Male breast cancer

Male breast cancer is cancer that forms in the breast tissue of men. Though breast cancer is most commonly thought of as a woman's disease, male breast cancer does occur.

Male breast cancer is most common in older men, though male breast cancer can occur at any age.

Men diagnosed with male breast cancer at an early stage have a good chance for a cure. Still, many men delay seeing their doctors if they notice unusual signs or symptoms, such as a breast lump. For this reason, many male breast cancers are diagnosed when the disease is more advanced.

Causes
It's not clear what causes male breast cancer. Doctors know that male breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do. The accumulating cells form a tumor that may spread (metastasize) to nearby tissue, to the lymph nodes or to other parts of the body.

Where breast cancer begins in men
Everyone is born with a small amount of breast tissue. Breast tissue is made up of milk-producing glands (lobules), ducts that carry milk to the nipples and fat. Women begin developing more breast tissue during puberty and men do not. Because men are born with a small amount of breast tissue, they can develop breast cancer.

Types of breast cancer diagnosed in men include:

    Cancer that begins in the milk ducts. Ductal carcinoma is the most common type of male breast cancer. Nearly all male breast cancers begin in the milk ducts.
    Cancer that begins in the milk-producing glands. Lobular carcinoma is rare in men because men have few lobules in their breast tissue.
    Cancer that spreads to the nipple. In some cases, breast cancer can form in the milk ducts and spread to the nipple, causing crusty, scaly skin around the nipple. This is called Paget's disease of the nipple.

Inherited genes that increase breast cancer risk
Some men inherit mutated genes from their parents that increase the risk of breast cancer. Mutations in one of several genes, especially a gene called BRCA2, put you at greater risk of developing breast and prostate cancers. The normal function of these genes is to help prevent cancer by making proteins that keep cells from growing abnormally. But if they have a mutation, the genes aren't as effective at protecting you from cancer.

Meeting with a genetic counselor and undergoing genetic testing can determine whether you carry gene mutations that increase your risk of breast cancer. Discuss the benefits and risks of genetic testing with your doctor.

Factors that increase the risk of male breast cancer include:

    Older age. Breast cancer is most common in men ages 60 to 70.
    Exposure to estrogen. If you take estrogen-related drugs, such as those used as part of a sex-change procedure, your risk of breast cancer is increased. Estrogen drugs may also be used in hormone therapy for prostate cancer.
    Family history of breast cancer. If you have a close family member with breast cancer, you have a greater chance of developing the disease.
    Klinefelter's syndrome. This genetic syndrome occurs when a boy is born with more than one copy of the X chromosome. Klinefelter's syndrome causes abnormal development of the testicles. As a result, men with this syndrome produce lower levels of certain male hormones (androgens) and more female hormones (estrogens).
    Liver disease. If you have liver disease, such as cirrhosis of the liver, your male hormones may be reduced and your female hormones may be increased. This can increase your risk of breast cancer.
    Obesity. Obesity may be a risk factor for breast cancer in men because it increases the number of fat cells in the body. Fat cells convert androgens into estrogen, which may increase the amount of estrogen in your body and, therefore, your risk of breast cancer.
    Radiation exposure. If you've received radiation treatments to your chest, such as those used to treat cancers in the chest, you're more likely to develop breast cancer later in life.

What Causes Infertility in Men?

There are several factors that can lead to infertility in men. Learn about possible causes for male infertility and available treatments.

It is estimated that between 10 percent and 20 percent of couples are infertile, which means they are unable to conceive after trying for one year or more. And infertility is not just an issue for women; male infertility problems are the cause of roughly one-third of all infertility cases.

Male Infertility: A Variety of Causes

Among the factors that can lead to male infertility are:

    Varicoceles. A tangle of troublesome varicose veins in the scrotum, causing an increase in temperature within the scrotum, is the most common cause of infertility in men. The heat generated by the condition can have a negative effect on the production of sperm, leading to male infertility.
    Blockage. A blockage in any part of the reproductive system that helps deliver sperm, such as the epididymis or vas deferens, can cause infertility.
    Medications. Certain medications, such as anabolic steroids, have been associated with infertility in men.
    Low sperm count. When a man produces too little sperm, it can cause problems with conception.
    Sperm problems. Sometimes sperm are shaped abnormally or move in abnormal ways, which can lead to male infertility.
    Undescended testicle. A testicle that doesn't move down from the abdomen into the scrotum can affect sperm production.
    Medical problems. Some medical conditions, such as kidney failure, can lead to male fertility problems.
    Unknown causes. There are cases of male infertility that can’t be identified, though some are thought to be due to genetic causes.

Male Infertility: Few Symptoms

There are usually no symptoms or warning signs that a man is infertile, notes Ira Sharlip, MD, clinical professor of urology at the University of California, San Francisco School of Medicine and spokesperson for the American Urological Association.

Men with varicoceles may be aware of a soft mass on the left side of the scrotum. "In rare situations, symptoms of marked hypogonadism may be present, including delayed puberty, low sex drive, decreased body hair, and muscle weakness, among others," says Dr. Sharlip.

Male Infertility: Diagnosis and Treatment

If you and your partner have been trying to conceive for a year (six months if the woman is over age 35) without success, you should consult a doctor. An examination, including an assessment of your medical history, and certain tests will check for problems with male fertility.

A common test for infertility in men is semen analysis, in which a sample of sperm is examined in a laboratory to determine the number and quality of the sperm. Many causes of male infertility can be treated. For instance, blockages in the male reproductive system can often be cleared with minor surgery, and there are procedures to correct varicoceles. In other cases, assisted reproductive techniques such as intrauterine insemination and in vitro fertilization (IVF) may be able to help you and your partner get pregnant.

Male Infertility: Can You Reduce Your Risk?

"There are no specific steps to prevent or optimize fertility," says Sharlip, adding that avoiding recreational drugs and anabolic steroids and maintaining good general health may reduce your risk of fertility problems. "What is good for general health is good for reproductive health."