Detection & Diagnosis
Early detection of male breast cancer improves the chances of a successful treatment. As in women, the most common symptom in men is a lump that can be felt in the breast. In most cases, such lumps are painless. Other symptoms may also include nipple retraction (flattening), inversion (when the nipple grows inwards), or discharge (release of fluid from the nipple). Redness or scaling of the nipple or breast skin may also occur. Some of these symptoms can be occur because of noncancerous reasons but you should see your doctor if you notice any changes in your breast.
Gynecomastia, a noncancerous condition that causes enlarged breast glands, is the most common type of breast lump in men. Gynecomastia is particularly common in adolescent boys and in elderly men, and can also be caused by a number of medications. Although the symptoms of gynecomastia may be similar to those of male breast cancer, there is no evidence that gynecomastia increases a man’s risk for developing the disease.
Screening Methods and Services
Memorial Sloan Kettering offers early breast cancer detection programs, including mammography and breast physical examinations at the Guttman Diagnostic Center and the Breast Examination Center of Harlem for men at risk for the disease.
If either a physical examination or imaging tests show a concerning change in the breast, the next step is a biopsy. During a breast biopsy, a sample of tissue is taken from the breast and the cells or tissue are then examined under a microscope by a pathologist, who can determine whether or not they are cancerous.
There are different types of biopsy methods. These include:
- Fine Needle Aspiration (FNA)
During this procedure, the doctor inserts a very thin needle into the suspicious area of the breast. Cells or fluid are withdrawn (aspirated) from the lump and placed on a slide for examination under a microscope by a pathologist. This type of biopsy is relatively quick, and any discomfort lasts only a few seconds.
- Core Needle Biopsy
A core needle biopsy may be used if a tissue sample larger than can be obtained with a fine needle aspiration biopsy is needed, or if the tissue removed during a needle aspiration biopsy does not yield a definitive diagnosis. This type of biopsy requires a local anesthetic. The doctor inserts a larger, hollow needle into the breast. A thin cylinder of tissue about one inch long is removed and is sent to a pathologist for analysis.
- Image-Guided Biopsy
If the suspicious area cannot be felt, then a radiologist can use imaging techniques to biopsy the area. The choice of ultrasound, stereotactic mammographic imaging, or MRI depends on what the abnormality looks like and which technique is most appropriate for visualizing it.
- Surgical Biopsy
- A surgical biopsy may be done if other biopsy procedures do not provide a definitive diagnosis. A surgical biopsy is also performed if the suspicious area is too deep or too superficial for a core biopsy.
- If the surgeon cannot feel the area in question, then the radiologist will insert a thin wire into the breast using mammography, ultrasound, or MRI to localize the area for the surgeon. This process is called a needle localization.
- A surgical biopsy takes place in an operating room, but it does not usually require an overnight stay in the hospital. During a surgical biopsy, the patient undergoes “twilight” sedation, but does not require general anesthesia. Under sterile conditions, a small incision is made on the breast; the suspicious breast tissue is removed entirely, or a representative sample is removed for analysis.