Men can develop breast cancer, a disease defined by the uncontrolled growth of cells in the breast tissues. While often discussed in the context of women’s health, it is a cellular disease that affects anyone with breast tissue. The condition involves malignant cells forming a tumor, most commonly starting in the ducts leading to the nipple. Recognizing this fact is crucial for better awareness and earlier detection in men.
Incidence and Scope of Male Breast Cancer
Male breast cancer is rare, accounting for less than one percent of all breast cancer diagnoses in the United States. The lifetime risk for an average man is approximately 1 in 726. Nearly 2,800 new cases of invasive male breast cancer are estimated to be diagnosed each year.
Men can develop this cancer because they possess the same basic breast anatomy as women, including ducts, fatty tissue, and connective tissue, though in a limited amount. The vast majority of cases, known as invasive ductal carcinoma, begin in these ducts. Since men have less breast tissue, a tumor can become noticeable quickly, but diagnoses often occur at a later stage due to lower awareness. The average age for diagnosis in men is around 67.
Recognizing the Physical Signs
The most frequent sign of male breast cancer is a new lump or swelling in the chest area. This lump is typically firm, painless, and often located directly beneath the nipple or areola, where most male breast tissue is concentrated. Any change in the tissue structure should be noted, especially if the mass feels fixed or hard.
Visible changes to the skin covering the chest can also signal the disease. These may include dimpling, puckering, a texture resembling an orange peel, or unexplained redness and irritation. Nipple abnormalities are another common indicator, such as inversion or rash-like scaling. Additionally, any spontaneous discharge from the nipple, which may be clear or bloody, requires immediate medical evaluation.
Key Risk Factors
Age is a non-modifiable risk factor, with the majority of men diagnosed after age 60. A strong family history of breast cancer in close relatives, both male and female, also increases personal risk. Inherited genetic mutations, particularly in the BRCA2 gene, carry the highest risk for men, with a lifetime chance of developing the disease being up to 7 in 100 for those with a BRCA2 mutation.
Conditions that lead to hormonal imbalance are important risk factors. Klinefelter syndrome, a genetic condition where a man is born with an extra X chromosome (XXY), results in higher estrogen levels and significantly elevates breast cancer risk. Other factors that increase estrogen, which can fuel tumor growth, include severe liver disease like cirrhosis, and obesity, where fat cells convert male hormones into estrogen. Furthermore, a history of chest wall radiation exposure, such as for the treatment of lymphoma, is linked to an increased risk.
Diagnosis and Treatment Approaches
The diagnostic process begins when a physical exam detects a suspicious mass or other symptom. Imaging tests are then ordered, typically starting with a diagnostic mammogram, followed by an ultrasound to determine if a lump is solid or fluid-filled. The only way to definitively confirm cancer is through a biopsy, where a small sample of the suspicious tissue is removed and analyzed.
Once cancer is confirmed, the treatment plan is largely based on protocols established for female breast cancer. Surgery is usually the first step, with a mastectomy—the removal of the entire breast, including the nipple—being the most common approach due to the limited amount of male breast tissue. After surgery, many men receive adjuvant therapies, which may include radiation therapy to the chest wall.
Chemotherapy may be used, often before or after surgery, to destroy cancer cells throughout the body. Hormone therapy is a mainstay treatment for the majority of male breast cancers, as nearly all are hormone receptor-positive, meaning their growth is driven by estrogen. The drug tamoxifen is frequently prescribed for five to ten years to block estrogen’s effects and reduce the chance of recurrence.