reproductive system disorders, surgery,

1. MALE BREAST
CANCER
BY: MANISHA SHARMA
NURSINGTUTOR

2. DEFINITION
 Male breast cancer (male breast neoplasm)
is a rare cancer in males that originates from
the breast. Many males with breast cancer
have inherited a BRCA mutation (BRCA gene
1 & 2 present on chromosome 17 and 13
respectively), but there are other causes,
including alcohol use disorder and exposure
to certain hormones and ionizing radiation.

3. ETIOILOGY
 There are no known cause of male breast
carcinoma but there may be some factors that
increase the risk of male breast cancer include:
• Older age.The risk of breast cancer increases as
you age. Male breast cancer is most often
diagnosed in men in their 60s.
• Exposure to estrogen. If a person take
estrogen-related drugs, such as those used for
hormone therapy for prostate cancer, the risk of
breast cancer is increased.
• Family history of breast cancer. If a person have
a close family member with breast cancer, there
is a greater chance of developing the disease.

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• Klinefelter's syndrome.This genetic
syndrome occurs when boys are born with
more than one copy of the X chromosome.
Klinefelter's syndrome causes abnormal
development of the testicles. As a result, men
with this syndrome produce lower levels of
certain male hormones (androgens) and
more female hormones (estrogens).

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• Liver disease: Certain conditions, such as
cirrhosis of the liver, can reduce male hormones
and increase female hormones, increasing the
risk of breast cancer.
• Obesity. Obesity is associated with higher levels
of estrogen in the body, which increases the risk
of male breast cancer.
• Testicle disease or surgery. Having inflamed
testicles (orchitis) or surgery to remove a testicle
(orchiectomy) can increase the risk of male
breast cancer.

6. STAGING
 Stage I
• Stage I is an invasive breast cancer with the
tumor not exceeding 2 cm and absence of
lymph node involvement.
 Stage II
• Stage II includes stages IIA and IIB.

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 Stage IIA
• One of the following three items applies:
 T0 orT1, N1 , M0:The tumor is 2 cm or less across (or is not
found) (T1 orT0) and either:
 It has spread to 1 to 3 axillary lymph nodes (N1a), but not to
distant sites (M0), or
 Tiny amounts of cancer are found in internal mammary lymph
nodes on sentinel lymph node biopsy (N1b), but not in distant
sites (M0)
 It has spread to 1 to 3 axillary lymph nodes, and tiny
amounts of cancer are found in internal mammary lymph
nodes on sentinel lymph node biopsy (N1c), but not to
distant sites (M0), or
 T2, N0, M0:The tumor is larger than 2 cm across and less
than 5 cm (T2), but it hasn't spread to the lymph nodes (N0)
or to distant sites (M0).

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 Stage IIB
• Either of the following applies:
 T2, N1, M0:The tumor is larger than 2 cm and less
than 5 cm across (T2). It has spread to 1 to 3 axillary
lymph nodes and/or tiny amounts of cancer are
found in internal mammary lymph nodes on sentinel
lymph node biopsy (N1). It has not spread to distant
sites (M0)
 T3, N0, M0:The tumor is larger than 5 cm across but
does not grow into the chest wall or skin (T3). It has
not spread to lymph nodes (N0) or to distant sites
(M0).


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 Stage III
• Stage III is divided into three subcategories:
 In IIIA there is breast cancer with axillary
lymph nodes clumped together or attached
to other structures.
 In IIIB the tumor has spread to the chestwall
or skin, and may have involved lymph nodes
of the axilla and/or breastbone.
 In IIIC the tumor has spread to the chest wall
or skin and lymph nodes below or above the
collar bone are affected.

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 Stage IV
• Stage IV is applied to metastatic breast
cancer; typically lungs, liver, bone, or brain
are involved.

11. CLINICAL MANIFESTATIONS
 Signs and symptoms of male breast cancer
can include:
• A painless lump or thickening in the breast
tissue
• Changes to the skin covering the breast, such
as dimpling, puckering, redness or scaling
• Changes to the nipple, such as redness or
scaling, or a nipple that begins to turn inward
• Discharge from the nipple

12. DIAGNOSTIC EVALUATIONS
 HISTORYTAKING: Previous medical and
surgical history.
Lifestyle history ( Diet, Exercise, Smoking,
Alcohol or drug abuse )
 PHYSICAL EXAMINATION
Breast examination.The doctor will check
both of the breasts and lymph nodes in the
armpit, feeling for any lumps or other
abnormalities.
Testicular and penile examination

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Mammogram. A mammogram is an X-ray of
the breast. Mammograms are commonly
used to screen for breast cancer. If an
abnormality is detected on a screening
mammogram, the doctor may recommend a
diagnostic mammogram to further evaluate
that abnormality.

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Breast ultrasound. Ultrasound uses sound
waves to produce images of structures deep
within the body. Ultrasound may be used to
determine whether a new breast lump is a
solid mass or a fluid-filled cyst.

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 Removing a sample of breast cells for
testing (biopsy). A biopsy is the only
definitive way to make a diagnosis of breast
cancer. During a biopsy, the doctor uses a
specialized needle device guided by X-ray or
another imaging test to extract a core of
tissue from the suspicious area.

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 Breast magnetic resonance imaging
(MRI).An MRI machine uses a magnet and
radio waves to create pictures of the interior
of the breast. Before a breast MRI, patient
receive an injection of dye. Unlike other types
of imaging tests, an MRI doesn't use radiation
to create the images.

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 Other tests may include:
• Blood tests, such as a complete blood count
• Bone scan
• Computerized tomography (CT) scan
• Positron emission tomography (PET) scan

18. TREATMENT
 Chemotherapy:
Some drugs used in chemotherapy are:
• Abemaciclib.
• Abraxane (PaclitaxelAlbumin-stabilized
Nanoparticle Formulation)
• Ado-Trastuzumab Emtansine.
• Afinitor (Everolimus)
• Alpelisib.
• Anastrozole.
• Aredia (Pamidronate Disodium)
• Arimidex (Anastrozole)

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 Radiation therapy:
Radiation therapy uses high-powered beams
of energy, such as X-rays and protons, to kill
cancer cells. Radiation therapy is typically
done using a large machine that aims the
energy beams at the body (external beam
radiation). But radiation can also be done by
placing radioactive material (beads) inside
the body (brachytherapy).

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 Surgery:
Most men with breast cancer have some type
of surgery as part of their treatment.There
are different types of breast surgery, and it
may be done for different reasons, depending
on the situation.

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 Surgery may be done to:
• Remove as much of the cancer as possible
(breast-conserving surgery or mastectomy)
• Find out whether the cancer has spread to the
lymph nodes under the arm (sentinel lymph
node biopsy or axillary lymph node
dissection)
• Relieve symptoms of advanced cancer

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 Types of surgeries
• Mastectomy :
A surgery in which the entire breast is
removed, including all of the breast tissue
and sometimes other nearby tissues. Most
men with breast cancer will undergo a
mastectomy since men have a small amount
of breast tissue.

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 There are several different types of
mastectomies:
• In a simple or total mastectomy, the surgeon
removes the entire breast, including the nipple,
but does not remove underarm lymph nodes or
muscle tissue from beneath the breast.
• In a modified radical mastectomy, the surgeon
extends the incision to remove the entire breast
and lymph nodes under the arm as well.

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• Breast-conserving surgery (BCS) (also called
a lumpectomy, quadrantectomy, partial
mastectomy, or segmental mastectomy) – A
surgery in which only the part of the breast
containing the cancer is removed.The goal is
to remove the cancer as well as some
surrounding normal tissue. How much of the
breast is removed depends on the size and
location of the tumor and other factors.

25. THANKYOU