Male Breast Cancer

Learn about male breast cancer, its common symptoms, risk factors, and early signs. Timely awareness can help in better diagnosis and treatment decisions.

Male Breast Cancer

  • Category

    Gynecology

  • Published By

    GetWellGo Team

  • Updated on

    20-Jun-2025

Male breast cancer symptoms

Male Breast Cancer Symptoms may be subtle and go unnoticed, causing a delay in diagnosis. The symptoms do need to be detected early, though, for successful treatment. The Early signs of male breast cancer are as follows:

Signs of breast cancer in men:

Lump in the Breast

  • A painless swelling or thickening of breast tissue (typically beneath the nipple or areola).
  • Most frequent symptom.
  • Typically hard, fixed, and will not move about easily.

Nipple Changes

  • Inversion of the nipple (turning inward).
  • Redness, scaling, or ulceration of the nipple.
  • Itching or burning.
  • Nipple Discharge
  • Discharge from the nipple (can be clear, yellow, or bloody).
  • Unusual in men and always needs to be investigated.

Pain or Tenderness

  • Pain is not always present, but tenderness over the lump or in the breast may develop.

Swelling

  • Swelling in the chest area, sometimes radiating to the armpit lymph nodes or near the collarbone.

Skin Changes

  • Dimpling, puckering, or redness of the skin on the breast.
  • Skin can have a texture resembling an orange peel (peau d'orange).

Enlarged Lymph Nodes

  • Lumps or swelling in the underarm (axillary lymph nodes).
  • Can also be felt under the arm or by the collarbone.

What causes male breast cancer?

Male breast cancer is resulted from uncontrolled proliferation of abnormal cells within the breast tissue, usually resulting from alterations (mutations) in DNA that control cell growth. While the definitive cause may not be evident at all times, a number of risk factors and underpinning mechanisms are responsible for the development of male breast cancer:

Male breast cancer risk factors:

Hormonal Imbalance

  • Elevated levels of estrogen (in comparison to testosterone) may induce breast cell proliferation.

May result from:

  • Obesity (fat cells convert androgens to estrogen)
  • Liver disease (e.g., cirrhosis)
  • Testicular disorders (e.g., undescended testes, orchitis)

Genetic Mutations

  • The most frequent genetic cause is BRCA2 gene mutation.
  • Other genes implicated: BRCA1, CHEK2, PALB2, TP53.
  • Men with a family history of breast or ovarian cancer have a greater risk.

Family History of Breast Cancer

  • Risk is increased if there is a first-degree relative (parent, sibling) with breast cancer.
  • Especially relevant if the relative was diagnosed at an early age.

Radiation Exposure

  • Past radiation treatment to the chest, particularly in childhood, raises risk.

Klinefelter Syndrome

  • A less common inherited condition where men carry an extra X chromosome (XXY).
  • Results in low testosterone and high estrogen levels.

Age

  • The majority of male breast cancer is seen between 60–70 years.
  • Risk rises with age.

Alcohol Use

  • Long-term alcohol consumption can raise estrogen levels and disrupt liver function, leading to cancer risk.

Occupational and Environmental Factors

  • Long-term exposure to heat, gasoline vapors, or hormones in some working environments could be a risk factor.

Obesity

  • Raises estrogen levels.
  • Associated with chronic inflammation and insulin resistance, which may support cancer development.

Testicular Conditions

  • Trauma, orchiectomy, or infections can cause hormonal changes that raise risk.

How to detect male breast cancer?

Detection of male breast cancer is a combination of self-examination, clinical assessment, and diagnostic investigations. As it is uncommon and signs are often subtle, early detection relies largely on noting abnormal changes and undergoing medical examination urgently.

Self-Examination

Men ought to perform regular checks on their chest for:

  • A lump or thickening beneath or close to the nipple.
  • Nipple discharge (particularly bloody or clear).
  • Nipple alterations (inversion, crusting, redness).
  • Skin alterations (dimpling, puckering, rash).
  • Swelling of the underarm (probable involvement of lymph nodes).

Clinical Breast Examination (CBE)

A physician will:

  • Perform physical examination of the chest and armpits.
  • Feel for lumps, asymmetry, or skin/nipple abnormalities.
  • Examine lymph nodes of the armpits and collarbone.

Imaging Tests

a. Mammography

  • X-ray examination of breast tissue.
  • Assists in the detection of abnormal masses or calcifications.
  • Mammography is available to men.

b. Breast Ultrasound

  • Uses sound waves to check lumps.
  • Aids in distinguishing between solid tumors and fluid-filled cysts.

c. MRI (Magnetic Resonance Imaging)

  • Detailed imaging, where used in difficult or uncertain situations.

Biopsy (Confirmatory Test)

In the event of a suspicious lump, a biopsy is required:

  • A tissue sample is removed (by needle or small cut).
  • Reviewed under a microscope to see if cancer cells are present.
  • Verifies type, grade, and receptor status (such as estrogen or HER2).

Hormone Receptor & Genetic Testing

In the event of confirmed cancer:

  • Tumor checked for estrogen/progesterone receptors (ER/PR).
  • HER2 status tested (to inform treatment).
  • BRCA gene testing can be recommended, particularly with a family history.

Treatment for male breast cancer

Treatment for male breast cancer mimics that of female breast cancer, with selection based on stage, type, and hormone receptor status of the tumor. The aim is to eradicate the cancer, prevent recurrence, and treat spread if it exists.

Surgery (Primary Treatment)

a. Mastectomy (most frequent)

  • Excision of the whole breast tissue, including nipple.
  • May be accompanied by sentinel lymph node biopsy or axillary lymph node dissection to verify spread.

b. Breast-Conserving Surgery (uncommon in men)

  • Lumpectomy can be performed in very early stages of cancer, but because of small male breast size, mastectomy is more prevalent.

Radiation Therapy

  • Usually applied after surgery (particularly if lymph nodes are involved or margins are near).
  • Aims to destroy any surviving cancer cells in chest wall or axilla.

Hormone Therapy (in ER/PR-positive cancers)

  • Approximately 90% of male breast cancers are hormone receptor-positive.

Common Drugs:

  • Tamoxifen (most common)
  • Aromatase inhibitors (e.g., anastrozole), with or without drugs to inhibit testicular function.

Chemotherapy

Recommended in case:

  • Cancer is bulky, high-grade, or involves lymph nodes.
  • Tumor is HER2-overexpressing or hormone receptor-negative.

Typical regimens:

  • AC (Doxorubicin + Cyclophosphamide)
  • CMF (Cyclophosphamide + Methotrexate + 5-FU)

Targeted Therapy (for HER2-overexpressing tumors)

If the tumor overexpresses HER2:

  • Trastuzumab (Herceptin)
  • Can be used in combination with chemotherapy.

Immunotherapy (Uncommon, in advanced stages)

  • Still investigated for breast cancer in men.
  • Being considered in triple-negative or advanced metastatic disease.

Breast cancer in men vs women

Incidence and Frequency

  • Breast cancer is far more prevalent among females than among males. 
  • Male breast cancer, in fact, accounts for fewer than 1% of all cases of breast cancer. 
  • Females are screened at regular intervals for breast cancer and are simply more conscious of the disease, as opposed to men, who do not even see themselves as being at risk and thus have a much lower rate of diagnosis.

Age of Onset

  • Though women may get breast cancer at any age—most commonly between ages 40 and 60—men tend to be diagnosed at an older age, generally between 60 and 70 years. 
  • This is partly due to the fact that men have less breast tissue and is not screened regularly, thus leading to delay in detection.

Symptoms

  • The presentation of breast cancer is the same in both men and women, but painless masses below or near the nipple is the most frequent symptom in men. 
  • Nipple discharge, inversion, or skin changes can also be experienced by men. 
  • Women are more likely to present with lumps in different locations within the breast and are more likely to seek medical attention early because they are more aware and practice self-examination or mammograms.

Hormonal and Genetic Causes

  • Hormonal imbalance is an even larger factor in male breast cancer. 
  • Conditions that increase estrogen in men—such as liver disease, obesity, or Klinefelter syndrome—may increase their risk. 
  • Genetic mutations, particularly BRCA2, are the leading cause in men. 
  • BRCA1 and BRCA2 mutations are associated with breast cancer in women and hormonal exposure (early menarche, late menopause, hormone replacement therapy) plays a key role in risk.

Diagnosis

  • Men and women both receive the same type of diagnostic tests, such as mammography, ultrasound, and biopsy. 
  • Men are generally diagnosed at a later stage of the disease because they tend to disregard symptoms or don't realize that men can develop breast cancer. 
  • Women are helped by systematic screening programs that identify cancer earlier, at a more curable stage.

Treatment

  • Treatment is largely the same for both men and women. 
  • Mastectomy is more often done in men because there is little breast tissue, and women have the potential for breast-conserving surgery (lumpectomy). 
  • Men and women can both be treated with chemotherapy, radiation, hormone therapy (such as Tamoxifen), and targeted therapy depending on the type of tumor. 
  • Men tend to have estrogen-receptor-positive (ER+) tumors more frequently, so hormone therapy is particularly beneficial for them.

Prognosis and Survival

  • The prognosis for men with breast cancer is marginally poorer, not because the cancer is more virulent, but because the cancer tends to be diagnosed at a higher stage. 
  • Women fare better overall due to earlier detection and increased public health awareness. Survival rates, though, are equal when matched stage-for-stage and by tumor type in men and women.

Male breast cancer diagnosis

Diagnosing male breast cancer is a step-by-step process that consists of clinical evaluation, imaging, and biopsy. Since male breast cancer is unusual, it tends to be diagnosed later than in women—early detection and complete testing are critical.

Clinical Evaluation

a. Medical History

Doctor inquires about:

  • Family history of ovarian or breast cancer.
  • Use of medications (e.g. estrogen-containing medications).
  • Symptoms such as lumps, discharge, or nipple changes.

b. Physical Examination

Manual examination for:

  • Lumps or thickening under the nipple or chest.
  • Nipple inversion, puckering of the skin, or discharge.
  • Swollen lymph nodes in the underarm or near the collarbone.

Imaging Tests

a. Mammography

  • Breast X-ray.
  • Detects mass, calcifications, or tissue distortion.
  • Usually the first imaging device even in men.

b. Ultrasound

  • Sounds waves used to determine if a lump is solid or fluid-filled.
  • Assists needle guide for biopsy.

c. MRI (if necessary)

  • Offers more detailed images, particularly in complex or uncertain situations.
  • May be utilized prior to surgery in order to determine the full extent of the tumor.

Biopsy (Confirmatory Test)

  • A biopsy is needed to prove cancer.

Types of Biopsy:

  • Fine Needle Aspiration (FNA): Thin needle takes out cells.
  • Core Needle Biopsy: Bigger needle takes out a sample of tissue.
  • Surgical Biopsy: A piece of lump or the whole lump is taken out for examination (used if needle biopsies are unable to give a diagnosis).

Biopsy tests for:

  • Type of cancer (e.g., ductal carcinoma).
  • Grade (how bad it appears under a microscope).
  • Hormone receptors (ER, PR).
  • HER2 protein status.

Hormone Receptor & HER2 Testing

  • Most breast cancers in men are estrogen receptor-positive (ER+).
  • Testing directs hormone therapy decisions (e.g., Tamoxifen).
  • HER2-positive tumors can benefit from targeted therapy such as trastuzumab.

Genetic Testing

  • Mutations in the BRCA2 gene are frequent in male breast cancer.

Indicated if:

  • Patient is less than 60.
  • Strong family history.
  • Bilateral breast cancer or other associated cancers (e.g., prostate, pancreatic).

Staging Workup (After Diagnosis)

To establish whether cancer has spread, the tests could include:

  • Chest X-ray or CT scan
  • PET-CT scan
  • Bone scan (for bone metastasis)
  • Blood work (e.g., liver enzymes, tumor marker tests)

Male breast cancer survival rate

Male breast cancer survival rates are based on a number of factors, such as the stage of diagnosis, type of tumor, age, overall health, and whether the cancer is hormone receptor-positive (ER/PR+) or HER2-positive. Overall, men's survival rates are lower than women's—but only due to later diagnosis, not because male breast cancer itself is more virulent.

5-Year Relative Survival Rates:

  • Localized (confined to breast): 95–97%
  • Regional (spread to nearby lymph nodes): 83–86%
  • Distant (metastasized to organs): 22–26%
  • Overall (all stages combined): 75–80%

Male breast cancer stages

Male breast cancer is staged with the TNM system—by Tumor size (T), lymph Node involvement (N), and Metastasis (M). Staging guides treatment and prognosis.

As in women, male breast cancer is classified from Stage 0 to Stage IV:

Stage 0 (In Situ / Non-Invasive)

  • The cancer cells are limited to the ducts or lobules and haven't spread.
  • Referred to as Ductal Carcinoma In Situ (DCIS).
  • No invasion of the surrounding tissues.
  • High cure rate with surgery and potential radiation.

Stage I (Early-Stage Invasive Cancer)

Stage IA:

  • Tumor is ≤ 2 cm.
  • No lymph node spread.
  • No distant metastasis.
  • Very high survival rate; normally treated by surgery ± hormone treatment.

Stage II (Locally Advanced Cancer)

Stage IIA:

  • Tumor is 2–5 cm without lymph node involvement, or
  • < 2 cm with 1–3 lymph nodes involved.

Stage IIB:

  • Tumor is 2–5 cm with 1–3 lymph nodes involved, or
  • 5 cm with no node involvement.

Stage III (Regionally Advanced Cancer)

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