Nisha Pandey

Health and Me

Breast Cancer Awareness Day: Experts Explain Most Overlooked Breast Changes That Can Delay Diagnosis In Men

<span><a href="https://www.healthandme.com/health/breast-cancer">Breast cancer</a> in men</span> is far less common than in women. So there are a lot of factors that drive delay in <span><a href="https://www.healthandme.com/health/breast-cancer">breast cancer</a></span> diagnosis in men. A breast lump in a man is dismissed as a fatty deposit, a hormonal change or something that happens only to women. However, men have breast tissue too, so overlooking warning signs can delay diagnosis.

On <span>Breast Cancer Awareness Day</span>, four experts spoke to <strong><em>HealthandMe </em></strong>about the breast changes men should watch for, why the disease is detected late, how to identify suspicious lumps from benign breast enlargement, and which men face a higher risk.

Besides misinformation and misconception, <strong>Dr Deepak Jha, Chief, Surgical Oncology and Breast Surgery, Artemis Hospital, Gurugram</strong>, pointed towards an important societal factor that can delay breast cancer diagnosis in men.

Dr. Jha said, “Embarrassment and fear of judgment can also put men off seeking medical advice.”

<h2>Breast Cancer Awareness Day: Breast Changes Should Men Never Ignore</h2>

A lump is not the only warning sign of breast cancer in men. Changes in the nipple, surrounding skin and underarm area may also warrant medical evaluation.

<strong>Dr Ankur Bahl, Principal Director, Medical Oncology, Fortis Cancer Institute, Defence Colony</strong>, explains that <a href="https://www.healthandme.com/health-wellness/breast-cancer-know-the-risks-recognise-the-signs-get-checked-article-156322666" data-type="tilCustomLink">breast cancer</a> can sometimes present with changes in the nipple or surrounding skin without an obvious lump.

“Men should watch for changes such as nipple inversion, unusual discharge, particularly blood-stained discharge, persistent redness, skin dimpling, ulceration or changes in the shape of the breast. Swelling in the underarm area may also warrant evaluation,” he told us.

Dr Jha, highlights thickening in the breast, even when there is no distinct lump, which is an overlooked sign of breast cancer.

“Cancer can sometimes start with subtle signs that are often disregarded. Even though pain is not a typical early sign of breast cancer, persistent pain should not be ignored,” he said.

<strong>Dr Kanav Kumar, Consultant Surgical Oncology, Head and Neck Cancer Institute of India</strong>, also urges men to pay attention to changes around the nipple and breast skin.

“Men should look out for changes in the nipple or the skin around the breast, even if they cannot feel a lump. Warning signs include the nipple turning inward, unusual or blood-stained nipple discharge, redness, scaling, skin dimpling or sores that do not heal. Swelling in the armpit or near the collarbone should also be checked,” he said.

<strong>Dr Ritu Dave, Medical Oncologist and Hemato-Oncologist, M|O|C Cancer Care, Pune</strong>, too, identifies nipple inversion, bloody discharge, redness or scaling, skin dimpling, thickening, ulceration and changes in breast shape as signs requiring medical evaluation.

She said that these changes do not necessarily indicate cancer, but persistent or unexplained symptoms should not be ignored. Men should seek medical advice rather than wait for a lump to appear or for existing symptoms to worsen.

Also read: <a href="https://www.healthandme.com/health-wellness/breast-cancer-at-26-sent-this-us-woman-into-menopause-before-30-what-is-the-hidden-toll-of-treatment-article-156362659" data-type="tilCustomLink">Breast Cancer At 26 Sent This US Woman Into Menopause Before 30: What Is The Hidden Toll Of Treatment</a>

<h2>Why Is Breast Cancer Diagnosed Late In Men?</h2>

Low awareness and embarrassment contribute to delays in diagnosing male breast cancer. Many men do not consider the disease a possibility and may dismiss early symptoms as harmless.

Dr Bahl explains that men may delay seeking medical advice because of the assumption that breast cancer affects only women. He adds that symptoms may be neglected until a lump enlarges. Dr Jha points to a similar problem, stating that men may mistake a <a href="https://www.healthandme.com/health-wellness/amanda-peets-breast-cancer-wasnt-a-lump-what-was-her-first-sign-article-156260232" data-type="tilCustomLink">breast lump</a> for a fat deposit, a hormonal change or a benign swelling.

Dr Kumar explains how these misconceptions can affect early detection. “Breast cancer is often seen as a woman's disease, so men may not recognise its symptoms or consider it a possibility. Some may dismiss a lump as harmless or delay seeing a doctor because of embarrassment or a lack of awareness,” he said.

Another important factor is the absence of routine screening for the general male population. As Dr Dave explains, “There is also no routine mammography screening for the general male population.”

This means that male breast cancer is often investigated only after symptoms become noticeable. Dr Dave also highlights an anatomical consideration: “Because men have less breast tissue, a tumour can reach the skin or nipple relatively early.”

Also read: <a href="https://www.healthandme.com/health-wellness/why-peak-incidence-for-breast-cancer-in-india-occurs-between-ages-4050-compared-to-6070-in-the-us-europe-article-156359994" data-type="tilCustomLink">Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US &amp; Europe</a>

<h2>Breast Cancer Or <span rel="noindex">Gynecomastia</span>?</h2>

Not every breast lump in a man is cancerous. <a href="https://www.healthandme.com/health-wellness/mammogram-may-spot-hidden-heart-risk-that-doctors-miss-in-women-article-156252702" data-type="tilCustomLink">Gynecomastia</a>, a non-cancerous enlargement of male breast gland tissue, is a common alternative explanation. It may be caused due to hormonal changes or certain medications.However, men should not rely on how a lump feels to determine whether it is harmless.

Dr Bahl explains the typical differences between the two conditions. “Gynecomastia, or enlargement of breast tissue in men, commonly causes a rubbery or firm, often disc-shaped area directly beneath the nipple. It may affect one or both breasts and can be tender. A suspicious lump may feel hard.” he said.

Dr Jha also said that a cancerous lump is more likely to be hard, painless, irregular and present on one side, sometimes away from the nipple. Nipple inversion, bloody discharge, skin dimpling and underarm swelling are additional warning signs he flagged.

<h2>Which Men Are At Higher Risk Of Breast Cancer?</h2>

Although male breast cancer is uncommon, certain genetic and lifestyle factors can increase the risk. Dr Bahl said increasing age, strong family history of breast or ovarian cancer, inherited BRCA1 or BRCA2 gene mutations, Klinefelter syndrome, previous chest radiation, <a href="https://www.healthandme.com/health-wellness/h-pylori-and-cancer-us-gastroenterologist-explains-how-a-common-stomach-infection-raises-risk-article-156350608" data-type="tilCustomLink">liver disease</a>, obesity and conditions associated with prolonged oestrogen exposure as relevant risk factors.

Dr. Kumar said, “The risk increases with age, particularly after 50.”

Other factors include previous radiation treatment to the chest and certain liver or testicular conditions. Dr Jha also identifies obesity and certain testicular disorders among the factors that require attention.

Dr Dave highlights the importance of identifying men with inherited mutations or a family history, who may need more monitoring.

She said, “Men with significant family history or inherited mutations should discuss genetic counselling and an individualised monitoring plan with their doctor. Routine mammography is not recommended for all men.”

Men with these risk factors should discuss these factors with their specialists. Depending on their medical and family history, genetic counselling, testing or personalised testing may be suitable.

Also read: <a href="https://www.healthandme.com/health-wellness/us-womans-pancreatic-cancer-spotted-on-routine-heart-scan-how-it-saved-her-life-article-156325224" data-type="tilCustomLink">US Woman’s Pancreatic Cancer Spotted On Routine Heart Scan: How It Saved Her Life</a>

<h2>Tests Needed To Rule Out Breast Cancer In Men</h2>

Breast Cancer Symptoms, Screening & Treatment | Breast Cancer Awareness Month

When a man presents with specific breast changes, doctors begin with a clinical examination and an assessment of his medical and family history.

Dr Bahl explains that the initial evaluation includes examining the breasts and lymph nodes, followed by diagnostic imaging and a biopsy.

He said, “Depending on the findings and the patient's age, diagnostic imaging may include mammography and targeted ultrasound. If the examination or imaging raises suspicion, a core needle biopsy is generally performed to obtain tissue for pathological confirmation.”

Dr Jha explains why imaging alone may not be sufficient. “Imaging can show that a change is suspicious, but it cannot always prove cancer. Doctors usually diagnose it with a core needle biopsy, which removes a small piece of tissue,” he said.

The biopsy sample is examined to establish whether cancer is present. If the diagnosis is confirmed, further testing helps determine the type of cancer and treatment.

Dr Dave explains the role of additional tumour testing. “In case when cancer is diagnosed, further analysis of hormonal receptors and HER2 will be necessary,” she said.

Hormone receptor and HER2 results help doctors understand the tumour's features and design treatment. Depending on the clinical stage and findings, further investigations may be needed.

Dr Kumar stresses the importance of timely assessment, saying that the first step is a clinical examination, followed by mammography or ultrasound where indicated and a biopsy if the findings are suspicious.

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Breast cancer in men is far less common than in women. So there are a lot of factors that drive delay in breast cancer diagnosis in men. A breast lump in a man is dismissed as a fatty deposit, a hormonal change or something that happens only to women. However, men have breast tissue too, so overlooking warning signs can delay diagnosis.On Breast Cancer Awareness Day, four experts spoke to HealthandMe about the breast changes men should watch for, why the disease is detected late, how to identify suspicious lumps from benign breast enlargement, and which men face a higher risk.Besides misinformation and misconception, Dr Deepak Jha, Chief, Surgical Oncology and Breast Surgery, Artemis Hospital, Gurugram, pointed towards an important societal factor that can delay breast cancer diagnosis in men. Dr. Jha said, “Embarrassment and fear of judgment can also put men off seeking medical advice.”Breast Cancer Awareness Day: Breast Changes Should Men Never IgnoreA lump is not the only warning sign of breast cancer in men. Changes in the nipple, surrounding skin and underarm area may also warrant medical evaluation.Dr Ankur Bahl, Principal Director, Medical Oncology, Fortis Cancer Institute, Defence Colony, explains that breast cancer can sometimes present with changes in the nipple or surrounding skin without an obvious lump.“Men should watch for changes such as nipple inversion, unusual discharge, particularly blood-stained discharge, persistent redness, skin dimpling, ulceration or changes in the shape of the breast. Swelling in the underarm area may also warrant evaluation,” he told us.Dr Jha, highlights thickening in the breast, even when there is no distinct lump, which is an overlooked sign of breast cancer.“Cancer can sometimes start with subtle signs that are often disregarded. Even though pain is not a typical early sign of breast cancer, persistent pain should not be ignored,” he said.Dr Kanav Kumar, Consultant Surgical Oncology, Head and Neck Cancer Institute of India, also urges men to pay attention to changes around the nipple and breast skin.“Men should look out for changes in the nipple or the skin around the breast, even if they cannot feel a lump. Warning signs include the nipple turning inward, unusual or blood-stained nipple discharge, redness, scaling, skin dimpling or sores that do not heal. Swelling in the armpit or near the collarbone should also be checked,” he said.Dr Ritu Dave, Medical Oncologist and Hemato-Oncologist, M|O|C Cancer Care, Pune, too, identifies nipple inversion, bloody discharge, redness or scaling, skin dimpling, thickening, ulceration and changes in breast shape as signs requiring medical evaluation.She said that these changes do not necessarily indicate cancer, but persistent or unexplained symptoms should not be ignored. Men should seek medical advice rather than wait for a lump to appear or for existing symptoms to worsen.Also read: Breast Cancer At 26 Sent This US Woman Into Menopause Before 30: What Is The Hidden Toll Of TreatmentWhy Is Breast Cancer Diagnosed Late In Men?Low awareness and embarrassment contribute to delays in diagnosing male breast cancer. Many men do not consider the disease a possibility and may dismiss early symptoms as harmless.Dr Bahl explains that men may delay seeking medical advice because of the assumption that breast cancer affects only women. He adds that symptoms may be neglected until a lump enlarges. Dr Jha points to a similar problem, stating that men may mistake a breast lump for a fat deposit, a hormonal change or a benign swelling.Dr Kumar explains how these misconceptions can affect early detection. “Breast cancer is often seen as a woman's disease, so men may not recognise its symptoms or consider it a possibility. Some may dismiss a lump as harmless or delay seeing a doctor because of embarrassment or a lack of awareness,” he said.Another important factor is the absence of routine screening for the general male population. As Dr Dave explains, “There is also no routine mammography screening for the general male population.”This means that male breast cancer is often investigated only after symptoms become noticeable. Dr Dave also highlights an anatomical consideration: “Because men have less breast tissue, a tumour can reach the skin or nipple relatively early.”Also read: Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US & EuropeBreast Cancer Or Gynecomastia?Not every breast lump in a man is cancerous. Gynecomastia, a non-cancerous enlargement of male breast gland tissue, is a common alternative explanation. It may be caused due to hormonal changes or certain medications.However, men should not rely on how a lump feels to determine whether it is harmless.Dr Bahl explains the typical differences between the two conditions. “Gynecomastia, or enlargement of breast tissue in men, commonly causes a rubbery or firm, often disc-shaped area directly beneath the nipple. It may affect one or both breasts and can be tender. A suspicious lump may feel hard.” he said.Dr Jha also said that a cancerous lump is more likely to be hard, painless, irregular and present on one side, sometimes away from the nipple. Nipple inversion, bloody discharge, skin dimpling and underarm swelling are additional warning signs he flagged.Which Men Are At Higher Risk Of Breast Cancer?Although male breast cancer is uncommon, certain genetic and lifestyle factors can increase the risk. Dr Bahl said increasing age, strong family history of breast or ovarian cancer, inherited BRCA1 or BRCA2 gene mutations, Klinefelter syndrome, previous chest radiation, liver disease, obesity and conditions associated with prolonged oestrogen exposure as relevant risk factors.Dr. Kumar said, “The risk increases with age, particularly after 50.” Other factors include previous radiation treatment to the chest and certain liver or testicular conditions. Dr Jha also identifies obesity and certain testicular disorders among the factors that require attention.Dr Dave highlights the importance of identifying men with inherited mutations or a family history, who may need more monitoring.She said, “Men with significant family history or inherited mutations should discuss genetic counselling and an individualised monitoring plan with their doctor. Routine mammography is not recommended for all men.”Men with these risk factors should discuss these factors with their specialists. Depending on their medical and family history, genetic counselling, testing or personalised testing may be suitable.Also read: US Woman’s Pancreatic Cancer Spotted On Routine Heart Scan: How It Saved Her LifeTests Needed To Rule Out Breast Cancer In Men         When a man presents with specific breast changes, doctors begin with a clinical examination and an assessment of his medical and family history.Dr Bahl explains that the initial evaluation includes examining the breasts and lymph nodes, followed by diagnostic imaging and a biopsy.He said, “Depending on the findings and the patient's age, diagnostic imaging may include mammography and targeted ultrasound. If the examination or imaging raises suspicion, a core needle biopsy is generally performed to obtain tissue for pathological confirmation.”Dr Jha explains why imaging alone may not be sufficient. “Imaging can show that a change is suspicious, but it cannot always prove cancer. Doctors usually diagnose it with a core needle biopsy, which removes a small piece of tissue,” he said.The biopsy sample is examined to establish whether cancer is present. If the diagnosis is confirmed, further testing helps determine the type of cancer and treatment.Dr Dave explains the role of additional tumour testing. “In case when cancer is diagnosed, further analysis of hormonal receptors and HER2 will be necessary,” she said.Hormone receptor and HER2 results help doctors understand the tumour's features and design treatment. Depending on the clinical stage and findings, further investigations may be needed.Dr Kumar stresses the importance of timely assessment, saying that the first step is a clinical examination, followed by mammography or ultrasound where indicated and a biopsy if the findings are suspicious.

breast cancer awareness day: experts explain most overlooked breast changes that can delay diagnosis in men

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