Also see Cancer programs.Encyclopedia Entry for Breast Cancer :Breast cancer in men. The cause of breast cancer in men is not clear. But there are risk factors that make breast cancer more likely in men: Exposure to radiation Higher estrogen levels due to factors such as heavy drinking, cirrhosis , obesity, and some medicines to treat prostate cancer Heredity, such as a family history of breast cancer, mutated BRCA1 or BRCA2 gene , and certain genetic disorders, such as Klinefelter syndrome Excess breast tissue ( gynecomastia ) Age. Most men are diagnosed with breast cancer between ages 60 to 70.Symptoms of breast cancer in men include: Lump or swelling in the breast tissue. One breast may be larger than the other. A small lump beneath the nipple. Unusual changes in the nipple or skin around the nipple such as redness, scaling, or puckering. Nipple discharge.You health care provider will take your medical history and family medical history. You will have a physical exam and a breast exam. Your provider may order other tests, including: A mammogram Breast ultrasound An MRI of the breast A blood test to check for signs of cancer If any of the tests suggest cancer, your provider will do a biopsy to check for cancer. If cancer is found, your provider will order other tests to find out: How quickly the cancer might grow How likely it is to spread What treatments might be best What are the chances that the cancer might come back The tests may include: Chest x-ray, specifically to see if it has spread to the lungs Bone scan CT scan PET scan Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes The biopsy and other tests will be used to grade and stage the tumor. The results of those tests will help determine your treatment.Treatment options for breast cancer in men include: Surgery to remove the breast, lymph nodes under the arm, the lining over chest muscles, and chest muscles, if needed Radiation therapy after surgery to kill any remaining cancer cells and to target specific tumors Chemotherapy to kill cancer cells that have spread to other parts of the body Hormone therapy to block hormones that may help certain types of breast cancer grow During and after treatment, your provider may ask you to have more tests. This may include tests you had during diagnosis. The follow-up tests will show how the treatment is working. They will also show if the cancer comes back.Cancer affects how you feel about yourself and your life. You can ease the stress of illness by joining a cancer support group. Sharing with others who have had the same experiences and problems can help you feel less alone. The group can also point you to helpful resources for managing your condition. Ask your provider to help you find a support group of men who have been diagnosed with breast cancer.The long-term outlook for men with breast cancer is excellent when the cancer is found and treated early. About 91% of men treated before cancer has spread to other areas of the body are cancer-free after 5 years. Almost 3 out of 4 men treated for cancer that has spread to lymph nodes but not to other areas of the body are cancer-free at 5 years. Men who have cancer that has spread to distant parts of the body have a smaller chance of long-term survival.Complications include side effects from surgery, radiation, and chemotherapy.Contact your provider right away if you notice something unusual about your breast, including any lumps, skin changes, or discharge.There is no clear way to prevent breast cancer in men. The best way to protect yourself is to: Know that men can develop breast cancer Know your risk factors and talk with your provider about screening and early detection with tests if needed Know the possible signs of breast cancer Tell your provider if you notice any changes in your breast.Infiltrating ductal carcinoma - male; Ductal carcinoma in situ - male; Intraductal carcinoma - male; Inflammatory breast cancer - male; Paget disease of the nipple - male; Breast cancer - male.Brinton LA, Cook MB, McCormack V, et al. Anthropometric and hormonal risk factors for male breast cancer: male breast cancer pooling project results. J Natl Cancer Inst. 2014;106(3):djt465. PMID: 24552677 www.ncbi.nlm.nih.gov/pubmed/24552677. Hunt KK, Mittendorf EA. Diseases of the breast.Encyclopedia Entry for Breast Cancer :Breast cancer screening. A mammogram is the most common type of screening. It is an x-ray of the breast using a special machine. This test is done in a hospital or clinic and only takes a few minutes. Mammograms can find tumors that are too small to feel. Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is generally recommended for: Women starting at age 40, repeated every 1 to 2 years. (This is not recommended by all expert organizations.) All women starting at age 50, repeated every 1 to 2 years. Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed. Mammograms work best at finding breast cancer in women ages 50 to 74. For women younger than age 50, the screening can be helpful, but may miss some cancers. This may be because younger women have denser breast tissue, which makes it harder to spot cancer. It is not clear how well mammograms work at finding cancer in women age 75 and older.This is an exam to feel the breasts and underarms for lumps or unusual changes. Your health care provider may perform a clinical breast exam (CBE). You can also check your breasts on your own. This is called a breast self-exam (BSE). Doing self-exams may help you become more familiar with your breasts. This may make it easier to notice unusual breast changes. Keep in mind that breast exams do not reduce the risk of dying from breast cancer. They also do not work as well as mammograms to find cancer. For this reason, you should not rely only on breast exams to screen for cancer. Not all experts agree about when to have or start having breast exams. In fact, some groups do not recommend them at all. However, this does not mean you should not do or have breast exams. Some women prefer to have exams. Talk with your provider about the benefits and risks for breast exams and if they are right for you.An MRI uses powerful magnets and radio waves to find signs of cancer. This screening is done only in women who have a high risk for breast cancer. Women at high risk for breast cancer (greater than 20% to 25% lifetime risk) should have an MRI along with a mammogram every year. You may have a high risk if you have: A family history of breast cancer, most often when your mother or sister had breast cancer at an early age Lifetime risk for breast cancer is 20% to 25% or higher Certain BRCA mutations, whether you carry this marker or a first degree relative does and you have not been tested First degree relatives with certain genetic syndromes (Li-Fraumeni syndrome, Cowden and Bannayan-Riley-Ruvalcaba syndromes) It is not clear how well MRIs work to find breast cancer. Although MRIs find more breast cancers than mammograms, they are also more likely to show signs of cancer when there is no cancer. This is called a false-positive result. For women who have had cancer in one breast, MRIs can be very helpful for finding hidden tumors in the other breast. You should do a MRI screening if you: Are at very high risk for breast cancer (those with a strong family history or genetic markers for breast cancer) Have very dense breast tissue.When and how often to have a breast screening test is a choice you must make. Different expert groups do not fully agree on the best timing for screening. Before having a mammogram, talk to your provider about the pros and cons. Ask about: Your risk for breast cancer. Whether screening decreases your chance of dying from breast cancer. Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it's discovered. Risks of screenings can include: False-positive results. This occurs when a test shows cancer when there is none. This can lead to having more tests that also have risks. It can also cause anxiety. You may be more likely to have a false-positive result if you are younger, have a family history of breast cancer, have had breast biopsies in the past, or take hormones. False-negative results. These are tests that come back normal even though there is cancer. Women who have false-negative results do not know they have breast cancer and delay treatment. Exposure to radiation is a risk factor for breast cancer. Mammograms expose your breasts to radiation. Overtreatment. Mammograms and MRIs may find slow-growing cancers. These are cancers that may not shorten your life. At this time, it is not possible to know which cancers will grow and spread, so when cancer is found it is usually treated. Treatment can cause serious side effects.Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening.American Cancer Society website. Breast cancer early detection and diagnosis. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection.html. Updated September 17, 2017. Accessed August 22, 2018. American College of Obstetricians and Gynecologists (ACOG) website. ACOG statement on breast cancer screening guidelines. www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Breast-Cancer-Screening-Guidelines. Updated January 11, 2016. Accessed August 22, 2018. National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated June 1, 2018. Accessed August 22, 2018. Siu AL; U.S. Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 www.ncbi.nlm.nih.gov/pubmed/26757170. Wolff AC, Domchek SM, Davidson NE, Sacchini V, McCormick B. Cancer of the breast.Encyclopedia Entry for Breast Cancer :Breast cancer staging. There are two types of staging for breast cancer. Clinical staging is based on tests done before surgery. These may include: Physical exam Mammogram Breast MRI Breast Ultrasound Breast Biopsy, either ultrasound or stereotactic Chest x-ray CT scan Bone scan PET Scan Pathological staging uses the results from lab tests done on breast tissue and lymph nodes removed during surgery. This type of staging will help determine additional treatment and help predict what to expect after treatment ends.Stages of breast cancer are defined by a system called TNM: T stands for tumor. It describes the size and location of the main tumor. N stands for lymph nodes. It describes whether cancer has spread to the nodes. It also tells how many nodes have cancer cells. M stands for metastasis. It tells whether the cancer has spread to parts of the body away from the breast.Doctors use 7 main stages to describe breast cancer. Stage 0, also called carcinoma in situ. This is cancer that is confined to the lobules or ducts in the breast. It has not spread to surrounding tissue. Lobules are parts of the breast that produce milk. Ducts carry the milk to the nipple. Stage 0 cancer is called noninvasive. This means it has not spread. Some stage 0 cancers become invasive later. But doctors cannot tell which ones will and which will not. Stage I. The tumor is small (or may be too small to see) and invasive. It may or may not have spread to the lymph nodes close to the breast. Stage II. There may be no tumor found in the breast, but cancer can be found that has spread to axillary lymph nodes or nodes close to the breastbone. Axillary nodes are nodes found in a chain from under the arm to above the collarbone. There might also be a tumor between 2 and 5 centimeters in the breast with small cancers in some of the lymph nodes. Or, the tumor could be larger than 5 centimeters with no cancer in the nodes. Stage IIIA. Cancer has spread to 4 to 9 axillary nodes or to nodes near the breastbone but not to other parts of the body. Or, there could be a tumor larger than 5 centimeters and cancer that has spread to 3 axillary nodes or to nodes near the breastbone. Stage IIIB. The tumor has spread to the chest wall or to the skin of the breast causing an ulcer or swelling. It may also have spread to axillary nodes but not to other parts of the body. Stage IIIC. Cancer of any size has spread to at least 10 axillary nodes. It may also have spread to the skin of the breast or breast wall, but not to distant parts of the body. Stage IV. The cancer is metastatic, which means it has spread to other organs such as the bones, lungs, brain, or liver.The type of cancer you have, along with the stage, will help determine your treatment. With stage I, II, or III breast cancer, the main goal is to cure the cancer by treating it and keeping it from coming back. With stage IV, the goal is to improve symptoms and prolong life. In almost all cases, stage IV breast cancer cannot be cured.Cancer can come back after treatment ends. If it does, it can occur in the breast, in distant parts of the body, or in both places. If it does return, it may need to be restaged.National Cancer Institute website. Breast cancer treatment (PDQ) - patient version. www.cancer.gov/types/breast/patient/breast-treatment-pdq. Updated November 2, 2017. Accessed December 19, 2017. Neumayer L, Viscusi RK. Assessment and designation of breast cancer stage.Encyclopedia Entry for Breast Cancer :Breast cancer. Breast cancer risk factors are things that increase the chance that you could develop breast cancer: Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control. The more risk factors you have, the more your risk increases. But, it does not mean you will develop cancer. Many women who develop breast cancer do not have any known risk factors or a family history. Understanding your risk factors can help you know how to prevent breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct link between breast cancer and pesticides.Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don't have symptoms may be found earlier. As the cancer grows, symptoms may include: Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt. Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange. Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus. In men, breast cancer symptoms include breast lump and breast pain and tenderness. Symptoms of advanced breast cancer may include: Bone pain Breast pain or discomfort Skin ulcers Swelling of the lymph nodes in the armpit (next to the breast with cancer) Weight loss.The health care provider will ask about your symptoms and risk factors. Then the provider will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area. Women are encouraged to perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is debatable. Needle biopsy of the breast Tests used to diagnose and monitor people with breast cancer may include: Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram Breast ultrasound to show whether the lump is solid or fluid-filled Breast biopsy , using methods such as needle aspiration, ultrasound-guided, stereotactic , or open CT scan to check if the cancer has spread outside the breast Mammography to screen for breast cancer or help identify the breast lump PET scan to check if the cancer has spread Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if the cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future. Open biopsy of the breast Breast cancer stages range from 0 to IV. The higher the stage, the more advanced the cancer. Sentinel node biopsy.Treatment is based on many factors, including: Type of breast cancer Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) Whether the cancer is sensitive to certain hormones Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: Hormone therapy. Chemotherapy , which uses medicines to kill cancer cells. Radiation therapy , which is used to destroy cancerous tissue. Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Lumpectomy Cancer treatment can be local or systemic: Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.New, improved treatments are helping people with breast cancer live longer. Even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns, even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free. Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor. How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors that determine the risk for recurrence and the likelihood of successful treatment include: Location of the tumor and how far it has spread Whether the tumor is hormone receptor-positive or -negative Tumor markers Gene expression Tumor size and shape Rate of cell division or how quickly the tumor is growing After considering all of the above, your provider can discuss your risk of having a recurrence of breast cancer.You may experience side effects or complications from cancer treatment. These may include temporary pain or swelling of the breast and surrounding area. Ask your provider about the possible side effects from treatment.Contact your provider if: You have a breast or armpit lump You have nipple discharge After being treated for breast cancer, call your provider if you develop symptoms such as: Nipple discharge Rash on the breast New lumps in the breast Swelling in the area Pain, especially chest pain, abdominal pain, or bone pain.Talk to your provider about how often you should have a mammogram or other tests to screen for breast cancer. Early breast cancers found by a mammogram have a good chance of being cured. Tamoxifen is approved for breast cancer prevention in women age 35 and older who are at high risk. Discuss this with your provider. Women at very high risk for breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is diagnosed. Possible candidates include: Women who have already had one breast removed due to cancer Women with a strong family history of breast cancer Women with genes or genetic mutations that raise their risk for breast cancer (such as BRCA1 or BRCA2 ) Many risk factors, such as your genes and family history, cannot be controlled. But making healthy lifestyle changes may reduce your overall chance of getting cancer. This includes: Eating healthy foods Maintaining a healthy weight Limiting alcohol consumption to 1 drink per day.Cancer - breast; Carcinoma - ductal; Carcinoma - lobular; DCIS; LCIS; HER2-positive breast cancer; ER-positive breast cancer; Ductal carcinoma in situ; Lobular carcinoma in situ.Breast radiation - discharge Chemotherapy - what to ask your doctor Lymphedema - self-care Mastectomy and breast reconstruction - what to ask your doctor Mastectomy - discharge Radiation therapy - questions to ask your doctor.Female Breast Female breast Needle biopsy of the breast Needle biopsy of the breast Open biopsy of the breast Open biopsy of the breast Breast self-exam Breast self-exam Breast self-exam Breast self-exam Breast self-exam Breast self-exam Lumpectomy Lumpectomy Breast lump removal - Series Breast lump removal - series Mastectomy - Series Mastectomy - series Sentinel node biopsy Sentinel node biopsy.Makhoul I. Therapeutic strategies for breast cancer.Encyclopedia Entry for Breast Cancer :Breast Cancer. Can be caused by Mouse mammary tumor virus (MMTV), Epstein-Barr virus, Human Papilloma virus (HPV), Bovine leukemia virus (BLV).Information from Marcello Allegretti.