Frequently Asked Questions

Q: What is Cancer?
A: In a healthy body, natural systems control the creation, growth and death (called apoptosis) of cells. Through the natural cycle of life, cells divide to make new tissue as older cells die. When tissue is injured, say by a cut on the hand, the body's cell growth regulators react by speeding up cell division to create new tissue in the injured area as fast as possible. When the body has healed, the creation of new tissue goes back to the normal pace.

Cancer is a condition where the natural systems do not work right and cells do not die at the normal rate. As a result, cell growth exceeds cell death. Cancer cells divide without their normal control and make a mass of extra tissue—a tumor.

As a tumor grows, it promotes the formation of new blood vessels (called angiogenesis) to bring in the oxygen and nutrients it needs. Cancer cells can also leave the tumor site and travel through the blood stream and lymphatic system (the network connecting lymph nodes throughout the body) to other parts of the body, such as the liver, lungs or bones. This process is called metastasis (meh-TAS-ta-sis). In the new site, cancer cells again may begin to divide too quickly and create a tumor.

Q: Warning Signs of Breast Cancer
A: Due to the increased use of mammography, most women in the United States are diagnosed at very early stages of breast cancer, before symptoms appear. However, not all breast cancer is found through mammography. The most common symptoms of breast cancer are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge. Warning signs you should be aware of are listed below:

Lump, hard knot or thickening in the breast or underarm area
Swelling, warmth, redness or darkening
Change in the size or shape of the breast
Dimpling or puckering of the skin
Itchy, scaly sore or rash on the nipple
Pulling in of the nipple or other parts of the breast
Nipple discharge that starts suddenly
New pain in one spot that doesn’t go away

Adapted from National Cancer Institute [5-6], American Cancer Society [7], and Centers for Disease Control and Prevention [8].

If you have any of these symptoms, see your health care provider right away. In most cases, these changes are not cancer. For example, breast pain is more common with benign breast conditions than with breast cancer. However, the only way to know for sure is to see your provider. If breast cancer is present, it is best to be diagnosed at an early stage, when the cancer is most treatable.

Breast lumps or lumpiness

Many women may find that their breasts feel lumpy. Breast tissue naturally has a bumpy texture. For some women, the lumpiness is more pronounced than for others. In most cases, this lumpiness is no cause to worry.

If the lumpiness can be felt throughout the breast and feels like your other breast, then it is probably normal breast tissue. Lumps that feel harder or different from the rest of the breast (or the other breast) or that feel like a change are a concern. When this type of lump is found, it may be a sign of breast cancer or a benign breast condition (such as a cyst or fibroadenoma). Learn more about benign breast conditions.

See your health care provider right away if:

You find a new lump or change that feels different from the rest of your breast.
You find a new lump or change that feels different from your other breast.
Feel something that is different from what you felt before.

If you are unsure whether you should have a lump checked, it is best to see your provider right away. Although a lump may be nothing to worry about, you will have the peace of mind that it has been checked.

Nipple discharge

Liquid leaking from your nipple (nipple discharge) can be troubling, but it is rarely a sign of cancer. Discharge can be your body's natural reaction when the nipple is squeezed. Signs of a more serious condition, such as breast cancer, include:

Discharge that occurs without squeezing the nipple
Discharge that occurs in only one breast
Discharge that has blood in it or is clear (not milky)

Nipple discharge can also be caused by an infection or another condition that needs medical treatment. For these reasons, if you have any nipple discharge, see your health care provider right away.

Q: Breast Facts for Men
A:

Breast Cancer in Men PDF, 128KB

Though boys and girls begin life with similar breast tissue, over time, men do not have the same complex breast growth and development as women. At puberty, high testosterone and low estrogen levels stop breast development in males. While some milk ducts exist, they remain undeveloped, and lobules are most often absent. However, breast problems, including cancer, can occur in men.

Learn more about breast anatomy.

For statistics on female breast cancer, visit Breast Cancer Statistics.

Male breast cancer in the United States

Breast cancer in men is rare, but it does happen. In 2010, it was estimated that among U.S. men there would be [31]:

1,970 new cases of breast cancer
390 breast cancer deaths

Rates of breast cancer incidence (new cases, including new cases of primary breast cancer among survivors, but not recurrence of original breast cancer among survivors) and mortality (the rate of death) are much lower among men than among women [31]. For example, in 2007 [32]:

	Men	Women
Incidence (new cases)	1.3 per 100,000	123 per 100,000
Mortality (deaths)	0.3 per 100,000	23 per 100,000

Survival rates for men are about the same as for women with the same stage of cancer at the time of diagnosis. However, men are usually diagnosed at a later stage because they are less likely to report symptoms.

Warning signs of male breast cancer

Changes in the breast or nipple can be warning signs of male breast cancer include [61-63]:

Lump, hard knot or thickening in the breast (usually painless, but may be tender)
Dimpling, puckering or redness of the skin of the breast
Itchy, scaly sore or rash on the nipple
Pulling in of the nipple or other parts of the breast
Nipple discharge
Inverted nipple

As men tend to have much less breast tissue compared to women, some of these signs can be easier to notice in men than in women. These symptoms may also be signs of a benign (non-cancer) breast condition. If you notice any of these signs or other changes in your breast or nipple, see your health care provider right away.

Learn more about benign breast conditions in women.

Types of male breast cancer

As with female breast cancers, most male breast cancers begin in the milk ducts of the breast (invasive ductal carcinomas). Less often, male breast cancers begin in the lobules of the breast (invasive lobular carcinoma). Learn more about the anatomy of the breast.

In rare cases, men can be diagnosed with inflammatory breast cancer, ductal carcinoma in situ (a non-invasive breast cancer) or Paget’s disease of the nipple [61-62,64]. Paget’s disease of the nipple is a cancer that begins in the milk ducts of the breast tissue, but spreads to the skin of the nipple. It can cause a scaly rash on the skin of the nipple. Although Paget’s disease is rare, it occurs more often in men than in women [62].

Learn about treatment for male breast cancer.

Benign breast conditions in men

Both men and women may develop benign (not cancer) breast conditions. However, the benign breast conditions that are most common in women (such as cysts and fibroadenomas) are very rare in men.

Learn about benign breast conditions in women.

Gynecomastia

The most common benign breast condition in men is gynecomastia (GUY-nuh-ko-MASS-tee-uh) (enlargement of the breast tissue). Gynecomastia results from a hormone imbalance in the body. Certain diseases, hormone use, obesity and other hormone changes can cause this imbalance [65]. For example, boys can get a temporary form of gynecomastia during puberty.

Gynecomastia does not need to be treated unless it is desired or it causes pain. In these cases, it can be treated with hormone therapy or surgery [65].

At this time, it is unclear whether gynecomastia is related to male breast cancer. Although some data suggest it may increase the risk of male breast cancer, most studies have found no link between the two [61,66-68].

Risk factors for male breast cancer

Age

Getting older increases the risk of male breast cancer. Most breast cancer in men occurs between ages 65 and 67 [61].

Klinefelter's syndrome

The strongest risk factor for male breast cancer is Klinefelter's syndrome, a condition related to high levels of estrogen in the body [61,65-66]. This rare condition occurs when men are born with two X chromosomes instead of one (XXY instead of XY). Men with Klinefelter’s syndrome have a 20 to 50 times greater risk of breast cancer compared to men without this condition [61].

Men with Klinefelter’s syndrome may have gynecomastia (enlargement of the breast tissue). Although some data suggest that gynecomastia may increase the risk of male breast cancer, most studies have found no link between the two [61,66-68].

BRCA2 gene mutations and family history of breast cancer

Similar to women, men with an inherited mutation in the BRCA2 gene have an increased risk of breast cancer [61,65-66]. Men who carry a BRCA2 mutation have about a seven percent chance of developing breast cancer by age 70 [69]. BRCA2 carriers are also at an increased risk for other types of cancer, such as prostate cancer.

Men can inherit a BRCA2 from either parent. And, a man who is a BRCA2 carrier can pass the mutation on to both his male and female children.

Learn more about BRCA2 mutations and cancer risk.

Whether or not a man carries a BRCA2 mutation, having a family member with breast cancer increases the chances of developing male breast cancer [62-63].

Gynecomastia

Gynecomastia (enlargement of the breast tissue) is a benign breast condition. At this time, it is unclear whether gynecomastia is related to male breast cancer. Although some data suggest that it may increase the risk of male breast cancer, most studies have found no link between the two [61,66-68].

Other risk factors

Heavy alcohol use, chronic alcoholism, chronic liver disease and obesity may also increase the risk of male breast cancer [61,66,68]. These conditions can increase estrogen levels in the body and these higher estrogen levels, in turn, may increase breast cancer risk. Some estrogen drugs used to treat prostate cancer also may increase the risk of male breast cancer [61-62].

Learn more about breast cancer.

For more information on male breast cancer, visit the National Comprehensive Cancer Network (www.nccn.com) or the American Society for Clinical Oncology’s website (www.cancer.net).