Men can get breast cancer too. It is not common, since fewer than one in a hundred cases is in a man, but it is common enough that doctors see it. The cause is nothing mysterious. A man has a bit of breast tissue behind each nipple, the same as anyone, and cells in that tissue can turn cancerous. The difficulty is that few men think of it, so a lump is often left alone for a while. That delay is the real problem with male breast cancer. The sections below cover who is at risk, what to watch for and how a lump is tested.
According to Prof. Dr. Sandeep Nayak, Surgical Oncologist in Bengaluru at MACS Clinic, the delay usually comes down to embarrassment, or to the belief that this is a women’s disease. “A man with a lump in his chest should get it looked at, the same as a woman would. Often it’s nothing serious, but you can’t know that by feeling it. It needs an examination, a scan and sometimes a biopsy.”
Have questions about male breast cancer? Speak to your surgical oncologist.
Who Gets Male Breast Cancer, and What Raises the Risk?
There isn’t one clear cause, and for many men there’s no obvious reason at all. A few things do show up more often, though.
Age. Mostly a disease of older men, with the average patient somewhere in his 60s or 70s. A man in his 40s can get it, but that’s unusual.
Family and genes. A mother, sister or father who has had breast cancer counts. Then there are the BRCA2 and BRCA1 genes. A fault in either one can come from the father’s side as well as the mother’s.
Hormones. Anything that leaves a man with more oestrogen than usual can play a part. Cirrhosis of the liver does this, and so does Klinefelter syndrome, a condition where a boy is born with an extra X chromosome. Both are linked with a higher risk.
Past radiation and extra weight. Radiotherapy to the chest earlier in life is one factor, since treatment for one cancer can rarely lead to a second cancer years later. Obesity is another, because body fat makes oestrogen.
Having a risk factor doesn’t mean cancer is coming. And plenty of men with breast cancer tick none of these boxes.
What Are the Signs of Breast Cancer in Men, and How Do Doctors Confirm It?
The lump. Hard, painless and usually just under the nipple or to one side of it. Men tend to find it by accident, in the shower or while pulling on a shirt. A separate guide covers breast cancer symptoms, screening and prevention in more detail.
The nipple. Watch for one that has started pulling inwards, any discharge (blood-streaked fluid especially), or a crusty, sore spot that won’t heal.
Skin and armpit. The skin over the chest may pucker or turn red, and a lump can show up in the armpit.
Not always cancer. Gynaecomastia is far more common than cancer, and it also causes swelling behind the nipple, sometimes on both sides. Fingers can’t tell the difference, which is why a doctor has to check.
Getting a diagnosis. First comes an examination, then usually a mammogram or ultrasound, and a needle biopsy to get a sample. The lab studies the sample under the microscope and also tests it for hormone receptors and HER2. Those two results matter a great deal once treatment is being planned.
What Determines Treatment for Male Breast Cancer?
Treatment is tailored to the man, and the stage carries the most weight. Doctors want to know whether the cancer is still within the breast, has reached the lymph nodes in the armpit, or has spread beyond. After that come the type of tumour, the receptor results and how fit he is for surgery. Male and female breast cancers are staged the same way.
Most plans start with surgery: the breast tissue comes out and the armpit nodes are checked. What follows depends on the pathology report. Radiotherapy is needed for some men, chemotherapy for others, and hormone tablets are often added when the tumour is hormone receptor positive. The surgeon looks at all these reports together when deciding on breast cancer treatment.
Key Takeaways
- Men can get breast cancer, but it is uncommon: fewer than one in a hundred cases.
- The tissue behind a man’s nipple is where it starts.
- Older age, relatives with breast cancer, BRCA changes and high oestrogen raise the risk.
- Any hard, painless lump near the nipple should be examined, even if it turns out to be harmless.
- Biopsy and receptor results decide the treatment, which usually starts with surgery.
Frequently Asked Questions
Is it possible for men to get breast cancer?
Yes, though it is rare, under one per cent of all cases.
What does breast cancer in men look like at first?
Usually a hard lump near the nipple that doesn’t hurt.
Is a breast lump in a man always cancer?
Not always. Harmless gynaecomastia is common, but get any lump checked.
How is male breast cancer treated?
Mostly surgery, then radiotherapy, chemotherapy or hormone tablets when the reports call for it.
References
- NHS. Breast cancer in men. https://www.nhs.uk/conditions/breast-cancer-in-men/
Explains symptoms, causes, tests and treatment of breast cancer in men. - National Cancer Institute (NIH). Male Breast Cancer Treatment (PDQ), Patient Version. https://www.cancer.gov/types/breast/patient/male-breast-treatment-pdq
Disclaimer: This blog is for informational and educational purposes only and is not a substitute for professional medical advice or diagnosis.
