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

According to the National Cancer Institute, breast cancer is the most common cancer among women in the United States, accounting for nearly 30% of all new female cancer cases each year.¹

You might assume that the prevalence and statistics would end there, as many often believe that only women get breast cancer. However, it's a disease that affects men too. While male breast cancer makes up less than 1% of all cases of breast cancer, it's still crucial for men to be aware of the risk factors and symptoms.

The American Cancer Society predicts that there will be about 2,710 new cases of males with breast cancer in the United States in 2022.²

With early treatment, the chances of being cured are high. The 5-year relative survival rate is 95% for localized breast cancer that has not spread in males.³ ⁴

Unfortunately, it can still be deadly when left untreated or detected late. The 5-year relative survival rate for cases in which cancer has spread to distant parts of the body drops to 19%. It's estimated that around 530 men in the U.S. will die from breast cancer in 2022.

With more awareness, early detection, and treatment of breast cancer in men, we can increase the survival rates of people in this population. 

What are the different types of breast cancer in men?

Several types of breast cancer can be found in males. They are largely the same as the ones seen in females:⁵

• Invasive ductal carcinoma: most common in both males and females; starts in the milk ducts and then spreads to other tissues

• Invasive lobular carcinoma: starts out in the milk-producing glands (termed "lobules") and may spread to other tissues

• Ductal carcinoma in situ (DCIS): non-invasive (has not spread) form of breast cancer that occurs in the milk ducts and can become invasive if left untreated

The symptoms of these various types of breast cancer are similar in men and women. This may include:⁶

• A lump or mass in the breast area

• Nipple discharge

• Inverted nipple

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

• Persistent pain in the area

• Swollen lymph nodes around the armpit.

Although such symptoms may not always be a sign of cancer, it's still important to see a doctor right away. Early detection is key to successful treatment.

How breast cancer starts in males

Most may not realize that, similar to women, men also have breast tissue. Even though this tissue is generally less dense than in women, its presence means that it can become cancerous.

When cells in the breast start multiplying abnormally, they form a mass of tissue called a tumor. As this 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, including the lungs, liver, and brain. This process is called metastasis.⁷ ⁸

How is male breast cancer diagnosed in males?

There are several ways that doctors can diagnose breast cancer in men. Your doctor will start off with a physical exam to check for lumps or other changes in the breast tissue.

Doctors may also perform other medical testing to confirm a diagnosis:

1. Mammogram: This is a low-dose specialized x-ray that 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.

2. Ultrasound: Breast cancer is often first detected by a mammogram, but sometimes an ultrasound is needed to discover 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 benign or malignant. Ultrasound imaging is non-invasive and 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.⁹

3. Biopsy: If the mammogram or ultrasound suggests that you might have breast cancer, your doctor might decide to do a biopsy to confirm the diagnosis and to plan for treatment. This is a medical procedure in which breast tissue or cells are removed from the body for examination. There are several types of biopsies, dependent on the location and size of the suspicious area.

• Core needle biopsy: In this procedure, a needle is used to remove a small cylinder of tissue from the breast, and it’s performed using local anesthesia, which numbs the area around the biopsy site.

• Fine-needle aspiration: During this procedure, a thin needle is inserted into the breast and used 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. This includes:¹⁰ ¹¹

• Age: Risk of breast cancer goes up after age 50.

• Family history: If someone in your family (first-degree male and female relatives) has had breast cancer, you are more likely to get it too. If you have multiple relatives with colon, ovarian, or prostate cancer, this can increase your risk as well.

• Radiation therapy around the chest area: The high-energy beams used in radiation therapy can damage DNA and potentially lead to the development of cancer.¹²

• Hormone therapy. Hormone therapy with drugs that contain estrogen (a female sex hormone) has also been linked to an increased risk of developing breast cancer.

• Klinefelter syndrome.Klinefelter syndrome is a condition that affects males and is typically characterized by the presence of an extra X chromosome. It can lead to increased estrogen production in the body. It's estimated that men with Klinefelter syndrome are at 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.

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

• Overweight and obesity. Males who are obese or overweight are more likely to develop breast cancer. This is because fat cells can increase the presence of the female hormone estrogen (which has been linked to breast cancer).  

More recently, researchers have also found some other key risk factors:

Genetic mutations in the BRCA1 and BRCA2 genes

BRCA1 and BRCA2 are genes that help to repair damaged DNA. However, mutations in these genes can cause them to malfunction, leading to the development of cancerous cells.

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

One U.S. study found that, regardless of age, the risk of male breast cancer was higher in carriers of either the BRCA1 or BRCA2 gene mutation compared to non-carriers.¹³

The risk peaked in men in their 30s and 40s and decreased as age increased. There was a slightly higher risk for carriers of the BRCA2 mutation compared to the BRCA1 mutation.

Researchers found that the estimated cumulative (over time) risk of breast cancers for males with the BRCA1 mutation at age 70 years was 1.2%. For those with the BRCA2 mutation carriers, it was 6.8%.

While the exact prevalence of BRCA1 and BRCA2 mutations is unknown, it is estimated that they account for up to 10% of all breast cancers. Not all BRCA1 and BRCA2 mutations will result in a person developing breast cancer.

Mutations in these genes can also increase the risk of other types of cancer, such as ovarian and prostate cancer.¹⁴

Male infertility

More recently, male infertility has been identified as a risk factor for breast cancer.

Male infertility is a condition that can be caused by a variety of factors, including genetic defects, hormone imbalances, and exposure to certain chemicals.¹⁵

A 2022 study published in the Breast Cancer Research journal reported that men with infertility may be twice as likely to be diagnosed with breast cancer compared to those who don't have fertility problems.¹⁶

The exact nature of the connection is not yet fully understood. Still, it is thought that the same underlying causes—such as hormonal imbalances or exposure to certain chemicals—may contribute to both conditions.

Preliminary research suggests that some treatments for male infertility (such as testosterone therapy) have been found to increase the risk of breast cancer. So more studies are needed to explore whether it's natural or treatment-induced hormonal changes that lead to breast cancer development.¹⁷

While more research is needed to confirm the link between male infertility and breast cancer, it is important for men struggling with fertility issues to be aware of the potential risks.

Lack of awareness is impacting male risk

In addition to these biological risks, there are also certain environmental issues related to the detection and treatment of male breast cancer.

Of note, men do not attend regular mammogram screenings, and many aren't aware that breast cancer can develop in males. As a result, they are more likely to be diagnosed at advanced stages of cancer which can affect their likelihood of survival.³

One U.S. cohort study which examined the mortality rates of males versus females with breast cancer found some worrying differences:¹⁸ ¹⁹

• Men had lower rates of survival than women. (The adjusted mortality rate for males was 19% higher than for females)

• The average age of diagnosis was 63.3 years for males and 59.9 years for females

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

How to reduce the risk of developing breast cancer as a male

There are several things that men can do to reduce their risk of breast cancer. This includes suggestions for early detection, which can help increase survival rates.

• Maintain overall good health. Eating a healthy diet and getting regular exercise can all help to reduce your risk of developing breast cancer.

• Genetic testing. If your family has a history of breast or ovarian cancer, you should consider genetic testing. This can help determine if you have an increased risk of developing the disease.

• Learn to do a male breast self-examination. Get familiar with how your breast usually feels. This will help you identify changes that could signal cancer (like lumps) when you do regular self-examinations.²⁰

These simple measures can help reduce breast cancer risk and identify when you might need treatment.

How is breast cancer treated in males?

Treatment for male breast cancer is typically the same as treatment for female breast cancer.²¹

Surgery is the most common option for removing the whole breast or part of it.

Depending on the individual case, chemotherapy, radiation therapy, or hormone therapy (sometimes in combination) may also be used:

• Chemotherapy uses drugs to destroy cancer cells. The drugs are usually given intravenously, injecting them into a vein.

• Radiation therapy is a cancer treatment that uses high-energy radiation to destroy cancer cells. 

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

The lowdown

Breast cancer is not just a disease that affects females; men who are at risk need to be aware of this to improve their survival rate. As male breast cancer becomes more common in public discussion, this will hopefully encourage males to check their breasts, seek breast cancer screening, and receive early and timely treatment if diagnosed.

Sources:

1. Key statistics for breast cancer | American Cancer Society

2. Key statistics for breast cancer in men | American Cancer Society

3. Male breast cancer | BreastCancer.org

4. Breast cancer survival rates in men | American Cancer Society

5. Breast cancer in men | Centers for Disease Control and Prevention (CDC)

6. Breast cancer in men | Cancer Council

7. How cancer starts, grows and spreads | Canadian Cancer Society

8. Breast cancer | Cleveland Clinic

9. Breast ultrasound | Johns Hopkins Medicine

10. Breast cancer in men | Centers for Disease Control and Prevention (CDC)

11. Risk factors for breast cancer in men | American Cancer Society

12. Radiation | NIH: National Cancer Institute

13. Breast cancer risk among male BRCA1 and BRCA2 mutation carriers (2007)

14. Men with BRCA mutations have much higher risk of cancer | BreastCancer.org

15. Male infertility | Cleveland Clinic

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

17. Risks of testosterone replacement therapy in men (2014)

18. Overall mortality after diagnosis of breast cancer in men vs women (2019)

19. Men with breast cancer have lower survival rates than women | BreastCancer.org

20. Self screening | Illinois Department of Public Health

21. Male breast cancer treatment (PDQ®)–Patient version | NIH: National Cancer Institute

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