Male breast cancer rare, but can be aggressive

NEW YORK (Reuters Health) - Men get diagnosed with breast cancer at less than one percent the rate of women, according to a new analysis of cancer rates from six cities and countries.

But when they did get breast cancer, men were caught with more advanced disease, on average, and were more likely to die from it.

"It's not surprising that men with breast cancer present with later stages," said Dr. Susan Dent, from the Ottawa Hospital Cancer Centre in Canada, who was not involved in the new study.

"That's just because the awareness of the fact that breast cancer can occur in men is not as acute," she told Reuters Health. "Men aren't as likely to think of it, and health care providers aren't as likely to think of men having breast cancer."

Men are most commonly in their 60s or 70s when diagnosed with breast cancer, according to the National Cancer Institute. Radiation exposure and diseases that increase estrogen levels - such as liver cirrhosis or Klinefelter syndrome, a genetic disorder - are among factors that raise a man's risk.

Dent added that men should be particularly aware of breast cancer -- and possibly consider getting screened for the disease -- if they have a family history of it, including a predisposition to cancer caused by mutations in the BRCA1 and BRCA2 genes, which are well-known to raise women's risk of breast and ovarian cancers.

But men with no family history should not be screened, experts agreed.

Researchers combined cancer registries from Denmark, Finland, Norway, Sweden, Singapore and Geneva, Switzerland, with cases dating back to 1970. That included about 460,000 women diagnosed with breast cancer and about 2,700 men.

Men were more likely to have disease that had spread beyond the breast by the time they were diagnosed. In treatment, they also had less surgery and radiation compared to women, but similar rates of chemotherapy and hormone therapy.

Over the entire time period, men had a 72 percent chance of surviving breast cancer in the five years after a diagnosis -- compared to 78 percent in women.

But researchers led by Dr. Mikael Hartman of the National University of Singapore found that when their cancer was spotted at the same stage and they got recommended treatment, men had a better chance than women of surviving a breast cancer diagnosis.

Hartman's team also noted in the Journal of Clinical Oncology that previous studies have shown it typically takes a few months from when men start getting symptoms until they are diagnosed with breast cancer.

"Men who develop a breast lump delay seeing their doctor longer than a comparable woman would with similar symptoms," Hartman wrote in an email to Reuters Health.

"Male breast cancer is rare but men can develop the disease and should be aware that they should seek care if a breast lump develops," Hartman added.

Because of recommendations for regular mammograms in women starting in the 40s or at age 50, depending on the country, many cancers are caught in women before they have any symptoms.

The United States Preventive Services Task Force, a federally-supported panel that sets guidelines for cancer screening, does not recommend regular breast cancer screening in men without symptoms.

"In total, male breast cancer is still a rare event," said Dent. "Never would I recommend that all men routinely go out and get screened."

SOURCE: http://bit.ly/n3B9oU Journal of Clinical Oncology, online October 3, 2011.