10
issue: breast
The HEALTH | NOVEMBER, 2018
Men and
breast cancer?
Male breast cancer
and the BRCA
genetic mutation.
Although rare, men exposed to BRCA
gene mutation have a possibility of
getting breast cancer
W
HAT is the likeli-
hood of a men
getting breast
cancer?
UM Specialist
Centre Consultant
Oncoplastic Breast
Surgeon Dr See Mee Hoong clarified that
in men – the benign lesion that they have
is called gynaecomastia.
“They rarely have fibroid adenoma
diseases as their breast tissue is so thin.
To develop that, they might have some
external factors that cause their breast
to enlarge first before they get all this
disease which is quite rare.”
What if a male is plump? Are there
any chances of getting any benign breast
condition?
“In our point of view, we don’t really
see men having these lesions, until they
get gynaecomastia and they approach us.
Even when we do a scan, we don’t see
any specific lump at all. So far, it’s only
general enlargement of the breast.”
BRCA gene mutation in men
“I don’t see much fibroid adenoma – not
in men. It is very rare, but they do have
higher risk when they have a family
history of BRCA. In this case, with the
genetic mutation, they have a chance
HIS BREAST CANCER
AWARENESS
“Those who
are exposed to
hormones such as
estrogen or those
who have an extra
X in their gene
(Klinefelter), they
are also at a higher
risk of getting
breast cancer but
not too many.”
of getting breast cancer in male family
members. Those who are exposed to
hormones such as estrogen or those who
have an extra X in their gene (Klinefelter),
they are also at a higher risk of getting
breast cancer but not too many.”
According to See, the other group who
are more susceptible of getting breast
cancer are those with liver disease.
“Their liver is like hardened (cirrhotic
liver) which makes them exposed to more
hormone (estrogen) which puts them at
higher risk of getting cancer as well.”
Management
See explained that when the patient
is a male and gets breast cancer – the
H9J.COM.BR
T
Treatment
“Because their breast tissue is so limited,
a lumpectomy is unsuitable so it would
be generally a mastectomy as the lymph
nodes there is also the same as females.”
“80 per cent of them are usually
estrogen receptor positive patient – so
after surgery – they’ll have to undergo
an anti-estrogen treatment in addition
to other treatment. Let’s say their lymph
nodes are all involved, they might need
chemo like they need radiotherapy. The
management is all the same.”
Breast care tips
1
Exercise
Fat cells produce estrogen, and
high levels of that hormone have
been linked to certain cancers. Working
out can shrink the size of fat cells, so
your body pumps out less estrogen.
Encoding
the Breast
Imaging
Reporting
and Data
System
HERE are more than 50 types of
benign breast condition - the most
common type being fibroadenoma
in younger age group, fibrocystic disease
in older age group – but they’re all benign.
Other benign breast disease include
ductal papilloma and breast cyst.
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See Mee
Hoong explained that although regular
follow ups are done, not all diseases ends
up in a biopsy.
“Follow up would help more at times,
as some patient might have four lesions in
one breast which means we can’t biopsy
all.
“Usually, in an ultrasound, the
circumference shows well. However, if
the patient doesn’t have risk factors, we
would then observe more. Six monthly,
we would do an ultrasound to make sure
management is roughly the same as the
female counterpart.”
2
Indulge in dark chocolate
Researchers have discovered a
compound in dark chocolate helps
fight enzymes in fast-growing cancers.
3
Don’t lose it over a lump
Many times a new bump turns
out to be a cyst, or fluid-filled sac,
associated with hormonal fluctuations.
Though a new lump is probably not
cancer, get it checked out by your doctor,
just in case.
4
Understanding the mammography screening is essential
whether it grows, it changes or not, unless
they have a risk factor like their next of
kin; first or second degree relatives
have breast cancer. We would be rather
concerned if they get lesions when they
reach 30 or 40 years of age.”
“Actually we have a Breast Imaging
Reporting and Data System (BIRADS)
which is a scheme for putting the find-
ings from mammogram screening into a
small number of well-defined categories,”
she explained.
BIRADS 0 means inadequate and
needs another test to adjunct. If the
patient has only done a mammogram,
the doctor would need to adjunct with
an ultrasound.
While BIRADS 1 and 2 are the benign
types.
“In this case, normal follow ups like
screening – yearly or every two years
once. When you come to BIRADS 3, you’d
need to monitor closely just to make sure
whether they grow otherwise or not. So
six monthly, you’ll need to check again.
“BIRADS 4 and above, you’ll need to do
a biopsy to see if it’s cancerous. BIRADS
5 is very high and is probably malignant
while BIRADS 6 is for someone who is
already diagnosed with cancer. At this
stage, the patient has to come back for
mammogram.”
Fill up on fruit and veggies
Several recent studies have sug-
gested that eating a lot of fruit
and veggies may be associated with a
lowered risk for developing estrogen-
receptor-negative breast tumors.
5
Drink less alcohol
A meta-analysis of 53 studies
showed that women who drank
more than three drinks a day had 1.5
times the risk of developing breast
cancer as did nondrinkers.
6
Get a good night’s sleep
Staying up late can result in greater
exposure to light at night, which
suppresses melatonin levels.
7
Take your folic acid
Not eating enough folate is linked
with impaired ability to repair
DNA. This in turn, has been linked to
cancer. Folate is found in foods such as
spinach and black-eyed peas, as well as
in folic-fortified cereals and grains.