Breast cancer in men
Infiltrating ductal carcinoma - male; Ductal carcinoma in situ - male; Intraductal carcinoma - male; Inflammatory breast cancer - male; Paget disease of the nipple - male; Breast cancer - male
Breast cancer is cancer that starts in breast tissue. Both males and females have breast tissue. This means that anyone, including men and boys, can develop breast cancer.
Breast cancer in men is rare. Male breast cancer accounts for less than 1% of all breast cancers.
Of all the different types of cancers, breast cancer is one of the most talked about, and with good reason. One out of every eight women will develop breast cancer sometime in their life. That's why every woman should be thinking about how to protect herself from this disease. Breast cancer is cancer that forms in the breast. Usually, it begins in the tubes that transport milk from the breast to the nipple. If the cancer spreads to other parts of the breast or body, it's called invasive breast cancer. Some breast cancers are more aggressive, growing more quickly than others. Although women are 100 times more likely to develop breast cancer, men can also get the disease because they do have breast tissue. You're more likely to get breast cancer if you're over 50, you started your periods before age 12, or you have a close family member with the disease. Drinking more than a couple of glasses of alcohol a day and using hormone replacement therapy for several years also may increase your risk. The telltale sign of breast cancer is a lump in your breast or armpit. You may also notice a change in the shape, size, or texture of your breast, or have fluid coming from your nipple when you're not breastfeeding. If you notice any changes in your breasts, call your doctor. You'll probably need to have an imaging scan, such as a mammogram, MRI, or ultrasound. A piece of tissue may be removed from your breast, called a biopsy. With these tests, your doctor can tell whether you have breast cancer, and if so, determine whether or not it has spread. So, how do we treat breast cancer? That really depends on the type of cancer, and how quickly it's spreading. Your doctor may recommend that you have the cancer removed with surgery. Sometimes it's enough just to remove the lump. That's called a lumpectomy. In other cases, the doctor will need to remove the entire breast to get rid of all the cancer or prevent it from coming back. That's called a mastectomy. Other treatments for breast cancer include chemotherapy, medicines that kill cancer cells, and radiation therapy, which uses energy to destroy cancer. Women whose cancer is fueled by the hormone estrogen may receive hormone therapy to block the effects of estrogen on their cancer. Today's breast cancer treatments are better than ever. Many women who have breast cancer go on to live long, healthy lives. The outlook really depends on how fast the tumor is growing, and how far it has spread. That's why it's so important to report any changes in your breasts to your doctor as soon as you notice them. Women who are at an especially high risk for breast cancer because of their family history can talk to their doctor about taking medicine or even having surgery to reduce their risk.
The cause of breast cancer in men is not clear. But there are risk factors that make breast cancer more likely in men:
- Exposure to radiation
- Higher estrogen levels due to factors such as heavy drinking, cirrhosis, obesity, and some medicines to treat prostate cancer
- Heredity, such as a family history of breast cancer, mutated BRCA1 or BRCA2 gene, and certain genetic disorders, such as Klinefelter syndrome
- Excess breast tissue (gynecomastia)
- Older age -- men are often diagnosed with breast cancer between ages 60 to 70
Symptoms of breast cancer in men include:
- Lump or swelling in the breast tissue. One breast may be larger than the other.
- A small lump beneath the nipple.
- Unusual changes in the nipple or skin around the nipple such as redness, scaling, or puckering.
- Nipple discharge.
Exams and Tests
Your health care provider will take your medical history and family medical history. You will have a physical exam and a breast exam.
Your provider may order other tests, including:
- A mammogram.
- Breast ultrasound.
- An MRI of the breast.
- If any of the tests suggest cancer, your provider will do a biopsy to check for cancer.
If cancer is found, your provider will order other tests to find out:
- How quickly the cancer might grow
- How likely it is to spread
- What treatments might be best
- What are the chances that the cancer might come back
The tests may include:
- Bone scan
- CT scan
- PET scan
- Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes
The biopsy and other tests will be used to grade and stage the tumor. The results of those tests will help determine your treatment.
Treatment options for breast cancer in men include:
- Surgery to remove the breast, lymph nodes under the arm, the lining over chest muscles, and chest muscles, if needed
- Radiation therapy after surgery to kill any remaining cancer cells and to target specific tumors
- Chemotherapy to kill cancer cells that have spread to other parts of the body
- Hormone therapy to block hormones that may help certain types of breast cancer grow
During and after treatment, your provider may ask you to have more tests. This may include tests you had during diagnosis. The follow-up tests will show how the treatment is working. They will also show if the cancer comes back.
Cancer affects how you feel about yourself and your life. You can ease the stress of illness by joining a cancer support group. Sharing with others who have had the same experiences and problems can help you feel less alone. The group can also point you to helpful resources for managing your condition.
Ask your provider to help you find a support group of men who have been diagnosed with breast cancer.
The long-term outlook for men with breast cancer is excellent when the cancer is found and treated early.
- About 91% of men treated before cancer has spread to other areas of the body are cancer-free after 5 years.
- Almost 3 out of 4 men treated for cancer that has spread to lymph nodes but not to other areas of the body are cancer-free at 5 years.
- Men who have cancer that has spread to distant parts of the body have a smaller chance of long-term survival.
Complications include side effects from surgery, radiation, and chemotherapy.
When to Contact a Medical Professional
Contact your provider right away if you notice something unusual about your breast, including any lumps, skin changes, or discharge.
There is no clear way to prevent breast cancer in men. The best way to protect yourself is to:
- Know that men can develop breast cancer
- Know your risk factors and talk with your provider about screening and early detection with tests if needed
- Know the possible signs of breast cancer
- Tell your provider if you notice any changes in your breast
Hunt KK, Mittendorf EA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 34.
Jain S, Gradishar WJ. Male breast cancer. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 76.
National Cancer Institute website. Male breast cancer treatment (PDQ) - health professional version.
Last reviewed on: 7/26/2018
Reviewed by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.