Male Breast Cancer

What is male breast cancer?

Breast cancer is a form of cancer that occurs in your breast(s). Men can get breast cancer, but it is more common in women. Because of this, men often don’t know they have breast cancer until it is advanced.

There are several types and levels of male breast cancer. Types vary based on the location of cancer cells and what they look like. Breast cancer can begin in your lining, ducts, or lobules. It also can occur in your nipple or areola (the circular area around your nipple). This is known as Paget’s disease of the nipple.

Breast cancer can be invasive. This means it has or could spread to other areas in your body. (It can travel through your lymphatic system to other tissue, organs, or bones.) If your cancer hasn’t spread, it is pre-invasive or “in situ.” Sometimes it is called non-invasive, but this can change if the cancer is not treated.

Cancer grades and stages depend on the cancer cells’ size, makeup, and features. The higher the grade is (1–3), the more abnormal the cells are. It also indicates how slow or fast your cancer cells grow. The higher the stage is (I–IV) the more advanced your cancer is. It also indicates the chance that your cancer will spread. Your grade and stage affect your treatment and outlook.

Infiltrating ductal carcinoma (IDC) is the most common form of male breast cancer. This starts in your breast ducts but is likely to spread to other areas.

Symptoms of male breast cancer

Men should be aware of the shape, size, and feel of their breasts. This can help you detect signs of breast cancer early on. Symptoms include:

  • A lump, or mass, in your breast tissue. This can feel round, like a marble, or flat, like button. The lump could be sore or painless.
  • Changes in the shape or size of your breast.
  • A dimple in the skin of your breast.
  • An inverted nipple.
  • Pain in your nipple, breast, or surrounding area, such as lymph nodes under your arm.
  • Red, rough, or itchy skin on your nipple or areola.
  • Nipple discharge.

If you have breast cancer that has spread to your lymph nodes, you could find other lumps. These could be on the side of your breast, under your arm, or by your collarbone.

What causes male breast cancer?

Cell growth occurs throughout your body. However, when cells grow and divide, they can mutate, or change. These abnormal cells can form a mass, or tumor. Tumors can be benign (noncancerous) or malignant (cancerous).

Boys and girls have similar amounts of breast tissue early on. At puberty, girls produce increased amounts of estrogen. This female hormone causes breast tissue to grow. At the same time, boys’ estrogen levels decrease, so little breast tissue grows.

Because men have less breast tissue, they often find cancer at a late stage. This also is due to low awareness of male breast cancer. Some men don’t check for lumps, see symptoms, or get care soon enough. Most, but not all, cases of male breast cancer include higher than normal estrogen levels.

How is male breast cancer diagnosed?

Early detection and treatment will lead to better outcomes. Seek medical care right away if you find a lump or notice symptoms.

Your doctor will perform a physical exam and review your history. Because a breast exam is not part of a regular physical for men, your doctor needs to know what symptoms you are having to know to perform one. If they think you might have breast cancer, they will order more tests.

  • A diagnostic mammography takes an X-ray of your breasts. Each breast is placed between two plates and flattened to see the tissue. Mammograms can be awkward and you might be sore for a moment. Your doctor will review the image(s) for anything abnormal.
  • An ultrasound gets an image of your breasts using sound waves. The test uses gel and a machine, and is painless. Your doctor will look for anything abnormal.
  • A magnetic resonance imaging (MRI) test gets a picture of your breasts using radio waves. The test is painless, but can take about an hour. Your doctor will look for anything abnormal.

If any tests show a mass or lump, you likely will need to have a biopsy. An exception is if the lump is a cyst, which is a fluid-filled sac. A biopsy is the only way to know if a mass is cancer or not. Your doctor will remove a sample of tissue to check. In some cases, they might need to remove the entire mass or lump. Biopsies determine the size, type, and grade of the cancer.

Cancerous cells also will be tested for certain hormones and genes. If your cells are receptive to estrogen and/or progesterone, you are hormone-positive. This accounts for most cases of male breast cancer. Positive hormone receptors can suggest better outcomes. If your cells contain high levels of HER2, you are HER2-positive. This form of cancer cells tends to be more aggressive.

Breast cancer can spread (metastasize) by way of your lymphatic system. If your cancer is invasive, you might need more testing.

Can male breast cancer be prevented or avoided?

Men cannot prevent or avoid breast cancer. The American Academy of Family Physicians (AAFP) does not recommend breast cancer screening for men. However, men should talk to their doctor if they are at high risk for breast cancer. Their doctor might suggest genetic testing or a mammogram.

Factors that can increase the risk of male breast cancer include:

  • Age. Risk of cancer increases the older you are. According to breastcancer.org, the average age of men diagnosed with breast cancer is 68.
  • Genetics. A family history of breast cancer and/or the gene (BRCA) are two risk factors.
  • High levels of estrogen. This could be a result of genes, certain medicines, or hormone treatments. Men who are overweight or alcoholic also might have more estrogen.
  • Radiation. Men who have radiation exposure to their chest area could develop breast cancer.
  • Gynecomastia. This is a benign condition in which a man’s breasts are larger than normal. In turn, they have more breast tissue and are at risk of breast cancer.
  • Klinefelter syndrome. Men who have this genetic disorder have two or more X chromosomes, along with a Y chromosome. (Normally, men only have one X and one Y chromosome.) Klinefelter syndrome is a birth defect. Men who have it can have enlarged breasts, as well as other traits.

Male breast cancer treatment

All factors of male breast cancer play a role in your treatment. This includes size, location, type, grade, and stage. The size of the mass doesn’t change the outlook, but it can affect treatment options. Other aspects include your age, general health, and personal lifestyle choices. Talk to your doctor in detail about the risks and side effects of each treatment.

Treatment can include one or more of the following:

  • Surgery: A mastectomy is the most common surgery for male breast cancer. It removes all or part of the breast tissue, nipple, areola, and surrounding lymph nodes. Surgery occurs in the hospital (inpatient) and requires anesthesia.
  • Radiation therapy: Radiation often is used after surgery. It can kill remaining cancer cells and help prevent it from spreading. It also can reduce the risk of cancer returning.
  • Chemotherapy: This treatment form is powerful and affects your whole body. The medicine is meant to kill all fast-growing cells, which include cancer cells and normal cells. This is why people who undergo chemotherapy often lose their hair. You can get chemotherapy in pill or intravenous (IV) form, or both. Your doctor might prescribe other medicines to treat side effects.
  • Hormonal therapy: This is an option if your cancer cells test positive for estrogen and/or progesterone receptors. It can help prevent cancer cells from growing and spreading.
  • Targeted therapy: Certain forms of chemotherapy target cell defects. Herceptin medicine is a type that treats HER2-positive cancer cells. It “marks” and kills just the cancer cells and not normal cells. It helps prevent cancer cells from growing and spreading. Targeted therapy often has fewer side effects.

Living with male breast cancer

The process to diagnose and treat cancer can be long and frustrating. Most treatments are invasive and cause side effects. Medicine(s) help counter these, but effects can be long lasting. You likely will need to make changes to your lifestyle.

After treatment, your cancer may subside. Remission can be brief or permanent. Cancer survivors usually require ongoing care. This can include testing and treatment to monitor and manage their health.

Living with cancer is emotional. You might consider joining a support group to help cope. Your doctor also might suggest rehabilitation to help with physical and life changes.

Having a male family member with breast cancer is a trigger for genetic testing and counseling. After receiving your diagnosis, a genetic counselor can help you determine if members of your family should be tested for mutations in the BRCA gene. Abnormalities in the BRCA gene cause forms of breast and ovarian cancer.

Questions to ask your doctor

  • If I’m at high risk of breast cancer, should I see a genetic counselor?
  • What is the outlook of my breast cancer?
  • How will cancer treatment affect my daily life?
  • Should I participate in clinical trials?
  • What is the chance of my cancer returning, and what are the signs or symptoms?