Priscilla F. McAuliffe

Dr. Priscilla McAuliffe, a breast surgical oncologist at UPMC, said one out of 100 cases of breast cancer will occur in a male.

McAuliffe, who practices at UPMC Magee-Womens Hospital and UPMC Passavant, said breast cancer can be divided into different categories.

Breast cancer that starts in the milk ducts of the breast gland make up 85% of breast cancer cases, and lobular breast cancer, which starts in the milk-producing parts of the breast glands, account for 15% of breast cancer cases. Both can spread into surrounding tissue, to lymph nodes and to other organs, such as the liver, lungs, brains and bones.

McAuliffe said men are very unlikely to be diagnosed with lobular breast cancer because they lack the milk-producing portion of the breast glands.

She said because yearly screening mammograms are not recommended for males as they are for females, “Most men will notice a nodule under or close to their nipple or notice a nipple discharge.”

This or any change to a person’s body or functions is cause for a call to the doctor.

“Any new finding in a person’s body should be checked out by one’s primary health care provider,” McAuliffe said.

Men with a strong family history of breast cancer should be on alert for new breast lumps or changes, especially as they age.

“There is more of a risk as you get older. It is known that age is a risk factor for the development of breast cancer in both males and females, but even more so in males,” she said. “Obesity is also a risk factor.”

To diagnose whether or not someone has breast cancer, patients undergo imaging and a needle biopsy of the suspicious lump.

Treatment for breast cancer will vary depending on the stage of the cancer.

“Treatment usually starts with surgery. This may include a lumpectomy, which will remove the tumor and a small area of the surrounding tissue around it. Sometimes the nipple/areola complex will be removed,” she said. “A mastectomy, which is the removal of the entire breast gland, is another option.”

Depending on the size and stage of the tumor, McAuliffe said it may be necessary to also check if the lymphs in the underarm regions have been affected by the cancer.

“An operation can be followed by radiation treatment sometimes, as well as endocrine therapy, most commonly with a pill called tamoxifen,” said McAuliffe. Tamoxifen binds the estrogen receptor, causing antiestrogen effects.

The side effects of tamoxifen in both men and women can include hot flashes, night sweats and hormone fluctuations in the patient’s body, she said.

McAuliffe said both a lumpectomy and a mastectomy can be an outpatient procedure. The long-term outcome can be excellent if the patient follows doctors’ orders.

“We hope that they follow the treatment. We have to meet the patient where they are, but most people will follow medical recommendations,” she said.

Untreated breast cancer can be fatal, as the cancer spreads to other organs which will not be able to work properly.

“Cancer can also get out and spread to the skin, causing bleeding and ulcerations. Muscles can be affected which can cause pain,” McAuliffe said.

But, McAuliffe added, “We’re getting better and better at detecting and diagnosing and have more effective treatments at every stage leading to better outcomes.”