Men Get Breast Cancer Too: Here's What You Need To Know

Editor’s note: This post was originally published on November 19, 2022, and has been updated on June 25, 2023, for accuracy and comprehensiveness.

The National Cancer Institute reports that breast cancer is the second most common cancer among women in the United States after skin cancer. It accounts for nearly 30% of all new female cancer cases yearly.¹

Many believe that only women can get breast cancer, but it can also affect men. It’s much less common (less than 1% of all breast cancer cases), but around 2,400 men receive a breast cancer diagnosis each year in the US.²

Unfortunately, social and healthcare disparities affect the detection, diagnosis, treatment, and prognosis of breast cancer in men. This means it’s really important for men to educate themselves about breast cancer and understand their risks and symptoms. This knowledge will enable them to advocate for themselves to be screened and therefore receive early diagnosis and treatment.

This blog will cover everything you need to know about breast cancer in men, including the risk factors that could affect you, how the disease is diagnosed, and the disparities that affect awareness of the condition and how to navigate them.

Different types of breast cancer in men

Men can develop several types of breast cancer. They are largely the same as those seen in females.³

• Invasive ductal carcinoma: This type is most common in males and females. It starts in the milk ducts before spreading to other tissues in the breast. From there, it may spread to other parts of the body.

• Invasive lobular carcinoma: This starts out in the milk-producing glands (called “lobules”) and spreads to the breast tissues. It may then spread to other parts of the body.

• Ductal carcinoma in situ (DCIS): “In situ” means “in its place,” as this is a non-invasive form of breast cancer. It presents with cancer cells in the lining of the milk ducts only. It can’t spread outside the breast. However, these cancer cells can become invasive and spread to other tissues if left untreated.

Symptoms of these types of breast cancer, which are similar in men and women, may include the following:⁴

• A lump or mass in the underarm or breast area

• Nipple discharge

• Inverted nipple

• Changes to the skin on the chest or nipples (like dimpling)

• Persistent pain in the area

• Swollen lymph nodes around the armpit

These symptoms may not always be signs of cancer, but it’s still important to see a doctor right away. Early detection is key to successful treatment.

How breast cancer starts in males

Similar to women, men also have breast tissue. It can become cancerous, even though this tissue is generally less dense than in women.

When cells in the breast start multiplying abnormally, they form a mass of tissue. This is called a tumor. Some tumors can be benign — not all are cancerous.

Each cell in the body contains genes telling it how to function. Cells can become cancerous when the genes inside the cells mutate, which occurs when the DNA is damaged or changed.⁵ Cancerous cells are abnormal. They can multiply out of control and damage the body.

For example, as a tumor grows, it puts pressure on surrounding organs and tissues, making it difficult for them to function properly. If left untreated, the tumor will eventually spread to other parts of the body, possibly including the lungs, liver, and brain. This process is called metastasis.⁶

How is male breast cancer diagnosed?

Doctors can diagnose breast cancer in men in several ways. They will start with a physical exam to check for lumps in the breast tissue or other changes. Doctors then perform other medical tests to confirm a diagnosis.

Mammogram

This low-dose specialized x-ray will allow the doctor to see inside the breast. It can help reveal any abnormalities or issues that might not be felt during a physical examination.

Mammograms are essential for screening, but they are not 100% accurate. They may provide false positive or negative results in some people.

Ultrasound

Breast tissue abnormalities are often first detected by a mammogram, but sometimes an ultrasound is needed to learn more about a suspicious area. For example, it can determine if a mass is solid or filled with fluid. This may indicate whether it’s a cyst or tumor that could be benign or malignant.

Ultrasound imaging is a non-invasive procedure. It utilizes sound waves to create pictures of the inside of your body. A gel is applied to the skin during a breast ultrasound, and a hand-held device called a transducer is passed over the area. The transducer releases sound waves that reflect off structures in the breast and are converted into images on a screen.

MRI

In women, magnetic resonance imaging (MRI) may be used alongside ultrasound and mammography to screen for breast cancer. It’s useful for indicating the size of a tumor and identifying others that may have developed in the breast. It’s typically used in women who have already received a breast cancer diagnosis or are at high risk of developing the condition.⁷

The method isn’t typically used to identify breast cancer in men, but it may be helpful in some cases.⁸

Biopsy

In this procedure, a medical professional removes breast tissue or cells from your body so they can be examined.

If the mammogram or ultrasound suggests you might have breast cancer, a biopsy is the only definitive way to prove this. Your doctor will need to do a biopsy to confirm the diagnosis, identify the subtype of breast cancer, and plan for the treatment you need.

There are several types of biopsies. Your doctor will select one depending on the location and size of the concerning area.

• Core needle biopsy: A needle is used to remove a small cylinder of tissue from the breast. Your doctor will give you local anesthesia, which numbs the area around the biopsy site.

• Fine-needle aspiration: A thin needle is inserted into the breast to aspirate or suction out small amounts of tissue. It is usually performed using local anesthesia or sedation.

• Surgical biopsy: In this procedure, all or part of the suspicious breast tissue is removed through an incision in the skin.

Risk factors for male breast cancer

Several common risk factors can increase the likelihood of a man developing breast cancer, including the following:⁹

• Age: Breast cancer risk rises after the age of 50.

• Family history: If someone in your close family (male or female relatives) has had breast cancer, you are more likely to get it too. Having multiple relatives with colon, ovarian, or prostate cancer can also increase your risk.

• Radiation therapy around the chest area: The high-energy beams used in radiation therapy can damage DNA and potentially cause cancer to develop.¹⁰

• Hormone therapy: Undergoing hormone therapy with drugs that contain estrogen (a female sex hormone) is thought to increase your breast cancer risk.

• Klinefelter syndrome: This is a condition that affects males. It is typically characterized by an extra X chromosome, and can lead to increased estrogen production in the body. It’s estimated that men with Klinefelter syndrome have a 20–60 times higher risk of developing breast cancer than those without the condition.¹¹

• Testicular medical conditions: An undescended testicle that has not moved to its correct position can increase breast cancer risk. Mumps in adulthood that causes testicular inflammation or having testicles (one or both) surgically removed can also increase this risk.

• Heavy alcohol consumption: Consuming excess alcohol increases your risk of developing breast cancer. A study reported that men’s risk increases by 16% per 10g of alcohol consumed.¹²

• Liver disease: Liver cirrhosis is when the liver becomes scarred and damaged. It can cause hormone imbalances, which may also increase cancer risk.

• Overweight and obesity: Males who are obese or overweight are at an increased risk for the condition. This is because fat cells can increase estrogen levels, and experts believe this is linked to breast cancer.

Researchers have also found some other key risk factors more recently:

Genetic mutations in the BRCA1 and BRCA2 genes

The genes BRCA1 and BRCA2 help repair damaged DNA, but mutations in these genes can cause them to malfunction, causing cancerous cells to develop.

While BRCA1 and BRCA2 mutations are most commonly associated with breast cancer in women, they can also cause the disease in men.

One US study found that the risk of male breast cancer was higher in carriers of either the BRCA1 or BRCA2 gene mutation compared to non-carriers, regardless of age.¹³ The risk was seen to peak in men in their 30s and 40s and decrease with age. People who carried the BRCA2 mutation had a higher risk than those with the BRCA1 mutation.

Researchers in the study found that the estimated cumulative (over time) risk of breast cancer for 70-year-old males with the BRCA1 mutation is 1.2%. For those with the BRCA2 mutation, the cumulative risk was found to be 6.8%.¹⁴

Male infertility

Researchers have recently identified male infertility as a risk factor for breast cancer.

A 2022 study reported that men with infertility may be twice as likely to be diagnosed with breast cancer compared to those without fertility problems.¹⁵

Experts still don’t understand the exact nature of the connection, but they believe the same underlying causes (such as hormonal imbalances or exposure to certain chemicals) may contribute to both conditions. Some hypothesize that any hormonal imbalance affecting testosterone levels can explain the link between infertility and breast cancer.

More research is needed to confirm the link between male infertility and breast cancer, but it’s important to know the potential risks if you’re struggling with fertility issues.

How to reduce your risk of breast cancer as a male

You can do several things to reduce your risk of breast cancer.

• Maintain overall good health. Eating a healthy diet low in saturated and trans fats and getting regular exercise to maintain a healthy weight can help reduce your risk of developing breast cancer.

• Stop smoking. The chemicals that enter your body when you smoke a cigarette can damage the DNA in your cells and make it harder for them to be repaired. Damaged DNA can cause cells to become cancerous.¹⁶

• Limit or avoid alcohol consumption. Consuming alcohol has been linked to breast cancer in men. Try to avoid alcohol or limit your consumption to the recommended amount for men: two drinks or less on days when you consume alcohol.¹⁷

• Undergo genetic testing. Consider genetic testing if your family has a history of breast or ovarian cancer. It can help determine if you have an increased risk of developing the disease.

• Learn to do a male breast self-examination. First, get familiar with how your breasts usually feel to help you identify changes that could signal cancer. Self-examine your breasts regularly to check for signs, such as lumps, changes in shape, or different skin texture.

• Advocate for yourself. Request a mammogram exam if you suspect any abnormal mass in your breast or have a reason to believe you have an increased risk of male breast cancer.

How is male breast cancer treated?

Treatment for male breast cancer is typically the same as it is for female breast cancer.¹⁸

Surgery is the most common option. It may involve removing the whole breast or part of it.

Depending on your individual case, here are some other treatment options your doctor may consider:

• Chemotherapy: This treatment involves administering drugs (usually intravenously) to destroy cancer cells.

• Radiation therapy: This type of therapy involves using high-energy radiation to destroy cancer cells.

• Hormone therapy: This treatment may be used to treat hormone-sensitive breast cancer. It either blocks the body’s hormone production or interferes with the way hormones work.

Breast cancer outcomes and survival rates in men

Doctors use survival rates to help people with cancer understand their chance of recovery.

What is a survival rate?

A survival rate estimates how many people with a specific type and stage of cancer will be alive after a period of time compared to those without the disease. It's given as a percentage.

Doctors usually provide a five-year relative survival rate. A rate of 90% would mean that, compared to the wider population, people with a specific type and stage of cancer are 90% as likely to be alive after five years.

You may have heard of cancer being categorized by stage (stage 1, stage 2, stage 3, and stage 4). This is the American Joint Committee on Cancer’s (AJCC) TNM system. However, the Surveillance, Epidemiology, and End Results (SEER) database (the data source used to calculate relative survival rates) categorizes cases into localized, regional, and distant. Here’s what these categories mean for men with breast cancer:¹⁹

• Localized — this means there’s no indication that the cancer has spread further than the breast

• Regional — in these cases, the cancer has spread outside the breast to nearby tissues, organs, or lymph nodes

• Distant — this means the cancer has spread to distant lymph nodes or organs

Relative survival rates cannot accurately predict how long you will live or how successful your treatment will be. Causes of death are not taken into consideration, and influencing factors, such as your age at diagnosis or your individual medical history, are not considered.

Surveillance data from SEER estimates that the average five-year relative survival rate for the condition in men is 84.7% when all stages are combined. The rate is 98.7% for localized cases, 83.7% for regional cases, and 25.9% for distant-stage cases.²⁰

It is important to note that a higher relative survival rate does not always equate to a lower mortality rate from this specific cancer on its own. This can be seen when examining the higher mortality rate of breast cancer in men compared to women, as discussed below.

Disparities in cancer outcomes

There are significant disparities in cancer outcomes when influencing factors like race and ethnicity are taken into consideration.

According to a report published by the Centers for Disease Control and Prevention (CDC), compared with non-Hispanic White people and Hispanic people, non-Hispanic Black men have the lowest relative survival rates at one and five years after diagnosis.²¹

The relative survival rate for breast cancer is also slightly lower in males than females, which is influenced by disparities in diagnosis, screening, and treatment. You can read more about this in the next section.

Males vs. females: disparities in screening, diagnosis, treatment, and outcomes

Aside from biological differences between males and females, certain factors related to detecting and treating male breast cancer may impact your prognosis and outcome. Let’s look at these disparities in more detail.

Screening

Breast cancer screening for women is well-established in the US. Women aged 50–74 with an average risk of developing breast cancer are encouraged to undergo screening every two years. Those with a high risk are typically encouraged to undergo screening more often and from a younger age.²²

​​Screening for breast cancer in men is not well-established. It has not been extensively studied to assess its usefulness, partly because the condition is rare in men.

However, the American Cancer Society (ACS) suggests that men with a high risk of developing breast cancer may benefit from screening. They may have a high risk because they have a known genetic mutation or a strong family history of the condition.²³

Diagnosis

Disparities in screening between males and females could explain why men are typically diagnosed later and have a poorer prognosis.

The ACS suggests other contributing factors, including that men are more likely to overlook or ignore breast lumps or make incorrect assumptions about what’s causing them. This could be due to limited awareness about male breast cancer. Another factor may be the belief that breast cancer is a female disease and the social stigmatization that can lead to.²⁴

Treatment

A 2019 study found significant disparities in mortality rates between male and female patients with breast cancer.²⁵ Clinical and treatment characteristics were identified as the most common factor in this disparity, accounting for more than two-thirds of the difference in mortality.

Even though most of the male patients in the study had more advanced cancer, they were less likely to receive conventional treatments. This is known as undertreatment.

The researchers highlighted that treatment for breast cancer in men typically follows the guidelines set out for treating females, suggesting more research is needed to develop sex-specific treatment guidelines.

Outcomes

Surveillance data suggests that the relative survival rate for breast cancer is slightly lower in males than females.

For comparison, here are the average five-year relative survival rate for breast cancer in men:

• Localized: 98.7%

• Regional: 83.7%

• Distant: 25.9%

For women, the rates are slightly higher:²⁶

• Localized: 99.3%

• Regional: 86.3%

• Distant: 31%

However, a recent US cohort study that examined the mortality rates of males versus females with breast cancer between the years 2004 and 2014 found some more significant differences:²⁷ ²⁸

• Compared with females, males had higher mortality across all stages. The five-year survival rate was 77.6% compared to 86.4% in women.

• Even after accounting for all the differences between clinical characteristics and treatments, the adjusted mortality rate for males was still 19% higher than for females.

• More men (14.0%) were also diagnosed with later-stage breast cancer (stage 3) compared to 8.9% of women.

Do trans men need breast cancer screening?

Not enough research has been conducted to determine how common breast cancer is in the female-to-male transgender population, or which risk factors apply to this group. More research is needed to fully understand breast cancer in this population so that trans men can be offered the best care and support.

Screening is recommended for trans men who have not undergone a bilateral mastectomy or who have had breast reduction surgery. Breast cancer risk is lower in trans men who have had a bilateral mastectomy, but they may still develop male breast cancer.

More research is needed to understand the usefulness of screening in trans men who have had a bilateral mastectomy. The best thing to do is speak to your doctor to understand your risk and the benefits and limitations of screening.²⁹

The lowdown

Breast cancer doesn’t discriminate against men, but it is much less common than in women.

Due to many factors, including the rarity of the disease in men, there are disparities in screening, diagnosis, and treatment. Overall, this contributes to men with breast cancer having a lower relative survival rate than women. However, more research is needed to fully understand the disparities in relative survival rates.

Increased awareness of male breast cancer may lead to earlier detection and improved outcomes. It starts with including men in the discourse about breast cancer and encouraging everyone, regardless of gender, to perform self-examinations and seek mammogram screening.

The information provided is designed to support, not replace, the relationship that exists between a patient/site visitor and their existing health care professional(s). Have feedback? Email content@healthmatch.io.

References:

1. Basic Information About Breast Cancer l Centers for Disease Control and Prevention

2. Breast Cancer in Men l Centers for Disease Control and Prevention

3. (As above)

4. Breast cancer in men l Cancer Council

5. How cancer starts, grows and spreads l Canadian Cancer Society

6. (As above)

7. Role of magnetic resonance imaging in breast cancer management (2018)

8. The Utility of Breast MRI for Further Evaluation of Male Breast Cancer (2020)

9. Risk Factors for Breast Cancer in Men l American Cancer Society

10. Risk Factors: Radiation l NIH: National Cancer Institute

11. Risk Factors for Breast Cancer in Men l American Cancer Society

12. Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study (2004)

13. Breast Cancer Risk Among Male BRCA1 and BRCA2 Mutation Carriers (2007)

14. Men With BRCA Mutations Have Much Higher Risk of Cancer (2017)

15. Infertility and risk of breast cancer in men: a national case–control study in England and Wales (2022)

16. How does smoking cause cancer? l Cancer Research UK

17. Dietary Guidelines for Alcohol l Centers for Disease Control and Prevention

18. Male Breast Cancer Treatment (PDQ®)–Patient Version l NIH: National Cancer Institute

19. Breast Cancer Survival Rates in Men l American Cancer Society

20. Breast Cancer Survival Among Males by Race, Ethnicity, Age, Geographic Region, and Stage — United States, 2007–2016 (2020)

21. (As above)

22. What Is Breast Cancer Screening? l Centers for Disease Control and Prevention

23. American Cancer Society Recommendations for the Early Detection of Breast Cancer l American Cancer Society

24. Can Breast Cancer in Men Be Found Early? l American Cancer Society

25. Overall Mortality After Diagnosis of Breast Cancer in Men vs Women (2019)

26. Cancer Stat Facts: Female Breast Cancer l NIH: National Cancer Institute — Surveillance, Epidemiology, and End Results Program

27. Overall Mortality After Diagnosis of Breast Cancer in Men vs Women (2019)

28. Men With Breast Cancer Have Lower Survival Rates Than Women (2019)

29. Breast Cancer in the Transgender Population (2019)

Dawn Teh is a health writer and former psychologist who enjoys exploring topics about the mind, body, and understanding what helps humans thrive.