21st Century Adult Cancer Sourcebook: Male Breast Cancer - Clinical Data for Patients, Families, and Physicians
Edition 1.0 - September 2011
National Cancer Institute
Smashwords Edition
Copyright 2011 Progressive Management
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PART ONE
Chapter 1A: Male Breast Cancer Patient Information
Chapter 2A: Male Breast Cancer Health Professional Information
Chapter 3A: Breast Cancer NCI Drugs
Chapter 4A: Breast Cancer Background Information
Chapter 5A: Male Breast Cancer Clinical Trials
PART TWO
Chapter 1B: Levels of Evidence for Adult and Pediatric Cancer Treatment Studies (NCI)
Chapter 2B: Glossary of Clinical Trial Terms
Chapter 3B: Clinical Trials Background Information
Chapter 4B: Cancer Clinical Trials -The Basic Workbook
Chapter 5B: Cancer Clinical Trials - The In-Depth Program
Chapter 6B: Clinical Trials at NIH
Chapter 7B: How To Find A Cancer Treatment Trial: A Ten Step Guide
Chapter 8B: Taking Part in Cancer Treatment Research Studies
Chapter 9B: Cancer Clinical Trials
Chapter 10B: Access to Investigational Drugs
Chapter 12B: Taking Time: Support for People with Cancer
Chapter 13B: Facing Forward - Life After Cancer Treatment
Chapter 14B: Chemotherapy and You
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PART ONE
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Chapter 1A: Male Breast Cancer Patient Information
Last Modified: 07/20/2011
Patient Version
General Information about Male Breast Cancer
Key Points for This Section
* Male breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
* Radiation exposure, high levels of estrogen, and a family history of breast cancer can increase a man’s risk of developing breast cancer.
* Male breast cancer is sometimes caused by inherited gene mutations (changes).
* Men with breast cancer usually have lumps that can be felt.
* Tests that examine the breasts are used to detect (find) and diagnose breast cancer in men.
* Survival for men with breast cancer is similar to survival for women with breast cancer.
* Certain factors affect prognosis (chance of recovery) and treatment options.
Male breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
Breast cancer may occur in men. Men at any age may develop breast cancer, but it is usually detected (found) in men between 60 and 70 years of age. Male breast cancer makes up less than 1% of all cases of breast cancer.
The following types of breast cancer are found in men:
* Infiltrating ductal carcinoma: Cancer that has spread beyond the cells lining ducts in the breast. Most men with breast cancer have this type of cancer.
* Ductal carcinoma in situ: Abnormal cells that are found in the lining of a duct; also called intraductal carcinoma.
* Inflammatory breast cancer: A type of cancer in which the breast looks red and swollen and feels warm.
* Paget disease of the nipple: A tumor that has grown from ducts beneath the nipple onto the surface of the nipple.
Lobular carcinoma in situ (abnormal cells found in one of the lobes or sections of the breast), which sometimes occurs in women, has not been seen in men.
Radiation exposure, high levels of estrogen, and a family history of breast cancer can increase a man’s risk of developing breast cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for breast cancer in men may include the following:
* Being exposed to radiation.
* Having a disease related to high levels of estrogen in the body, such as cirrhosis (liver disease) or Klinefelter syndrome (a genetic disorder).
* Having several female relatives who have had breast cancer, especially relatives who have an alteration of the BRCA2 gene.
Male breast cancer is sometimes caused by inherited gene mutations (changes).
The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups. Men who have an altered gene related to breast cancer have an increased risk of developing this disease.
Tests have been developed that can detect altered genes. These genetic tests are sometimes done for members of families with a high risk of cancer.
Men with breast cancer usually have lumps that can be felt.
Lumps and other symptoms may be caused by male breast cancer. Other conditions may cause the same symptoms. A doctor should be seen if changes in the breasts are noticed.
Tests that examine the breasts are used to detect (find) and diagnose breast cancer in men.
The following tests and procedures may be used:
* Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The following are different types of biopsies:
* Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
* Core biopsy: The removal of tissue using a wide needle.
* Excisional biopsy: The removal of an entire lump of tissue.
* Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.
* HER2 test: A test to measure the amount of HER2 in cancer tissue. HER2 is a growth factor protein that sends growth signals to cells. When cancer forms, the cells may make too much of the protein, causing more cancer cells to grow. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out if there is too much HER2 in the cells. The test results show whether monoclonal antibody therapy may stop the cancer from growing.
Survival for men with breast cancer is similar to survival for women with breast cancer.
Survival for men with breast cancer is similar to that for women with breast cancer when their stage at diagnosis is the same. Breast cancer in men, however, is often diagnosed at a later stage. Cancer found at a later stage may be less likely to be cured.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
* The stage of the cancer (whether it is in the breast only or has spread to other places in the body).
* The type of breast cancer.
* Estrogen-receptor and progesterone-receptor levels in the tumor tissue.
* Whether the cancer is also found in the other breast.
* The patient’s age and general health.
Glossary Terms
abnormal (ab-NOR-mul)
* Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
alteration (all-teh-RAY-shun)
* A change resulting in something that is different from the original.
biopsy (BY-op-see)
* The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
BRCA2
* A gene on chromosome 13 that normally helps to suppress cell growth. A person who inherits certain mutations (changes) in a BRCA2 gene has a higher risk of getting breast, ovarian, prostate, and other types of cancer.
breast (brest)
* Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
breast cancer (brest KAN-ser)
* Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
cancer (KAN-ser)
* A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
* The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
cirrhosis (seh-ROH-sis)
* A type of chronic, progressive liver disease in which liver cells are replaced by scar tissue.
condition (kun-DIH-shun)
* In medicine, a health problem with certain characteristics or symptoms.
core biopsy (... BY-op-see)
* The removal of a tissue sample with a wide needle for examination under a microscope. Also called core needle biopsy.
cure (kyoor)
* To heal or restore health; a treatment to restore health.
diagnosis (DY-ug-NOH-sis)
* The process of identifying a disease, such as cancer, from its signs and symptoms.
duct (dukt)
* In medicine, a tube or vessel of the body through which fluids pass.
ductal carcinoma in situ (DUK-tul KAR-sih-NOH-muh in SY-too)
* A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma.
estrogen (ES-truh-jin)
* A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
estrogen receptor test (ES-truh-jin reh-SEP-ter test)
* A lab test to find out if cancer cells have estrogen receptors (proteins to which estrogen will bind). If the cells have estrogen receptors, they may need estrogen to grow, and this may affect how the cancer is treated.
excisional biopsy (ek-SIH-zhuh-nul BY-op-see)
* A surgical procedure in which an entire lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope.
fine-needle aspiration biopsy (... NEE-dul AS-pih-RAY-shun BY-op-see)
* The removal of tissue or fluid with a thin needle for examination under a microscope. Also called FNA biopsy.
fluid (FLOO-id)
* A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.
gene (jeen)
* The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.
genetic (jeh-NEH-tik)
* Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.
genetic testing (jeh-NEH-tik TES-ting)
* Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder.
growth factor (grothe FAK-ter)
* A substance made by the body that functions to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy.
HER2/neu
* A protein involved in normal cell growth. It is found on some types of cancer cells, including breast and ovarian. Cancer cells removed from the body may be tested for the presence of HER2/neu to help decide the best type of treatment. HER2/neu is a type of receptor tyrosine kinase. Also called c-erbB-2, human EGF receptor 2, and human epidermal growth factor receptor 2.
hereditary (huh-REH-dih-tayr-ee)
* Transmitted from parent to child by information contained in the genes.
hormone (HOR-mone)
* One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hormone therapy (HOR-mone THAYR-uh-pee)
* Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.
infiltrating ductal carcinoma (IN-fil-TRAY-ting DUK-tul KAR-sih-NOH-muh)
* The most common type of invasive breast cancer. It starts in the cells that line the milk ducts in the breast, grows outside the ducts, and often spreads to the lymph nodes.
inflammatory breast cancer (in-FLA-muh-TOR-ee brest KAN-ser)
* A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d'orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin.
Klinefelter syndrome (KLINE-fel-ter SIN-drome)
* A genetic disorder in males caused by having one or more extra X chromosomes. Males with this disorder may have larger than normal breasts, a lack of facial and body hair, a rounded body type, and small testicles. They may learn to speak much later than other children and may have difficulty learning to read and write. Klinefelter syndrome increases the risk of developing extragonadal germ cell tumors and breast cancer.
liver (LIH-ver)
* A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lobe
* A portion of an organ, such as the liver, lung, breast, thyroid, or brain.
lobular carcinoma in situ (LAH-byuh-ler KAR-sih-NOH-muh in SY-too)
* A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast. Also called LCIS.
monoclonal antibody (MAH-noh-KLOH-nul AN-tee-BAH-dee)
* A type of protein made in the laboratory that can bind to substances in the body, including tumor cells. There are many kinds of monoclonal antibodies. Each monoclonal antibody is made to find one substance. Monoclonal antibodies are being used to treat some types of cancer and are being studied in the treatment of other types. They can be used alone or to carry drugs, toxins, or radioactive materials directly to a tumor.
Paget disease of the nipple (PA-jet dih-ZEEZ ...)
* A form of breast cancer in which the tumor grows from ducts beneath the nipple onto the surface of the nipple. Symptoms commonly include itching and burning and an eczema-like condition around the nipple, sometimes accompanied by oozing or bleeding.
pathologist (puh-THAH-loh-jist)
* A doctor who identifies diseases by studying cells and tissues under a microscope.
progesterone (proh-JES-teh-RONE)
* A type of hormone made by the body that plays a role in the menstrual cycle and pregnancy. Progesterone can also be made in the laboratory. It may be used as a type of birth control and to treat menstrual disorders, infertility, symptoms of menopause, and other conditions.
progesterone receptor test (proh-JES-teh-rone reh-SEP-ter test)
* A lab test to find out if cancer cells have progesterone receptors (proteins to which the hormone progesterone will bind). If the cells have progesterone receptors, they may need progesterone to grow, and this can affect how the cancer is treated.
prognosis (prog-NO-sis)
* The likely outcome or course of a disease; the chance of recovery or recurrence.
protein (PROH-teen)
* A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.
radiation (RAY-dee-AY-shun)
* Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).
receptor (reh-SEP-ter)
* A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell.
risk factor (... FAK-ter)
* Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.
stage
* The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
survival rate (ser-VY-vul ...)
* The percentage of people in a study or treatment group who are alive for a certain period of time after they were diagnosed with or treated for a disease, such as cancer. The survival rate is often stated as a five-year survival rate, which is the percentage of people in a study or treatment group who are alive five years after diagnosis or treatment. Also called overall survival rate.
symptom (SIMP-tum)
* An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
therapy (THAYR-uh-pee)
* Treatment.
tissue (TIH-shoo)
* A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
* An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
Table of Links
1 http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/HealthProfes
sional
2 http://www.cancer.gov/cancertopics/pdq/prevention/breast/Patient
3 http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient
Stages of Male Breast Cancer
Key Points for This Section
* After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
* There are three ways that cancer spreads in the body.
* The following stages are used for male breast cancer:
* Stage 0 (carcinoma in situ)
* Stage I
* Stage II
* Stage IIIA
* Stage IIIB
* Stage IIIC
* Stage IV
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. This process is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Breast cancer in men is staged the same as it is in women. The spread of cancer from the breast to lymph nodes and other parts of the body appears to be similar in men and women.
The following tests and procedures may be used in the staging process:
* Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
* CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
* Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
* PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
* Through tissue. Cancer invades the surrounding normal tissue.
* Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
* Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for male breast cancer:
Stage 0 (carcinoma in situ)
There are 2 types of breast carcinoma in situ:
* Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive.
* Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition has not been seen in men.
Pea, peanut, walnut, and lime show tumor sizes.
Stage I
In stage I, cancer has formed. Stage I is divided into stages IA and IB.
* In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast.
* In stage IB, either:
* no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or
* the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.
Stage II
Stage II is divided into stages IIA and IIB.
* In stage IIA
* no tumor is found in the breast, but cancer is found in the axillary lymph nodes (lymph nodes under the arm); or
* the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or
* the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
* In stage IIB, the tumor is either:
* larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
* larger than 5 centimeters but has not spread to the axillary lymph nodes.
Stage IIIA
In stage IIIA:
* no tumor is found in the breast. Cancer is found in axillary lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or
* the tumor is 2 centimeters or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or
* the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or
* the tumor is larger than 5 centimeters. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.
Stage IIIB
In stage IIIB, the tumor may be any size and cancer:
* has spread to the chest wall and/or the skin of the breast; and
* may have spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.
Cancer that has spread to the skin of the breast is inflammatory breast cancer. See the section on Inflammatory Male Breast Cancer 1 for more information.
Stage IIIC
In stage IIIC, there may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer:
* has spread to lymph nodes above or below the collarbone; and
* may have spread to axillary lymph nodes or to lymph nodes near the breastbone.
Cancer that has spread to the skin of the breast is inflammatory breast cancer.
Stage IIIC breast cancer is divided into operable and inoperable stage IIIC.
In operable stage IIIC, the cancer:
* is found in ten or more axillary lymph nodes; or
* is found in lymph nodes below the collarbone; or
* is found in axillary lymph nodes and in lymph nodes near the breastbone.
In inoperable stage IIIC breast cancer, the cancer has spread to the lymph nodes above the collarbone.
Stage IV
In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.
Glossary Terms
abnormal (ab-NOR-mul)
* Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
axillary lymph node (AK-sih-LAYR-ee limf node)
* A lymph node in the armpit region that drains lymph from the breast and nearby areas.
blood (blud)
* A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
bone cancer (bone KAN-ser)
* Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).
bone scan (bone skan)
* A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.
breast (brest)
* Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
breast cancer (brest KAN-ser)
* Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
breast carcinoma in situ (brest KAR-sih-NOH-muh in SY-too)
* There are 2 types of breast carcinoma in situ: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct (a tube that carries milk to the nipple). The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known how to predict which lesions will become invasive cancer. LCIS is a condition in which abnormal cells are found in the lobules (small sections of tissue involved with making milk) of the breast. This condition seldom becomes invasive cancer; however, having LCIS in one breast increases the risk of developing breast cancer in either breast. Also called stage 0 breast carcinoma in situ.
breastbone (brest...)
* The long flat bone that forms the center front of the chest wall. The breastbone is attached to the collarbone and the first seven ribs. Also called sternum.
cancer (KAN-ser)
* A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
capillary (KA-pih-layr-ee)
* The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.
cell (sel)
* The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
centimeter (SEN-tih-MEE-ter)
* A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.
chest wall (chest wawl)
* The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.
chest x-ray (chest EX-ray)
* An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.
collarbone (KAH-lur …)
* One of a pair of bones at the base of the front of the neck. The clavicles connect the breastbone to the shoulder blades. Also called clavicle.
condition (kun-DIH-shun)
* In medicine, a health problem with certain characteristics or symptoms.
contrast material (KON-trast muh-TEER-ee-ul)
* A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.
CT scan (… skan)
* A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
diagnosis (DY-ug-NOH-sis)
* The process of identifying a disease, such as cancer, from its signs and symptoms.
duct (dukt)
* In medicine, a tube or vessel of the body through which fluids pass.
ductal carcinoma in situ (DUK-tul KAR-sih-NOH-muh in SY-too)
* A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma.
glucose (GLOO-kose)
* A type of sugar; the chief source of energy for living organisms.
inflammatory breast cancer (in-FLA-muh-TOR-ee brest KAN-ser)
* A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d'orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin.
injection (in-JEK-shun)
* Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
inoperable (in-AH-peh-ruh-bul)
* Describes a condition that cannot be treated by surgery.
invasive cancer (in-VAY-siv KAN-ser)
* Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.
lesion (LEE-zhun)
* An area of abnormal tissue. A lesion may be benign (not cancer) or malignant (cancer).
liver (LIH-ver)
* A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lobular carcinoma in situ (LAH-byuh-ler KAR-sih-NOH-muh in SY-too)
* A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast. Also called LCIS.
lobule (LOB-yule)
* A small lobe or a subdivision of a lobe.
lung
* One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymph (limf)
* The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
lymph node (limf node)
* A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
lymph vessel (limf ...)
* A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.
lymphatic system (lim-FA-tik SIS-tem)
* The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
malignant (muh-LIG-nunt)
* Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
metastasis (meh-TAS-tuh-sis)
* The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).
millimeter (MIH-luh-MEE-ter)
* A measure of length in the metric system. A millimeter is one thousandth of a meter. There are 25 millimeters in an inch.
noninvasive (NON-in-VAY-siv)
* In medicine, it describes a procedure that does not require inserting an instrument through the skin or into a body opening. In cancer, it describes disease that has not spread outside the tissue in which it began.
operable (AH-peh-ruh-bul)
* Describes a condition that can be treated by surgery.
organ (OR-gun)
* A part of the body that performs a specific function. For example, the heart is an organ.
PET scan (… skan)
* A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.
primary tumor (PRY-mayr-ee TOO-mer)
* The original tumor.
radioactive (RAY-dee-oh-AK-tiv)
* Giving off radiation.
scanner (SKA-ner)
* In medicine, an instrument that takes pictures of the inside of the body.
stage
* The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I breast cancer (... brest KAN-ser)
* Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.
stage IA breast cancer (... brest KAN-ser)
* Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast.
stage IB breast cancer (... brest KAN-ser)
* Stage I breast cancer is divided into stages IA and IB. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.
stage II breast cancer (... brest KAN-ser)
* Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes. In stage IIB, the tumor is (1) larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or (2) larger than 5 centimeters but has not spread to the axillary lymph nodes.
stage IIA breast cancer (... brest KAN-ser)
* Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
stage IIB breast cancer (... brest KAN-ser)
* Stage II breast cancer is divided into stages IIA and IIB. In stage IIB, (1) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary (under the arm) lymph nodes; or (2) the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.
stage IIIA breast cancer (... brest KAN-ser)
* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIA, (1) no tumor is found in the breast, but cancer is found in axillary (under the arm) lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or (2) the tumor is 2 centimeters or smaller and cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and cancer has spread to axillary lymph nodes that are attached to each other or to other structures
stage IIIB breast cancer (... brest KAN-ser)
* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIB, the tumor may be any size and cancer (1) has spread to the chest wall and/or the skin of the breast; and (2) may have spread to axillary (under the arm) lymph nodes that may be attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone.
stage IIIC breast cancer (... brest KAN-ser)
* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIC, there may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer (1) has spread to lymph nodes above or below the collarbone and (2) may have spread to axillary (under the arm) lymph nodes or to lymph nodes near the breastbone. In operable stage IIIC, the cancer is found (1) in ten or more axillary lymph nodes; or (2) in the lymph nodes below the collarbone; or (3) in axillary lymph nodes and in lymph nodes near the breastbone. In inoperable stage IIIC, the cancer has spread to the lymph nodes above the collarbone.
stage IV breast cancer (... brest KAN-ser)
* Cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.
staging (STAY-jing)
* Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.
tissue (TIH-shoo)
* A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
* An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
vein (vayn)
* A blood vessel that carries blood to the heart from tissues and organs in the body.
x-ray (EX-ray)
* A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.
Table of Links
1 http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/Patient/Page3#Section 214
Inflammatory Male Breast Cancer
In inflammatory breast cancer, cancer has spread to the skin of the breast and the breast looks red and swollen and feels warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin. The skin of the breast may also show the dimpled appearance called peau d’orange (like the skin of an orange). There may not be any lumps in the breast that can be felt. Inflammatory breast cancer may be stage IIIB, stage IIIC, or stage IV.
Recurrent Male Breast Cancer
Recurrent breast cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the breast, in the chest wall, or in other parts of the body.
Treatment Option Overview
Key Points for This Section
* There are different types of treatment for men with breast cancer.
* Four types of standard treatment are used to treat men with breast cancer:
* Surgery
* Chemotherapy
* Hormone therapy
* Radiation therapy
* New types of treatment are being tested in clinical trials.
* Targeted therapy
There are different types of treatment for men with breast cancer.
Different types of treatment are available for men with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
For some patients, taking part in a clinical trial may be the best treatment choice. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials is available from the NCI Web site 1. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Four types of standard treatment are used to treat men with breast cancer:
Surgery
Surgery for men with breast cancer is usually a modified radical mastectomy (removal of the breast, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes part of the chest wall muscles).
Breast-conserving surgery, an operation to remove the cancer but not the breast itself, is also used for some men with breast cancer. A lumpectomy is done to remove the tumor (lump) and a small amount of normal tissue around it. Radiation therapy is given after surgery to kill any cancer cells that are left.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Hormone therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site 1.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy being studied in the treatment of male breast cancer.
Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies are also used in combination with chemotherapy as adjuvant therapy (treatment given after surgery to lower the risk that the cancer will come back).
Trastuzumab (Herceptin) is a monoclonal antibody that blocks the effects of the growth factor protein HER2.
Glossary Terms
abdomen (AB-doh-men)
* The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
adjuvant therapy (A-joo-vunt THAYR-uh-pee)
* Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy.
antibody (AN-tee-BAH-dee)
* A protein made by plasma cells (a type of white blood cell) in response to an antigen (a substance that causes the body to make a specific immune response). Each antibody can bind to only one specific antigen. The purpose of this binding is to help destroy the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen.
breast (brest)
* Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
breast cancer (brest KAN-ser)
* Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
breast-conserving surgery (brest-kun-SER-ving SER-juh-ree)
* An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor). Also called breast-sparing surgery.
cancer (KAN-ser)
* A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
catheter (KA-theh-ter)
* A flexible tube used to deliver fluids into or withdraw fluids from the body.
cavity (KA-vih-tee)
* A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.
cell (sel)
* The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
cerebrospinal fluid (seh-REE-broh-SPY-nul FLOO-id)
* The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between two of the meninges (the thin layers of tissue that cover and protect the brain and spinal cord). Cerebrospinal fluid is made by tissue called the choroid plexus in the ventricles (hollow spaces) in the brain. Also called CSF.
chemotherapy (KEE-moh-THAYR-uh-pee)
* Treatment with drugs that kill cancer cells.
chest wall (chest wawl)
* The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.
clinical trial (KLIH-nih-kul TRY-ul)
* A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
drug (drug)
* Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
external radiation therapy (...RAY-dee-AY-shun THAYR-uh-pee)
* A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.
gland
* An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.
growth factor (grothe FAK-ter)
* A substance made by the body that functions to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy.
HER2/neu
* A protein involved in normal cell growth. It is found on some types of cancer cells, including breast and ovarian. Cancer cells removed from the body may be tested for the presence of HER2/neu to help decide the best type of treatment. HER2/neu is a type of receptor tyrosine kinase. Also called c-erbB-2, human EGF receptor 2, and human epidermal growth factor receptor 2.
hormone (HOR-mone)
* One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hormone receptor (HOR-mone reh-SEP-ter)
* A cell protein that binds a specific hormone. The hormone receptor may be on the surface of the cell or inside the cell. Many changes take place in a cell after a hormone binds to its receptor.
hormone therapy (HOR-mone THAYR-uh-pee)
* Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.
immune system (ih-MYOON SIS-tem)
* The complex group of organs and cells that defends the body against infections and other diseases.
infusion (in-FYOO-zhun)
* A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.