Male breast carcinoma: increased awareness needed

Breast cancer is predominantly a female disease with 49,492 cases (invasive and non-invasive) diagnosed in the UK in 2006 [1]. According to data from the International Agency for Research on Cancer, this is broadly in line with figures from other western nations [2]. Tremendous strides in our understanding of breast cancer have been made over the past two decades and, when detected early, breast cancer is one of the most curable and treatable of all cancers. Male breast cancer is much less frequent with 334 cases diagnosed in the UK in 2006 [1], accounting for just under 1% of all breast cancers.Owing to the rarity of male breast cancer, establishing precise risk factors for the disease has proved challenging. Male and female breast cancers share many common risk factors; for example, advancing age and previous family history. In terms of male breast cancer, data from the Breast Cancer Linkage Consortium showed that men harbouring BRCA2 mutations have a relative risk of 80 for developing breast cancer [3] - making BRCA2 the strongest known gene associated with male breast cancer [4,5]. Androgen receptor mutations have also been reported [6]. Some suggested risk factors associated with male breast cancer are summarised in Table 1[4-8].Although still a rare disease, anecdotal evidence from clinical and pathology colleagues coupled with reports from recent literature suggests that male breast cancer is becoming more common [9-12]. As a means of corroborating this, we analysed data from four western nations: England, Scotland, Canada and Australia. Data for England were provided by the West Midlands Cancer Intelligence Unit [13]. Data for Scotland were obtained from the Information Services Division (Scotland) website [14]. Canadian data were obtained from the Public Health Agency of Canada [15], and data for Australia from the Australian Institute of Health and Welfare [16]. As the population of Scotland is considerably smaller than the other three nations, Scottish an