of a breast cancer;
whether it is limited to one area in the breast or it has spread to healthy tissues inside the breast; and
whether the cancer has spread to the lymph nodes or to other parts of the body beyond the breast.

Stages of breast cancer are numbered from 0 to 4. Classification helps determine the right treatment plan – and is based on a pathologist’s study of any tumour tissue or lymph nodes removed during biopsy or surgery.

Stage 1 or 2 – Early breast cancer

Stage 1 breast cancers are smaller than two centimetres and have not spread to the lymph nodes in the armpit (axillary nodes). Stage 2A breast cancers are larger than 2cm but less than 5cm, and/or have spread to the axillary nodes. The goal of treatm …

Stage 2 or 3 – Locally advanced breast cancer

Stage 3 and some stage 2 breast cancers are locally advanced breast cancers. These have spread beyond the breast to either the chest wall, skin of the breast, or to lymph nodes in the underarm or breastbone area (internal mammary lymph nodes). They h …

Stage 4 – Metastatic Breast Cancer

Stage 4 (metastatic or advanced) breast cancer has spread beyond the breast to other organs in the body. Most commonly this is in the bones, lungs, liver or brain. There is currently no way to eradicate stage 4 breast cancer. The goal of treatment is …

Molecular types of breast cancer

Breast cancer treatments are based on the tumour’s specific biological or molecular signature. Find out about the different types of breast cancer, current research and personalised treatments.

Breast cancer treatments are based on the specific biological or molecular signature of a tumour. Each tumour is different and requires a personalised approach. The most common treatments include:

Surgery

The goal of breast cancer surgery is to remove the entire tumour from the breast. A lumpectomy aims to preserve the breast and remove only cancerous tissue. A mastectomy removes the entire breast. Some of the lymph nodes from the underarm area (axillary nodes) may also be removed to see if cancerous cells are present.

Radiation therapy

Radiation is given to the breast, chest, collarbone and underarm to kill any cancer cells that might remain after surgery.

Chemotherapy

Chemotherapy is a chemical compound that kills rapidly dividing cells, such as cancer cells. It is usually given to those with early breast cancer after surgery (adjuvant chemotherapy). For large tumours, it can be used before surgery (neoadjuvant chemotherapy) to shrink the tumour.

Hormone therapy

Some breast cancer cells need estrogen and/or progesterone (female hormones) to grow. Hormone therapy slows or stops their growth by preventing the cancer cells from getting these hormones. It is usually given after surgery as a long-term preventative treatment. High-risk women who have never had breast cancer may take it as a preventive therapy.

Targeted therapies

A targeted therapy is a drug designed to attack a molecular agent or pathway involved in the development of a particular breast cancer. For example, HER2 positive breast cancer has too many copies of a particular gene known as HER2 which stimulates cell growth. The drug trastuzumab (Herceptin) works by attaching itself to the HER2 receptors on the surface of breast cancer cells, blocking them from receiving growth signals. Unlike chemotherapy drugs, targeted therapies kill cancer cells with little harm to healthy cells.

Personalised therapy and/or precision medicine

Increasingly, research is allowing a combination of personalised treatments to be used. A person’s individual situation, overall health, age, lifestyle risk factors and the molecular make-up of his/her tumour are taken into account to provide the best strategy.

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22FebJune 11, 2023

By MHN Author

What It’s Like Living With Breast Cancer Treatment Side Effects

I was 49 years old, and I hadn’t had a mammogram in three years. I decided to get caught up. I went for the mammogram and, judging from the way the technician reacted to the image, I was pretty sure something needed further scanning. I had an ultrasound at another appointment. They sent the results to my primary doc, who told me I had cancer.

I got a breast MRI, and they found a second tumor in the same breast. The breast surgeon told me I also had all the signs of inflammatory breast cancer; my breasts were pinker than they should have been, and they were radiating heat.

I started chemo a month after the mammogram. The surgeon wanted to shrink the first tumor before surgery because it was large, and she also wanted to make sure the cancer hadn’t spread. Chemo was the most effective way to do it. I went for treatment every other week for five months, then had a bilateral mastectomy. When I recovered from that, I had 40 radiation treatments, one every weekday for eight weeks.

My treatment was intense because it was a very large tumor and there was the possibility of inflammatory breast cancer. Once I got through radiation, I had 52 weeks of Herceptin [a drug that targets the HER2 protein in some breast cancers], and I’ve been on tamoxifen [which blocks estrogen from causing cell mutations that could lead to cancer] for five years.

In September, I’ll have been cancer-free for seven years. But I’ve had minor–and major–side effects along the way. Some have been temporary, like nausea from chemo. My doctors managed to control that with anti-nausea medications.

Others are permanent. The first I really became aware of was neuropathy in my fingers and toes, which I still have to this day. I have tingling, numbness–my fingers and toes don’t feel right. I don’t take any medication for it, it’s just something I’m aware of and accept. I’m an accountant, so at first I was afraid I wasn’t going to be able to run a 10-key calculator. It was scary until I found out that I could.

Courtesy of the tamoxifen, about once a month or so, I get pain like a hot poker in the knuckles in my left hand. It only lasts a couple of minutes and then it stops, but it’s blinding pain.

When you start chemo, doctors tell you that your hair is going to fall out. You think it’s the hair on your head, forgetting that you have hair on other parts of your body. My nose kept running, and I realized I had lost all my nose hairs. On the bright side, I don’t have to shave my legs as often.

Because of the intense radiation, I couldn’t have the typical breast reconstruction surgery, so I ended up getting a Deep Inferior Epigastric Artery Perforator or DIEP flap. Basically, the surgeon takes tissue from your abdomen and makes breasts out of it. My surgery took more than 12 hours. I had a second surgery for refinements, and then another to actually rebuild the nipples.

“Chemo brain” has been an absolute nightmare. I had nearly a photographic memory before this all started. After the chemo, I looked at someone I knew I had known for 20 years at my church, and I had to apologize because I couldn’t remember their name. It’s so frustrating.

Since finishing chemo, my memory has returned to probably 98 to 99% of what it was, but every now and again I’ll still have an instance where I just have this block, and I attribute it to chemo brain. A couple of months ago, I started having chemo brain symptoms again, as well as fogginess, blurry vision, and headaches. I wasn’t able to do a simple math problem in my head that I normally would be able to do without a second thought. My brain just wasn’t functioning the way it normally does. My oncologist sent me for an MRI to make sure it wasn’t cancer in the brain, and fortunately it wasn’t. (The blurry eyes were from dry eye.)

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I had one other scare that the cancer had come back or spread. I put my hand on my chest and felt what I thought was a lump in my right breast, the one that had the cancer and is now basically abdominal tissue. I found out it was fat necrosis; the radiation was still killing tissue.

I get checked out every six months. I’m very aware of every ache and pain in my body. But I live every day to the fullest because tomorrow is not guaranteed.

Lora McCann is a member of the National Coalition for Cancer Survivorship’s Cancer Policy and Advocacy Team, which advocates to improve the delivery of cancer care for everyone impacted by cancer.

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22FebJune 11, 2023

By MHN Author

Breast Cancer Diagnosis in the Family: Now What? | Blue Cross Blue Shield of Texas – Blogs – Health and Wellness

How can Blue Cross and Blue Shield help?
Having a breast cancer diagnosis can be overwhelming. On top of understanding and processing the diagnosis, knowing what to do next can seem like too much to think about.

The first thing you can do as a Blue Cross and Blue Shield member is to call the customer service number on your member ID card. One phone call can help determine what resources and help are available.

Blue Cross and Blue Shield has a team of professionals to help you on your breast cancer recovery journey. Specialized case managers work with you to holistically manage your needs.

A team of registered nurses and social workers provide support to help you get the best care. They can be a lifeline to support services, including:

Help with your feelings and emotions
Finding resources for a wig
Getting a dietitian to help you with your new nutrition needs
Understanding your treatment options
Referrals to Blue Distinction doctors, for example if you need a second opinion
Help with planning for your treatment and recovery
Resources to assist you and your family, such as child care, transportation, or finding affordable medications

Case managers also work with our multi-disciplinary teams of doctors and pharmacists to review recommended treatments and medicines.

Case managers also work behind the scenes to coordinate care among your doctors.

These reviews can help make sure that there will not be any harmful interactions with other medicines you’re taking. And they can find food restrictions that need to be followed to prevent interference with a medicine.

But the role of a case manager isn’t just about coordinating medical care. Their goal is to help you understand what’s ahead, provide answers to your medical questions, and guide you through the journey ahead with compassion.

Did you know?

About 1 in 8 American women (about 12 percent) will develop invasive breast cancer over the course of her lifetime. And this year alone, over 230,000 new cases of invasive breast cancer are expected to be diagnosed in women in the United States.

So what happens when you or your loved one is part of that 12 percent? Breast cancer treatment is a journey. You’ll need help and resources along the way.

Sharing the News About Your Diagnosis
Finding out you have cancer can put you and your family on an emotional rollercoaster. Although it’s easy to pronounce, if you’ve just been diagnosed, cancer can be the hardest word to say.

But talking with friends and family is healthy. It can help you cope and relieve feelings of isolation and frustration. When you are ready, prepare to tell your loved ones about the diagnosis.

Keep in mind that cancer affects the whole family, and how family members respond may surprise you. Remember, people’s reactions don’t necessarily reflect their feelings toward you. They are dealing with their own fears about the situation. Communicating openly can help them overcome their fears.

Try the following advice when it’s time to break the news.

Plan ahead. Most people will have questions about your prognosis or next steps. Think about how much you want to share — it’s up to you. There may be topics you feel uncomfortable discussing, such as treatment choices. Think about how to change the subject if something you don’t want to talk about comes up.
With children, be gentle but honest. They’ll sense something is wrong and should hear about your cancer from you. Be calm and assure them that they’ll be cared for.
Use words that are comfortable for you. There’s no one right way to discuss your disease.
Get help. Make a list of people you want to tell personally. Then ask a family member or trusted friend to talk with others.

Taking Good Care of You
Here are some steps you can take to help you cope better.

Take care of yourself. Get enough rest, eat a healthy diet and stay physically active.
Not all parts of your life need to be put on hold. Try to keep up hobbies and other things you enjoy.
Get help from your doctor if you feel anxious, hopeless or depressed for more than two weeks.
Find quiet time for reflection and relaxation.

Beginning Treatment
Making decisions about starting your treatment may seem overwhelming. And cancer treatments offer numerous alternatives, so decisions may not be straightforward. Understanding your treatment options can help you feel more in control and less worried about the road ahead.

Learn as much as you can about your cancer and treatment options. Being actively involved in the decision-making can help you better understand your treatment. You’ll feel more confident and satisfied with your choices. Research also shows that participating in treatment decisions is associated with better outcomes.

Here’s how to start:

Find someone who is willing to go with you to your appointments and help you take notes. It is normal to feel overwhelmed, and having a partner you trust there can help you keep all of the new information straight in your head.
Get a second opinion. It may provide more information about your diagnosis and treatment options.
Get the facts about the kind of cancer you have. Ask for written material and question your doctor and others on your health care team. Be sure to make a list of questions before your appointments and write down the answers. Reliable websites like the National Cancer Institute, MedlinePlus and Cancer.net can also provide helpful information.
Communicate with your doctor about the goal for your treatment and your role in it. Is the purpose to cure, control or treat symptoms? You are an important part of your cancer care team. Don’t be afraid to ask questions about treatment choices so that you clearly understand your options.
Seek support from family, friends and other people who have experienced cancer. Ask your doctor about resources that can help you cope with your illness and treatment. Ask about support groups, counseling and other services.
Keep track of medical records, test results, your own notes and any other related paperwork. Create a system to help you stay organized. Having all the information you need in order and readily available can help you deal more easily with your cancer care team.

How has your community helped you on your journey? Share your story in the Comments.

Last update: 10/9/2017

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22FebJune 11, 2023

By MHN Author

Male Breast Cancer – Sassy Chick

November 26, 2018 By: sassychickcomment

male breast cancer

I recently had a routine check-up with my radiation oncologist. While I was at the cancer center, I met Robert, a volunteer at the American Cancer Society kiosk. The station provides information regarding resources for patients and even has a few wigs to try on. I was fortunate enough to receive two wigs there while I was on treatment for FREE!

I got to talking to Bob. He said that the reason he volunteers for the American Cancer Society is to make folks aware that men have breast cancer too. What a great reminder!

Yes, Men Do Get Breast Cancer Too

Thankfully it is fairly uncommon. But male breast cancer does happen. According to the National Breast Cancer Foundation, Inc, male breast cancer makes up less than one percent of all breast cancer and only one in a thousand men will ever be diagnosed with breast cancer.

Bob told me that he was in the parking lot after his doctor’s appointment and realized that he forgot to bring the mass to his doctor’s attention. Thankfully he did go back and in and his work up was initiated.

Bob is correct. Men that do find a breast lump, are less likely to assume a mass is breast cancer which delays going to the doctor for diagnosis and treatment.

Symptoms

Men usually have a lump or mass that can be felt. Other symptoms can include, a change in size or shape of the breast, a dimple or puckering in the skin, a change in the nipple, fluid draining from the nipple and scaly, red or swollen skin on the breast, nipple, or areola. Just like women, if men have any of these symptoms they should seek prompt medical attention.

Treatment of Male Breast Cancer

Treatment can be similar to women’s breast cancer including surgery, radiation, chemotherapy, and hormone therapy.

Survival

According to the National Cancer Institute, survival for men with breast cancer is similar to survival to women with breast cancer. But again men tend to be diagnosed at a later stage due to not seeking diagnosis and treatment immediately.

Additional Information

The national cancer institute’s website has amazing resources for most types of cancer. See: https://www.cancer.gov/

Here is a link for more information specific to male breast cancer; male breast cancer

While researching information for this post another site that provided helpful information is from Comanche County Medical Center. Here’s a link: male breast cancer.

We are both breast CA survivors male breast CA

Robert and I. We’re both breast cancer survivors!

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22FebJune 11, 2023

By MHN Author

Expression of androgen receptor and prostate-specific antigen in male breast carcinoma | Breast Cancer Research

Research article
Open Access

Noman Kidwai1,
Yun Gong1,
Xiaoping Sun1,
Charuhas G Deshpande1,
Anjana V Yeldandi1,
M Sambasiva Rao1 and
Sunil Badve1, 2 Email author

Breast Cancer Research20036:R18

https://doi.org/10.1186/bcr733

© Kidwai et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article’s original URL. 2004

Received: 17 March 2003
Accepted: 9 October 2003
Published: 7 November 2003

Abstract

Background

The androgen-regulated proteins prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) are present in high concentrations in normal prostate and prostatic cancer and are considered to be tissue-specific to prostate. These markers are commonly used to diagnose metastatic prostate carcinoma at various sites including the male breast. However, expression of these two proteins in tumors arising in tissues regulated by androgens such as male breast carcinoma has not been thoroughly evaluated.

Methods

In this study we analyzed the expression of PSA, PSAP and androgen receptor (AR) by immunohistochemistry in 26 cases of male breast carcinomas and correlated these with the expression of other prognostic markers.

Results

AR, PSA and PSAP expression was observed in 81%, 23% and 0% of carcinomas, respectively. Combined expression of AR and PSA was observed in only four tumors.

Conclusion

Although the biological significance of PSA expression in male breast carcinomas is not clear, caution should be exercised when it is used as a diagnostic marker of metastatic prostate carcinoma.

Keywords

androgen receptor
immunohistochemistry
male breast carcinoma
prostate-specific antigen

Introduction

Male breast carcinoma (MBC) is rare and represents less than 1% of all mammary carcinomas [1]. Although less frequent, it tends to be more aggressive than its female counterpart [2, 3]. One of the reasons for this is the relatively small size of the male breast, which may permit earlier and/or easier access for the tumor cells to the chest wall. Because of the rarity of the disease, randomized clinical trials have not been performed and the treatment of MBC has not been standardized [4]. MBCs are treated, like female breast carcinomas (FBCs), with radical mastectomy followed by adjuvant chemotherapy and radiation. Tamoxifen has also been used in estrogen receptor (ER)-positive cases.

It is presumed that MBC is biologically similar to FBC. However, there are differences between the two: a higher frequency of expression of ER (81%) and progesterone receptor (PR) (74%) is in MBC (for review see [5]). In contrast to women, men do not have a higher incidence of ER-positive tumors with advancing age. The relationship of ER with overall survival is uncertain. In a multi-institutional study, Donegan and colleagues [6] found that ER was associated with better survival; however, in a series of 229 patients from the Princess Margaret Hospital no significance was found in multivariate analysis [7]. Wang-Rodriguez and colleagues found better survival in ER-positive patients but did not find a benefit from treatment with Tamoxifen [8]. Proliferative activity is higher in ER+/PR+MBCs than in ER-/PR- tumors [9]. More recently, Pich and colleagues [4] found no correlation between the expression of ER, PR or androgen receptor (AR) with overall survival. They concluded that MBCs are biologically different from FBCs and questioned the rationale for the use of anti-hormonal (Tamoxifen) therapy in MBCs.

The male sex hormones (5α-androstan-3α,17β-diol dipropionate; 2α-methyl dihydro testosterone; and testosterone propionate) have been shown to cause regression of 7,12-dimethylbenz[a]anthracene-induced breast cancers in rats [10] and to suppress the growth of breast cancer cell lines. Additionally, an increased risk of breast cancer is seen in patients with hypoandrogenism and gynecomastia. They have therefore been considered protective agents in the etiopathogenesis of male breast cancer [5, 6, 11]. Androgens in the prostate stimulate the secretion of androgen-dependent proteins such as prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP). Similarly, the production of PSA is seen in some breast cancer cell lines after treatment with androgens [12, 13], suggesting an intact androgen pathway. In this retrospective study we attempt to analyze the functional status of the AR pathway in MBCs by assessing the expression of the androgen-regulated proteins PSA and PSAP.

Materials and methods

Twenty-six cases of MBC were retrieved from the archives of the Department of Pathology at Northwestern Memorial Hospital and Lakeside VA Hospital, Chicago, IL, between the years 1977 and 1999. Clinical charts were reviewed to obtain follow-up information. Archival paraffin slides were reviewed to confirm histologic grade in accordance with the modified Scarff–Bloom–Richardson system [14]. Data about the expression status in these tumors of ER/PR, Her-2/Neu, epidermal growth factor receptor and Ki-67 were also available for comparison.

One block from each case was selected to analyze the expression of PSA, PSAP and AR on serial sections by immunohistochemical methods. Paraffin-embedded sections (4 μm thick) after peroxide blocking (3% hydrogen peroxide in methanol) and antigen retrieval (a microwave oven pressure cooker with Citra [BioGenex®]) were incubated with serum block to reduce non-specific staining before exposure to the primary antibody. Polyclonal antibodies against PSA and PSAP (both from Dako Corp®; 1:1800), and monoclonal antibody against AR (Novocastra®, 1:10) were used. Biotin-labeled secondary antibody and ABC complex (Vector®) followed by exposure to diaminobenzidine tetrahydrochloride (Sigma Corp®) were used to detect the antigen. The slides were counter-stained with hematoxylin and mounted in Permount. Phosphate-buffered saline and rabbit or mouse isotypic antibody were used to confirm specificity of the staining. Normal prostatic tissue (from other patients) was used for positive control for AR, PSA and PSAP.

The criteria used to evaluate expression were as follows. Expression of PSA and PSAP was classified as focal or diffuse depending on the fraction of the tumor cells stained. The criteria for AR positivity were based on the intensity and percentage of tumor cells showing expression. The intensity was graded as negative, weak, moderate or strong. Tumors that had more than 10% of cells exhibiting moderate or strong intensity of expression were considered positive.

We reviewed the databases of the Northwestern Memorial Hospital as well as Lakeside VA Hospital to obtain the follow-up information of MBC. Follow-up information was available for 17 cases. The overall follow-up ranged from 12 to 168 months; the median follow-up was 48 months.

The expression of the antigens was correlated with clinical and histological features including tumor grade, mitotic activity, tumor size, histological grade, steroid receptors, axillary lymph node status, and clinical outcome. Significance of the association was assessed by the χ2 test for independence with the use of the Prophet® Statistical Program (BBN Systems and Technology). P values less than 0.05 were considered significant.

Results

Histologically, 25 of the tumors were infiltrating ductal carcinomas; the remaining tumor was an infiltrating lobular carcinoma. Three cases were grade I, 11 cases were grade II and 12 cases were grade III (Table

). AR-positive cases were histologically classified as grade I (3 of 3 cases), grade II (7 of 11 cases) and grade III (9 of 12 cases). ER was expressed in 22 of the 26 cases (84.6%), whereas PR expression was seen in 13 cases (50%). All the cases that expressed PR were ER-positive. Expression of Her-2 was seen in 18 cases, epidermal growth factor receptor in 12 cases and p53 in one case. Ki-67 expression in more than 30% of the cells was seen in 21 cases. Of the 19 cases with axillary dissection, 10 showed lymph node metastases.

Table 1

Correlation of histological grade of male breast carcinoma with expression of androgen receptor (AR), prostate-specific antigen (PSA), and prostate-specific acid phosphatase (PSAP)

I	3		2	1		3		3	3		3		3
II	16	2	14	4	2	16		18	7	11	18	3	15
III	19	2	12	9	5	16	1	20	9	12	21	3	18

AR expression, like that of ER and PR, was seen in the nuclei of breast epithelial cells (Fig.

) and in scattered stromal cells. The expression in tumor cells was seen in 19 of 26 cases (73%).

Figure 1

Nuclear expression of androgen receptor in a case of male breast carcinoma. High magnification.

In contrast, PSA expression was cytoplasmic (Fig.

). Normal breast tissue, both ducts and stromal elements (including adipocytes and vascular endothelium), did not show any expression of this protein. Expression was observed in six (23%) cases of tumors; five of these (19%) showed focal expression, and one (4%) demonstrated diffuse staining. These PSA-positive cases were histologically grade II and III tumors (three cases each). PSAP expression was not detected in any of the cases studied.

Figure 2

Male breast carcinoma showing cytoplasmic expression of prostate-specific antigen. Medium magnification.

Correlation between the expression of PSA and AR with other parameters is shown in Tables

and

respectively. PSA expression was not correlated with AR expression (

= 0.61), ER (

= 0.16), or PR (

= 0.35). Similarly, expression of AR did not correlate with any of these parameters. Neither of these markers (PSA and AR) was significantly associated with positive lymph node status. There was no significant association of PSA or AR with overall follow-up, and neither was able to predict the clinical behavior in these patients.

Table 2

Patient characteristics and correlation with prostate-specific antigen (PSA) in male breast cancer

Age (years)	≤ 65	1	7	0.39
	> 65	4	12
Tumor size (cm)	≤ 2	3	6	0.36
	> 2	3	14
LN status	Positive	3	7	0.604
	Negative	2	7
Tumor grade	I		3	0.52
	II and III	6	17
Histological type	Ductal	6	19	–
	Lobular		1
ER	Positive	4	18	0.164
	Negative	2	2
PR	Positive	2	11	0.35
	Negative	4	9
AR	Positive	4	11	0.61
	Negative	2	9
C-erb-b2	Positive	4	14	0.82
	Negative	2	6
p53	Positive	1		0.06
	Negative	5	20

Table 3

Association between androgen receptor (AR) and other factors for male breast cancer

Age (years)	≤ 65	6	2	0.24
	> 65	8	8
Tumor size (cm)	≤ 2	4	3	0.79
	> 2	9	8
LN status	Positive	6	4	0.65
	Negative	4	5
Grade	I	2	1	0.73
	II and III	13	10
Histological type	Ductal	15	10	–
	Lobular		1
ER	Positive	12	10	0.44
	Negative	3	1
PR	Positive	8	5	0.69
	Negative	7	6
C-erb-b2	Positive	9	8	0.1
	Negative	6	3
p53	Positive	1		0.38
	Negative	14	11

Discussion

Because MBC is rare, it has often been suggested that metastatic carcinoma from other sites should be considered before diagnosis of a primary tumor [15]. Prostatic carcinoma is one of the many primary sites from which metastases can arise. It has been suggested that immunohistochemistry should be performed to rule out this possibility [15]. In the present study we demonstrated the expression of PSA in 6 of 26 cases of MBC. We were unable to observe any expression of PSAP in these cases. Similar findings were reported by Gatalica and colleagues [16] in their cases of MBC and gynecomastia. Cho and Epstein [17] reported coexpression of PSAP and PSA in 23 of 25 cases of metastatic prostatic carcinoma involving supra-diaphragmatic lymph nodes. Taken together, these findings suggest that PSAP might be a better marker for excluding metastases from a prostatic primary at this site. The reasons for the differential expression of PSA and PSAP are not known; however, similar divergence of expression has previously been recorded.

PSA and PSAP are androgen-regulated proteins and are thought to be relatively specific to the prostate. Although serum PSA in males is predominantly derived from the prostate, there are additional sources of this protein: low levels are found even in females [18–20]. PSA has been shown to be present in several sites including salivary glands and the breast. Whether PSA is expressed in normal healthy breast is controversial [21], although Yu and colleagues [22], using quantitative methods and polymerase chain reaction, were able to demonstrate PSA in normal breast tissues in 33% of cases. PSA has been demonstrated in milk from lactating breast [18–20], in nipple aspiration fluid [23], and in apocrine foci within fibrocystic disease of the breast [24] in addition to breast cancer (for review see [25]). In male breast, Gatalica and colleagues [16] have reported focal strong PSA expression in normal and hyperplastic ductal epithelium in 5 of 18 cases of gynecomastia. In our study we did not observe any immunoreactivity for PSA in peritumoral breast tissues.

PSA from breast tumors has the same molecular characteristics as seminal or prostatic PSA. In the prostatic secretions PSA is important in the dissolution of the gel structure of freshly ejaculated semen [26], through the specific proteolysis of both high molecular mass semenogelin and fibronectin. PSA, like some other proteases, can also digest other substrates. It can, for example, digest insulin-like growth factor-binding proteins, leading to the release of these growth factors [27]. Similarly, digestion of the basement membrane and extracellular matrix proteins might facilitate cell migration and invasion [27]. However, PSA has also been shown to inhibit the endothelial cell response to angiogenic stimulation by fibroblast growth factor-2 and vascular endothelial growth factor [28]. It has been suggested that PSA might be an endogenous anti-angiogenic compound. This might contribute to the association between PSA and prognosis seen in some studies [29, 30].

PSA expression in FBC has been associated with younger age [31, 32] in some studies but with postmenopausal status in others [33]. Alanen and colleagues [33] and Howarth and colleagues [34] found a correlation of PSA expression in FBCs with differentiated tumor types and low tumor grade. Similarly, Yu and colleagues [30] reported that the presence of PSA was significantly associated with smaller tumors, tumors with low S-phase fraction, diploid tumors, younger patient age, and tumors with lower cellularity. In their study, PSA expression was associated with good prognosis in FBC even after multivariate analysis. All the MBC cases in our study that expressed PSA were histologically of grade II or III. Our study, although limited by size and follow-up information, could not identify a prognostic role for PSA.

PSA expression in FBCs is strongly correlated with expression of ER and AR. Most PSA-producing FBCs are positive for steroid hormone receptor (ER/AR), but not all tumors that are positive for steroid hormone receptors produce PSA [35]. Hall and colleagues [36] have reported an even stronger association of AR and PSA expression with AR expression seen in 98% of FBCs expressing PSA. In the present study, of the six cases that were positive for PSA, AR expression was seen in only four. These observations are consistent with the hypothesis [4] that MBC is biologically different from FBC. The presence of PSA expression in breast carcinomas (both FBCs and MBCs) in the absence of AR expression would suggest the presence of an AR-independent pathway for PSA expression. Yu and colleagues [37] have shown the expression of PSA in normal breast tissue from a woman taking Brevicon, a progesterone-containing contraceptive. Of the two cases in our series that were PSA+/AR+, only one was PR+. However, both expressed ER. This is consistent with the reported expression of PSA in breast cancer cell lines after stimulation by norethindrone or ethinylestradiol [37].

The expression of AR in FBC, although not associated with smaller tumor size or negative lymph node status [38, 39], is significantly associated with longer disease-free and/or overall survival [40–43]. This has been suggested to be due in part to its association with ER status and therefore its better response to hormone therapy [40, 41, 44]. In MBC, the relationship between AR and ER is more variable, from positive association [4, 45] to no association (this study), and even a significant inverse correlation [46]. Additionally, ER status in MBCs, in contrast to FBCs, does not seem to have a significant effect on prognosis [4, 47]. Although this might be due in part to a higher frequency of expression, it has been suggested that ERs in MBCs do not have the same function as in FBCs [48].

Conclusion

In the present study the expression of PSAP was not observed in any of the 26 cases examined; this suggests that this marker might have a greater utility in distinguishing primary breast carcinomas from metastatic prostatic tumors. Further studies to confirm these findings are necessary. Male breast cancers can express PSA. The expression of PSA did not correlate with AR expression, suggesting the existence of alternative pathways for the control of PSA expression. The expression of neither of the two proteins was correlated with other clinical and pathologic tumor parameters. These observations are unlike those seen in FBCs and support the contention that MBC is biologically different from FBC [4].

Abbreviations

AR:

androgen receptor

ER:

estrogen receptor

FBC:

female breast carcinoma

MBC:

male breast carcinoma

PR:

progesterone receptor

PSA:

prostate-specific antigen

PSAP:

prostate-specific acid phosphatase.

Declarations

Acknowledgements

The study is partly supported by a gift from the Avon Products Foundation Breast Cancer Research and Care Program. SB was also supported by the Pathology Core of the SPORE grant 1P 50 89018-01.

Competing interests

None declared.

Authors’ Affiliations

(1)

Northwestern University Medical School, Chicago, IL, USA

(2)

Division of Surgical Pathology, Indiana University School of Medicine, Rm 3465, 550 N University Boulevard, Indianapolis, IN, USA

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Ratings 78% (98) Research paper on breast cancer apa format

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22FebJune 11, 2023

By MHN Author

Breast Cancer

The model announced in October that she had been diagnosed with stage four metastatic breast cancer.

My inaccurate results meant I had been carrying around a devastatingly unnecessary burden for more than a decade.

“It got me through the most difficult period of my life,” Jeong recalled.

“You get to see me as this model, and I’m also a breast cancer survivor, I’m also black, I’m also queer. I’m not just one identity that you want to pull out, right?”

SHE Media’s Reshma Gopaldas on the importance of friends on your breast cancer journey.

Caroline Modarressy-Tehrani spoke with SHE Media’s Reshma Gopaldas about living with cancer at age 35 — with a dash of humor and Chipotle.

The “Grease” star wants her fans to know that despite her cancer, reports she is dying have been “greatly exaggerated.”

How could I feel confident when I was wholeheartedly embarrassed by my jagged pink scars?

The reality TV star had received her stage 4 diagnosis just two months earlier.

In the weeks and months after the best-possible outcome, I felt lost.

“I really want people people to be aware that this is an option,” the tattoo artist and eyebrow expert said.

For some survivors, this is the only way they can become biological parents.

Serena Williams got out of her “comfort zone” by singing a rendition of “I Touch Myself” to promote self-examinations and early detections for breast cancer.

In January, I found out I had the mutated BRCA1 gene.

“The idea of not being covered when you’re in a crisis … is an unconscionable thing to me,” said the “Veep” star, who was diagnosed with cancer a year ago.

The “Veep” actress is back to work and baring her soul in a new interview.

The “E! News” host gets real about how she takes care of herself each day.

A man is more likely to accidentally drown than to contract breast cancer, but it still happens.

There was a wave of excitement at Ireland’s Magheramore beach this past weekend ― and that’s the naked truth. That’s because

Genetic testing and counseling rates among women of color and men in general are still too low.

The FDA’s recent OK is a step backward for efforts to increase genetic testing access.

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