June 1, 2021
Breast Cancer in Men: What You Need to Know

When you think of breast cancer, what comes to mind? Many people picture women, sometimes wearing pink, or a pink ribbon. Although breast cancer very commonly seen in women, men can also develop breast cancer and it’s important to raise awareness and support men breast cancer thrivers or survivors as well.

The following are key facts about breast cancer in men:

  • The ratio of male-to-female breast cancer diagnoses is 1 man to every 120 women.
  • Male breast cancer rates are on the rise, which may be related to the hormonal effects of obesity.
  • Men are often diagnosed with breast cancer at later stages than women (because routine screening is not recommended for men).
  • Male breast cancer is usually estrogen receptor positive (ER+).

 

Specific risk factors for male breast cancer include the following:

  • A family history of breast cancer, especially in other male relatives
  • Certain genetic syndromes
  • BRCA gene mutation and other genetic mutations.
  • Klinefelter’s syndrome (sex chromosome combination of XXY), which carries a 50-fold increase in risk

 

How Is Breast Cancer in Men Diagnosed?

Usually, a man will discover the breast mass himself and seek medical attention. His physician will then take a careful history, perform a physical exam, and often order breast imaging, including mammography and breast ultrasound. If the imaging is suspicious, the patient will need a biopsy for a tissue sample.

How Is Breast Cancer in Men Treated?

Surgical treatment options for men diagnosed with breast cancer are the same as those for women. Male breast cancer can be successfully treated with lumpectomy and radiation therapy (also called breast conservation therapy). The current breast conservation rate for male breast cancer in the United States is 13%. This means that many men with breast cancer are being treated with mastectomy.

Chemotherapy and/or endocrine therapy treatment recommendations are similar for men and women, and are dependent on the stage and biology of the patient’s cancer. For estrogen receptor–positive breast cancers in men, tamoxifen is the drug of choice.

The risk of developing a new breast cancer in the opposite breast for a male breast cancer patient is about 1% to 2%. Due to this very small risk, preventive mastectomy, also called prophylactic mastectomy, for the opposite breast is not recommended.

Other Considerations for Men with Breast Cancer:

  • Genetic testing—8% of all male breast cancer patients will carry a BRCA2 gene defect. This information is especially important for their female relatives. Genetic counseling for family members can be lifesaving.
  • Risk of another type of cancer—12.5% of men with breast cancer will develop a second type of cancer. The most common associated cancers are prostate cancer, pancreatic cancer, stomach cancer and colon cancer. Appropriate cancer screening guidelines are recommended.

 

Are Survival Rates Different for Men and Women?

Breast cancer survival for men and women is the same when the stage and biology of the breast cancer is similar. As with women, the earlier a breast cancer is detected and treated in a man, the better the chances are of taking care of the breast cancer and improving long-term survival.

 

-Dr. Ann Chuang