Life / Health

The rise of male breast cancer

Judith Potts 6 October 2015 • 4:13pm

Strictly Come Dancing favourites Kevin Clifton and Karen Hauer wear pink for Breast Cancer Now Credit: Rex Features

When I first wrote about breast cancer in men, I made the mistake of calling it ‘male breast cancer’ and was immediately taken to task by several readers who – quite logically – argued that we do not refer to male kidney cancer or male liver cancer, so why male breast cancer?

I took their point, but notice that in scientific research the condition is known as MBC – male breast cancer – and so, because of the need to quote accurately, for this piece I will use the acronym.

As far as we know, the first reported cases of MBC were in Paris, where the condition was ‘described as the cause of death of five men between the years 1830 and 1840’. However, that the condition can arise in men is still not widely known among the public, meaning those who are diagnosed have a double shock with which to contend.

Professor Valerie Speirs, from the Leeds Institute of Cancer and Pathology at St. James’s University Hospital, whose expertise is in breast cancer with particular emphasis on MBC, works closely with the Breast Cancer Now Tissue Bank (see box below).

Samples held by the Tissue Bank include those from MBCs and, for Breast Cancer Awareness Month, I asked Professor Speirs to update me on her work in that area. She told me: “Using samples supplied by the Breast Cancer Now Tissue Bank, the Leeds group has been examining the genomic landscape of male and female breast cancer and have shown that male breast cancers over-express a family of proteins called eukaryotic initiation factors. There are already approved drug therapies available which target this pathway, so if these findings can be recapitulated in independent cohorts by other scientists, these drugs may be suitable as more directed therapies for MBC in the years ahead.”

Invasive ductal breast cancer is the most commonly diagnosed type in men and most MBCs have hormone receptors. Nine out of ten are oestrogen-positive (i.e. the cancer requires oestrogen to grow), so similar drugs to those used for breast cancer in women are used for their male counterparts. After surgery, radiotherapy is often given because the cancer in men is always close to the muscle of the chest wall – there being so little breast tissue – and the treatment helps to stop the cells growing back into the chest wall itself. Chemotherapy, hormone therapy and biological therapy are used too but, all too often, by the time the patient consults his GP, the cancer is at an advanced stage.

Giles Cooper, a chartered surveyor, who lost his father and uncle to breast cancer and has had a double mastectomy himself Credit: Jay Williams

However, Professor John Boyages – oncologist and author of the e-book ‘Male Breast Cancer: Taking Control’ –says: “I have seen many patients who have seen their doctor with a lump or discharge from their nipple, to be told it was a fatty lump or man boobs, or enlarged tender breasts due to a hormone imbalance or medications.”

Around 350 men are diagnosed in the UK each year but there has been a gradual rise in the numbers over the last 20 years or so. I asked Professor Speirs why this is happening. She said: “Reasons for this are unknown. However, scientists in Leeds believe lifestyle factors may be responsible. Intriguingly, in work published earlier this year in the open access journal BMC Medicine, they have shown very close parallels between rising levels of obesity and increases in male breast cancer. Although there is currently no substantive proof to link the two, there are certainly provocative parallels.”

In the same way as women are taught to examine their breasts as part of their health routine, men should be encouraged to do the same. Symptoms which should take a man to his GP – and insist on a referral to a breast specialist - include:

A discharge or oozing from the nipple – which may be blood stained
Swelling of the breast area
An ulcer or a sore on the breast skin
The nipple being pulled inwards
A lump under the arm

Apart from men born with Klinefelter’s Syndrome (a rare genetic condition where a man is born with an extra female chromosome – XXY instead of XY), who are 20 times more like to develop breast cancer than the average man, it is important to take into account a family history of breast cancer – particularly an inherited BRCA2 gene mutation (BRCA1 mutations can also cause MBC but the risk is lower) – and age. On average, men with breast cancer are about 68 years old – but, like all cancers, it has been found in younger men.

The Breast Cancer Now Tissue Bank

First set up by Breast Cancer Campaign (which this year merged with Breakthrough Breast Cancer to form Breast Cancer Now), with the financial help of Asda’s ‘Tickled Pink’ Campaign and ‘Walk the Walk’, the Tissue Bank is now located in five different research institutes/hospitals in the UK – the University of Nottingham, the University of Leeds, the Barts Cancer Institute/Queen Mary University of London, the University of Sheffield and the University of Southampton.

I visited the Barts Centre in 2011 and described what I learned in a Blog post for The Telegraph. By the following year, the Tissue Bank was open to all breast cancer researchers in the UK and Ireland. Currently, there are 37,000 samples from around 9,000 patients available to researchers. Over 7,500 samples have been used in or allocated to research projects. All donations of tissue are gratefully received and fully utilised. If you (male or female) are undergoing breast surgery at one of the above centres - and would like to offer your tissue to the Bank – please log on to breastcancernow.org to find out how this can be done.