Male Breast Cancer

Question 1

What is gynecomastia?

• Describe the features of gynecomastia

Answer 1

Breast enlargement

• Unilateral or bilateral
• May present as a subareolar mass
• Periductal hyaline, collagenous tissue
• Epithelial hyperplasia of ducts
• No breast lobules (TDLUs) present

Question 2

What can cause gynecomastia?

Answer 2

• Syndrome
  
  • Klinefelter-XXY
• Systemic disease
  
  • Cirrhosis
• Drugs
  
  • ​Alcohol, marijuana, anabolic steroids
• Tumors
  
  • ​Functioning testicular tumor

Question 3

Male Breast Cancer:

• Incidence:
• Risk factors:
• Associated with ….

Answer 3

• Rare, lifetime risk of 0.11% (as compared to a lifetime risk of 13% in women)
• 1500 cases and 400 deaths per year
• Risk factors
  
  • 1stdegree relatives with breast cancer
  • Decreased testicular function
  • Exposure to exogenous estrogens
  • Increasing age, infertility, obesity
• Associated with BRCA2 mutations

Question 4

What is the clinical presentation of male breast cancer?

Answer 4

• Palpable subareolar mass
• Nipple discharge is a common symptom
• Axillary lymph node involvement is present in half the cases at presentation
• Distant metastases involve lungs, brain, bone and liver
• Prognosis and treatment are the same as in women