Male breast cancer is a rare type of cancer that typically causes cancerous (malignant) cells develop in tissues in the breast or chest. Risk factors like a family history of cancer and radiation treatment of the chest increase your chances of developing this condition. Male breast cancer is estimated to cause less than 3,000 new cases a year in the United States, representing about 1% of all breast cancer cases.
Symptoms can differ based on the type of male breast cancer as well as how far it has spread. If untreated, cancer can spread from the breast to other parts of the body. Treatment options depend on how advanced and severe the cancer is.
Health recognizes that not everyone who is female was born with female reproductive organs and that not everyone who is male was born with male reproductive organs. Health also recognizes that people may not identify as any one sex or gender. The information in this article is based on how researchers present their results, and the gender- and sex-based language used most accurately reflects their research design and outcomes.
Male breast cancer is classified based on the type of cancer cells that arise as well as the tissues they affect. The most common forms include:
- Invasive ductal carcinoma: This type represents 90% of all male breast cancer cases. Invasive ductal carcinoma (IDC) starts in a milk duct (inactive in most males at birth) and spreads to fat surrounding the breast. These ducts are smaller and more central in people assigned male at birth, so this cancer can spread to the nipple.
- Ductal carcinoma in situ: Ductal carcinoma in situ (DCIS) also develops in the ducts of glands, but the cancer cells haven’t spread to other tissues. Healthcare providers consider this a pre-cancer because not all cases of DCIS lead to IDC, the invasive type.
- Invasive lobular carcinoma: This type is very rare in males but the second most common type in females. Cancer cells develop in the lobules of the glands in the breast. They can remain pre-cancerous (in situ) or become invasive and spread.
- Paget disease: About 5% of male breast cancer cases are this type of cancer. Paget disease starts in the breast ducts and spreads to the nipple and the areola (darker tissue surrounding the nipple). Affected areas become crusty, scaly, or red, and lumps can form.
- Inflammatory breast cancer: This type of cancer is rare and aggressive. Instead of causing lumps like other male breast cancers, its symptoms include warmth, tenderness, and inflammation in the breast.
Male Breast Cancer Symptoms
Symptoms of male breast cancer can vary based on type and how far it has spread. By definition, pre-cancerous forms don’t cause any physical signs, but clinical tests can detect abnormal cells. Typical signs include:
- Growths: The development of a painless lump is the main sign of most types of male breast cancers. Lumps typically develop on one side of the chest.
- Nipple retraction: Male breast cancer causes the nipple to retract or pull back inward. The nipple can also become painful.
- Redness: Patches of red and flaking skin can develop on the breast.
- Irritation: The skin on the chest might become irritated, itchy, and inflamed, and dimples might form.
- Nipple discharge: Blood or clear fluid can leak from the affected nipples.
- Swollen glands: This is a sign that the cancer is spreading. Glands called lymph nodes (a part of the immune system) in the armpits swell and grow larger.
Male breast cancer arises when abnormal cells develop in male breast tissue, often in the ducts of the milk glands or the lobules of these glands. These become cancer cells, dividing uncontrollably and eventually spreading to lymph nodes and other tissues.
It's unclear why these cancer cells develop. However, changes in hormone levels, gene mutations, and environmental factors might all contribute.
Risk Factors
Several health factors can increase the risk of developing male breast cancer. Risk factors include:
- Age (over 71 years old)
- Family history of breast cancer
- Mutations of certain genes, especially BReast CAncer gene 1 (BRCA1) and BReast CAncer gene 2 (BRCA2)
- History of radiation therapy treatment for cancer
- Klinefelter syndrome, a rare genetic disorder in which males are born with an extra X chromosome
- Liver disease causing cirrhosis (liver scarring)
- Being overweight or having obesity
- Estrogen hormone exposure, as in therapy for prostate cancer or other conditions
Diagnosis
When diagnosing male breast cancer, healthcare providers try to rule out other potential causes of symptoms. These include gynecomastia (enlarged breasts in males), abscesses (puss-filled bumps in the chest due to infection), and cancer spreading from other parts of the body.
In addition to taking your medical history, your healthcare provider may perform the following diagnostic tests:
- Physical exam: The healthcare provider checks for any growths in the chest and looks for other signs of the disease.
- Mammogram: This type of X-ray lets healthcare providers screen breast tissue for signs of abnormal cells and tumors.
- Ultrasound: This form of imaging uses sound waves to create three-dimensional images of tissues to distinguish cancerous growths from other conditions and screen for signs of spread to lymph nodes.
- Biopsy: In this minimally invasive procedure, healthcare providers collect a small sample of abnormal tissue for laboratory evaluation to confirm cancer diagnosis.
Stages of Breast Cancer
Based on the results of your tests and biopsies, your healthcare provider will stage the disease, often using the tumor, node, and metastasis (TNM) system:
- Stage 0 (T0): Clinical tests can detect evidence of abnormal cells, but there are no noticeable tumors.
- In situ (Tis): There are cancer cells in the ducts (ductal carcinoma in situ), but the cancer hasn’t formed tumors or spread to other parts of the breast.
- Stage 1 (T1): Tumors two centimeters (cm) or less (about 0.75 inches) have developed in the breast, but there are no signs of spread elsewhere.
- Stage 2 (T2): The tumors are still confined to breast tissues but are between 2.1-5 cm (about 2 inches).
- Stage 3 (T3): Lumps are larger than 5 cm.
- Stage 4 (T4): Tumors are spreading to surrounding tissues, and cancer cells reach lymph nodes or other organs.
When treating male breast cancer, healthcare providers work to rid the body of cancer tissue or achieve remission. Remission refers to reductions or a complete absence of the signs or symptoms of cancer, though cancer cells may still be present. The specific treatment approach depends on the stage and severity of the disease.
Surgery
Surgery is the primary option for early-stage male breast cancer, and it’s often paired with radiation therapy. This may involve mastectomy (removing the entire breast tissue) or lumpectomy (removing the cancerous lump).
If the cancer has spread to the lymph nodes, surgeons may remove them by performing axillary lymph node dissection.
Radiation Therapy
Radiation therapy relies on high doses of radiation to kill cancer cells and shrink tumors. It’s typically indicated after surgery to get rid of any remaining cancer, especially if the cancer is more advanced.
Chemotherapy
Commonly known as chemo, chemotherapy involves the intravenous (IV) application (injecting the medication into a vein) of certain drugs to target and kill cancer cells directly. It involves multiple treatments and, like radiation therapy, is often used alongside surgery.
Hormone Therapy
The hormone estrogen is associated with breast cancer development. Hormone therapies reduce estrogen levels and reduce its effects. Soltamox (tamoxifen) is most commonly used for male breast cancer. Other options include aromatase inhibitors (AI), such as Arimidex (anastrozole) and Aromasin (exemestane).
Targeted Therapy h3
Targeted therapies work to interrupt the process of cancer cell formation. They are most often used with other treatments, including drugs that act on hormone receptors or cells with certain gene mutations. These drugs include:
- Monoclonal antibodies, such as Herceptin (trastuzumab) and Perjeta (pertuzumab)
- Antibody drug conjugates, such as Kadycla (ado-trastuzumab emtansine) and Enhertu (fam-trastuzumab deruxtecan)
- Kinase inhibitors, including Tykerb (lapatinib), Nerlynx (neratinib), and Tukysa (tucatinib)
Should Men Get Screened for Breast Cancer?
Generally, the earlier you detect a cancer, the better the outcome. That said, because male breast cancer is so rare, healthcare providers generally don’t think there’s a benefit to screening for people without symptoms or who aren't at higher risk.
However, if you have any growths on your chest, screening is critical. It’s also recommended if you have increased risk and have a family history of breast cancer. In addition, medical societies, such as the American Cancer Society, suggest screening if you have mutations of the BRCA gene, which increases your chances of developing this type of cancer and other cancers.
When advanced, male breast cancer can cause metastasis, meaning the cancer cells spread to other parts of the body. This leads to serious, fatal complications, most often in the bones, brain, liver, and lung. Here are some complications related to metastatic breast cancer in particular areas:
- Bone: Cancer that spreads from the breast to the bone causes bone pain and fractures.
- Liver: Liver cancer causes jaundice (yellowing of the whites of the eyes and skin), abdominal swelling, vomiting, and unexplained weight loss.
- Lung: When it spreads to the lungs, cancer causes symptoms like breathing difficulties, wheezing, coughing up blood, and chest pain.
- Brain: Cancer that spreads to the brain causes symptoms like headaches, dizziness, and seizures (irregular brain activity leading to changes in behavior, sensation, awareness, and movement).
Living With Male Breast Cancer
Male breast cancer is challenging because it’s typically caught at a late stage when it’s more difficult to treat. The treatment outcome is significantly affected by how advanced the cancer is. The five-year survival rate for people with stage 1 cancer is 75-95%, but this drops to 20-30% for stage 4.
There’s little doubt that a cancer diagnosis can be devastating. Treatment side-effects and the progression of the disease can severely affect mental health and quality of life. It's important to have support throughout the journey. Here are some ideas:
- Connect with emotions: Learning to recognize, accept, and be open about your feelings can help you move through the many emotions you might experience.
- Focus on self-care: Create space for things you enjoy and practice healthy habits.
- Get support: Talk to your loved ones, family, and friends about your condition, and seek out help or support when you need it.
- See a professional: If you’re struggling emotionally or mentally, counseling sessions with a therapist or counselor may help.
- Join a group: Ask your cancer care team about support groups for those living with cancer or survivors.
- Use advocacy organizations: Organizations such as the American Cancer Society or National Cancer Institute can be helpful sources of information. They also support research and promote awareness.
Living with cancer involves adapting to a new way of living. Your priorities will likely change, as may your ability or need to reach out to others for help and support. You will likely experience physical, mental, and emotional changes. Even after treatment, or when your cancer goes into remission, you may worry about its recurrence.
Every day may be different, but you always have support of some kind.
Frequently Asked Questions
What is the survival rate for male breast cancer?
To a great degree, the survival rate for male breast cancer depends on how advanced the case is. For those diagnosed with cancer confined to the breast (stages 1-3), 95% are alive at five years; however, for late-stage cases, this drops to as low as 20%. Looking at US national data from 2012 to 2018, researchers found 80.7% of those diagnosed with this cancer survive five years or more.
How common is breast cancer in males?
Male breast cancer is very rare. Of all cases of breast cancer, only 1% occur in males, and this type represents only 0.5 % of all cancer cases among this population. Causing less than 3,000 cases a year in the US, the average chances of developing this cancer over the course of a lifetime is one in 726.
Is breast cancer in men more aggressive?
Compared side by side, the prognosis and outcomes are consistent when you compare stages of male and female breast cancer. However, because of a lack of knowledge about the condition, male breast cancer is usually detected when it’s more advanced. As a result, in males, breast cancer tends to be more aggressive.
