Male breast cancer

reproductive system disorders, surgery,

1. MALE BREAST CANCER BY: MANISHA SHARMA NURSING TUTOR

2. DEFINITION Male breast cancer  ( male breast neoplasm ) is a rare cancer in males that originates from the breast. Many males with breast cancer have inherited a  BRCA   mutation (BRCA gene 1 & 2 present on chromosome 17 and 13 respectively), but there are other causes, including alcohol use disorder and exposure to certain hormones and ionizing radiation.

3. ETIOILOGY There are no known cause of male breast carcinoma but there may be some factors that increase the risk of male breast cancer include: Older age.  The risk of breast cancer increases as you age. Male breast cancer is most often diagnosed in men in their 60s. Exposure to estrogen.  If a person take estrogen-related drugs, such as those used for hormone therapy for prostate cancer, the risk of breast cancer is increased. Family history of breast cancer.  If a person have a close family member with breast cancer, there is a greater chance of developing the disease.

4. Continue Klinefelter's syndrome.  This genetic syndrome occurs when boys are 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).

5. Continue Liver disease: Certain conditions, such as cirrhosis of the liver, can reduce male hormones and increase female hormones, increasing the risk of breast cancer. Obesity.  Obesity is associated with higher levels of estrogen in the body, which increases the risk of male breast cancer. Testicle disease or surgery.  Having inflamed testicles ( orchitis ) or surgery to remove a testicle ( orchiectomy ) can increase the risk of male breast cancer.

6. STAGING Stage I Stage I is an invasive breast cancer with the tumor not exceeding 2 cm and absence of lymph node involvement. Stage II Stage II includes stages IIA and IIB.

7. Continue Stage IIA One of the following three items applies: T0 or T1, N1 , M0: The tumor is 2 cm or less across (or is not found) (T1 or T0) and either: It has spread to 1 to 3 axillary lymph nodes (N1a), but not to distant sites (M0),  or Tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy (N1b), but not in distant sites (M0 ) It has spread to 1 to 3 axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy (N1c), but not to distant sites (M0),  or T2, N0, M0: The tumor is larger than 2 cm across and less than 5 cm (T2), but it hasn't spread to the lymph nodes (N0) or to distant sites (M0).

8. Continue Stage IIB Either of the following applies: T2, N1, M0: The tumor is larger than 2 cm and less than 5 cm across (T2). It has spread to 1 to 3 axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy (N1). It has not spread to distant sites (M0 ) T3, N0, M0: The tumor is larger than 5 cm across but does not grow into the chest wall or skin (T3). It has not spread to lymph nodes (N0) or to distant sites (M0).

9. Continue Stage III Stage III is divided into three subcategories: In IIIA there is breast cancer with axillary lymph nodes clumped together or attached to other structures. In IIIB the tumor has spread to the chestwall or skin, and may have involved lymph nodes of the axilla and/or breastbone. In IIIC the tumor has spread to the chest wall or skin and lymph nodes below or above the collar bone are affected.

10. Continue Stage IV Stage IV is applied to metastatic breast cancer; typically lungs, liver, bone, or brain are involved .

11. CLINICAL MANIFESTATIONS Signs and symptoms of male breast cancer can include: A painless lump or thickening in the breast tissue Changes to the skin covering the breast, such as dimpling, puckering, redness or scaling Changes to the nipple, such as redness or scaling, or a nipple that begins to turn inward Discharge from the nipple

12. DIAGNOSTIC EVALUATIONS HISTORY TAKING: Previous medical and surgical history. Lifestyle history ( Diet, Exercise, Smoking, Alcohol or drug abuse ) PHYSICAL EXAMINATION Breast examination.   The doctor will check both of the breasts and lymph nodes in the armpit , feeling for any lumps or other abnormalities . Testicular and penile examination

13. Continue Mammogram .  A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, the doctor may recommend a diagnostic mammogram to further evaluate that abnormality.

14. Continue Breast ultrasound.  Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.

15. Continue Removing a sample of breast cells for testing (biopsy).  A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, the doctor uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area.

16. Continue Breast magnetic resonance imaging (MRI).  An MRI machine uses a magnet and radio waves to create pictures of the interior of the breast. Before a breast MRI, patient receive an injection of dye. Unlike other types of imaging tests, an MRI doesn't use radiation to create the images.

17. Continue Other tests may include: Blood tests, such as a complete blood count Bone scan Computerized tomography (CT) scan Positron emission tomography (PET) scan

18. TREATMENT Chemotherapy: Some drugs used in chemotherapy are: Abemaciclib . Abraxane ( Paclitaxel Albumin-stabilized Nanoparticle Formulation) Ado- Trastuzumab Emtansine . Afinitor ( Everolimus ) Alpelisib . Anastrozole . Aredia ( Pamidronate Disodium) Arimidex ( Anastrozole )

19. Continue Radiation therapy: Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. Radiation therapy is typically done using a large machine that aims the energy beams at the body (external beam radiation). But radiation can also be done by placing radioactive material (beads) inside the body ( brachytherapy ).

20. Continue Surgery: Most men with breast cancer have some type of surgery as part of their treatment. There are different types of breast surgery, and it may be done for different reasons, depending on the situation. 

21. Continue Surgery may be done to : Remove as much of the cancer as possible (breast-conserving surgery or mastectomy) Find out whether the cancer has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection) Relieve symptoms of advanced cancer

22. Continue Types of surgeries Mastectomy   : A surgery in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues. Most men with breast cancer will undergo a mastectomy since men have a small amount of breast tissue.

23. Continue There are several different types of mastectomies : In a  simple  or  total mastectomy , the surgeon removes the entire breast, including the nipple, but does not remove underarm lymph nodes or muscle tissue from beneath the breast. In a  modified radical mastectomy , the surgeon extends the incision to remove the entire breast and lymph nodes under the arm as well.

24. Continue Breast-conserving surgery (BCS)  (also called a  lumpectomy ,  quadrantectomy ,  partial mastectomy, or segmental mastectomy )  –  A surgery in which only the part of the breast containing the cancer is removed. The goal is to remove the cancer as well as some surrounding normal tissue. How much of the breast is removed depends on the size and location of the tumor and other factors.

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