Breast cancer is one of the most common cancers in women. It can develop in men too but is commoner in women. According to the American Cancer Society, 1 in every 8 females is at risk to develop breast cancer whereas breast cancer in men accounts for 1% of total breast cancers. Males and females have similar breast anatomy till puberty, thereafter the breast develops in females and the breast cells become highly active and receptive to estrogen levels, in contrast to males, where they remain inactive and unexposed to high estrogen levels. TheHealthSite.com spoke to Dr. Mukul Roy, Consultant Radiation Oncologist, Jaslok Hospital & Research Centre, to understand the various risk factors associated with the condition and how one can manage it.
Risk Factors For Males
Genetic mutations in CHEK2, PTEN and or PALB2 genes can cause breast cancer in men.
Males with this syndrome have extra X chromosomes & have higher estrogen levels compared to other males. They develop gynecomastia that leads to the growth of breast tissue. These men have an increased chance of developing breast cancer by 20 to 60 times.
Undescended testicles or testicles surgically removed, etc could also cause increased chances of breast cancer in men.
Risk Factors Specific For Females
Females have a higher rate of getting breast cancer than males because of the difference in anatomy and function.
Starting of menses before age 12 and menopause after 55 are increased risk factors due to prolonged estrogen exposure.
First childbirth at an older age or never giving birth (nulliparous) increases the risk of developing breast cancer. Pregnancy is like a rest period to the ovaries and therefore can be protective against breast cancer.
Common Risk Factors For Both Genders
Female breast cancer increase with age until the seventies as per the American Cancer Society (ACS), the average age of diagnosis is 62 years. Male breast cancer rates also increase with age and the average age of diagnosis is 72. It is seen that 1 in 5 males with breast cancer has a close family member who has/had breast cancer. Females with one first-degree female relative with breast cancer have 1.5 times higher risk compared to those with no family history and 2 to 4 times higher risk with more than one first-degree relative with breast cancer history.
Other Risk Factors For Breast Cancer Are
- Alcohol intake
- Sedentary lifestyle
- Past history of breast cancer
- Previous exposure to radiation
Breast cancer usually presents as a lump, single or multiple, in the breast or in the armpit. These lumps can have the following features:
- Usually occurs in one breast
- May feel hard/firm inconsistency
- May appear under/around the nipple
- May/may not be mobile
- May grow over time gradually or fast
- Discharge from the nipple may be bloody/ blood-tinged
- Any change in feel and orlook ofskin, like dimpling
- Nipple changes – turning inwards
- Adjoining skin changes – hard or thickened skin.
- Rash, crusting, or scaly/itchy skin around the nipple area.
- There are no guaranteed steps to avoid breast cancer completely but there are ways of reducing the chances of developing the disease.
- Self-breast examinations (SBE – monthly) are one of the foundations of prevention and early detection of breast cancer. Following are the steps of SBE –
- Observe the breasts for any asymmetry/ lumps/ nipple changes/ skin changes in front of the mirror in a standing position.
- Raise the hands & see for any changes if any as mentioned in step 1.
- Lie down & feel for any lump in the left breast with fingers of the right hand. Press down and see in a circular motion in all regions of the breast & armpit.
- The right breast should be examined similarly with fingers of the left hand.
- Repeat the above steps either standing or sitting.
Other Ways of Prevention
- Genetic testing for individuals with a strong family history of breast cancer
- Maintain a moderate weight
- Regular exercise to stay physically fit
- A healthy diet which is rich in fruits and vegetables. Phytoestrogens are especially beneficial. Avoid refined and processed food, smoking, and alcohol.
The treatment is a multimodal approach with surgery that may be breast conservation surgery/ mastectomy (removal of the whole breast) along with chemotherapy/hormonal therapy and radiotherapy. The results are excellent with early-stage and locoregional cancers. The latest techniques of radiotherapy include IMRT, Deep inspiration Breath-hold techniques, and VMAT/Rapid arc modalities that have revolutionized radiation with hardly any side effects. Breast cancers are curable with excellent survival and quality of life in both men and women.
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