Male Breast Cancer

Can men get breast cancer?

While breast cancer primarily affects women, thousands of men are diagnosed with the disease in the United States each year.

At the time of diagnosis, the average age for a male breast cancer patient is 67, versus age 62 for females. The five-year survival rate for male breast cancer is slightly lower than for female breast cancer. There are a number of different reasons for the lower survival rate. One is patient age, and the health challenges that come with it.

In addition, male breast cancer is typically more advanced when it is diagnosed. The tumor tends to be larger and the cancer is more likely to have spread to regional lymph nodes. Doctors attribute these later diagnoses to a general lack of awareness of male breast cancer, as well as the absence of widespread screening for the disease.

Types of male breast cancer

Like female breast cancer, male breast cancer can be classified by the molecular receptor status of the cancer cells.

Receptors are molecules that cancer cells produce on their surface. They can bond with, or recognize, specific proteins and hormones in the patient’s body. Researchers have identified receptors that fuel the growth of breast cancer cells when they bond with a specific protein or hormone. Interrupting this bond with cancer drugs can slow or stop the disease’s growth.

The three main receptor types for breast cancer (in both men and women) are:

• HER2-positive, a protein that promotes cell growth and multiplication. HER2-positive cancers have much higher levels of the HER2 protein than normal.
• Hormone receptor-positive, which recognizes the hormones estrogen and progesterone.
• Triple-negative, which doesn’t recognize HER2, estrogen or progesterone. Because there is no molecular receptor to interrupt, this is the most difficult breast cancer subtype to treat.

About 90% of breast cancers in men are hormone receptor-positive, while another 9% are both hormone receptor-positive and HER2-positive.

Risk factors

Anything that increases the chance of a person developing cancer is a risk factor. Doctors have identified several risk factors for male breast cancer.

• BRCA mutations: Normal BRCA1 and BRCA2 genes suppress the development of tumors. People with a mutated BRCA gene have a higher risk of breast cancer. Between 8%-15% of male breast cancer patients have a BRCA mutation, compared to 5%-10% of female breast cancer patients. In addition to causing breast cancer, BRCA mutations are also linked to ovarian cancer, pancreatic cancer and melanoma.
• Family history of breast cancer: The risk of breast cancer is doubled for men who have a parent, sibling or child with the disease.
• Age: As men age, their chances of developing breast cancer increases.
• Obesity
• Gynecomastia, or enlarged breasts caused by a hormone imbalance or certain medications
• Radiation exposure, often as part of treatment for another cancer
• Race: African-American men have a higher risk of male breast cancer than non-Hispanic white men.

Symptoms

The symptoms of male breast cancer are very similar to symptoms of breast cancer in women. They include: 

• Lump or mass in the breast
• Lump or mass in the armpit
• Breast skin changes, including skin redness and thickening of the breast skin, resulting in an orange-peel texture
• Dimpling or puckering on the breast
• Discharge from the nipple
• Scaliness on nipple, which sometimes extends to the areola
• Nipple changes, including the nipple turning inward, pulling to one side or changing direction
• An ulcer on the breast or nipple, sometimes extending to the areola
• Swelling of the breast

Diagnosis

The first diagnostic procedure for male breast cancer is typically an imaging exam. Breast imaging is usually carried out with a mammogram or ultrasound. Occasionally, doctors will use magnetic resonance imaging (MRI) or other specialized examinations. Learn more about imaging exams.

Biopsy

If the imaging exam shows an unusual or suspicious mass or skin thickening, doctors will need a tissue sample to make a definitive diagnosis. The process of retrieving and examining this tissue under a microscope is called a biopsy.

For breast cancer, patients usually undergo an image-guided core needle biopsy. During this procedure, a live image of the breast tissue is used help doctors guide the needle to the suspected cancer tissue. In many cases, this biopsy is performed during the initial imaging exam in order to speed up the diagnosis.

If the biopsy reveals cancerous tissue, additional images and biopsies may be needed to determine the exact scope of the disease. This part of the diagnosis shows whether the cancer has spread to nearby lymph nodes or other parts of the body.

Molecular diagnosis

If the patient is diagnosed with breast cancer, doctors will also analyze the cancer cells to determine the disease’s molecular receptor subtype. By understanding the subtype, they can develop a comprehensive, personalized treatment plan.

Treatment

Treatment for male breast cancer is very similar to treatment for female breast cancer. Options include surgery, chemotherapy, radiation therapy and targeted therapy.

Because of the small breast size, most male breast cancer patients who get surgery undergo a full mastectomy (the removal of the entire breast) instead of a lumpectomy (the removal of just the tumor and a small amount of surrounding tissue).