Breast Cancer in Men: The Power of Awareness

When the mammography technician routinely asked about my family history of breast cancer, “Yes!” I replied, “My father had breast cancer.” She looked up from her computer screen, astonished, and exclaimed, “Really! Your father? I know it exists, but even as a mammography tech, I’ve never met anyone with a family history of male breast cancer or any men with breast cancer.” I smiled. “It’s real!” I said. And so is my father, Olaf.

People naturally associate the words “breast cancer” with “women.” After all, pink – often described as a feminine color – is the symbol of breast cancer awareness worn every October, an opportune time to highlight this disease that affects so many people globally. But it’s important to remember that men, or people assigned male at birth, get breast cancer too!

In the U.S., about 2,700 men will learn they have breast cancer in 2022, and 530 are expected to die from the disease. According to the American Cancer Society, about 1 in 833 men will get breast cancer in their lifetime – compared to 1 in 8 women. Male breast cancer tends to develop in older people between 60 and 70 years of age.

As uncommon as male breast cancer is, most people tend to be diagnosed in the late stage when the cancer is more advanced. Greater awareness is crucial. Below, we’ll cover what you need to know about breast cancer in men, its symptoms, risk factors, and treatment.

Men have breasts

You may not realize it, but as a man, or a person assigned male at birth, you have breast tissue on your chest. And having breast tissue means the potential to develop cancer in these tissues is also there.

Cancer occurs when cells grow uncontrollably. This can be due to gene defects or environmental effects. Male breast cancer happens when these abnormal growths develop in a man’s breast tissue.

Invasive ductal carcinoma (IDC) is the most common type of male breast cancer and is found in about 8 out of 10 male breast cancers; it’s sometimes called infiltrating ductal carcinoma. There are also subtypes of IDC.

It’s (not) just a bump – get it checked out

Because men don’t have screening mammograms as is recommended for women, male breast cancer is usually found when symptoms develop. Many symptoms of breast cancer in men resemble those in women:

• A lump is the most common warning sign – it can be found in the chest, behind the nipple, or in the armpit area and is often painless but not always.
• A change in the skin of the breast/chest.
• Swelling or redness in the breast/chest.
• A change in the way the breast/chest looks – it may have a different shape, or you may notice dimpling of the skin.
• Discharge coming out of the nipple, or the nipple turns inward.

These symptoms don’t always mean you have cancer. They can be caused by non-cancerous conditions, but you won’t know until you get them checked out by a healthcare provider. See your doctor immediately if you feel a lump, any of the symptoms above, or anything different in your body.

Olaf felt a lump on his left chest for several months and ignored it. “I’m vigilant about my health, but I never made much of it. I’d feel it when I shower, and I thought it was just a bump,” he recalls.

It wasn’t until he underwent a chest x-ray – for a completely different reason – that the mass in his breast was brought to his attention, and he was referred for more tests.

Are you at risk of male breast cancer?

The cause of male breast cancer is unknown, but scientists have found some factors that can increase a person’s chance of developing this disease:

• Being older – the average age at diagnosis is 72.
• Having a family history of breast cancer.
• Carrying the BRCA1 or BRCA2 gene mutation.
• Having Klinefelter syndrome.
• Having received prior radiation therapy to the chest.
• Having been treated with hormone therapy for prostate cancer.
• Drinking alcohol heavily.
• Having a liver disease like cirrhosis of the liver.
• Having obesity.
• Having certain conditions that affect the testicles.

Remember that cancer doesn’t discriminate. You can still develop male breast cancer even if you don’t have any of these risk factors.

But if you have one or more of these risk factors, talk to your healthcare provider so they can assess your risk and determine if you need screening tests. Some men at high risk for breast cancer may undergo genetic testing to find out if they have an inherited mutated gene.

Staying physically active, maintaining a healthy weight, and avoiding heavy alcohol consumption are steps that you can take to reduce your risk.

Diagnosing breast cancer in men

If your doctor suspects you have breast cancer, they may recommend that you have a mammogram – this test uses a machine that compresses your breast tissue to look for changes.

A breast ultrasound is also often done to further examine the breast tissue and the lymph nodes, and you may also be asked to have a magnetic resonance imaging (MRI) of the breast.

To help make a definitive diagnosis, a biopsy – where a small sample of breast tissue is removed and sent to the laboratory to be analyzed – is usually necessary.

If the biopsy reveals cancer, you may need additional staging imaging tests to help your healthcare providers understand if the disease has spread.

After the chest x-ray revealed the mass, Olaf underwent a mammogram, ultrasound, and eventually a biopsy confirming his diagnosis of invasive mucinous carcinoma – a rare subtype of IDC.

Treating male breast cancer

Once a diagnosis is confirmed, you will most likely be treated by a team of doctors. Treatment for male breast cancer includes:

Surgery: Most men with breast cancer have a mastectomy to remove the entire breast or a lumpectomy – also called breast-conserving surgery – to remove only the tumor. Nearby lymph nodes may also be removed at the same time.

Depending on the size of the tumor and other factors, radiation therapy may be recommended.

Chemotherapy may also be prescribed in certain situations. Sometimes, chemotherapy is given before surgery to help shrink the tumor; sometimes, it’s administered after surgery.

Hormone therapy is another treatment option that blocks the hormone receptors on cancer cells – yes, men have estrogen and progesterone hormones too, but less than women.

Targeted therapy may be administered for certain types of tumors.

Immunotherapy is also sometimes used in the fight against male breast cancer.

A mastectomy with the removal of some of the lymph nodes in his armpit was recommended for Olaf. Since his tumor was hormone receptor-positive – meaning the cancer cells use signals, or fuel, from estrogen and progesterone to grow – his oncologist also prescribed hormone therapy.

Outlook for breast cancer in men

About 82% of men diagnosed with breast cancer survive this disease for five years or longer. This number can vary significantly depending on how far the tumor has spread at the time of diagnosis. The key is early detection. The earlier this disease is found, the better the chance of successful treatment and survival.

Breast cancer in men is rare, but it’s very real! Most male breast cancers are diagnosed at a later stage, which is believed to be due to people ignoring the warning signs. The odds of survival are substantially higher the earlier the disease is caught and the sooner treatment starts. Talk to your healthcare provider immediately if you notice any warning signs or have one or more risk factors. Don’t ignore a mass in your breast or chest, and don’t delay seeking treatment.

"My father, Olaf, was diagnosed with invasive mucinous breast cancer in January 2019. Although he ignored a lump in his left chest for months, his breast cancer was incidentally found thanks to a chest x-ray. After undergoing a mastectomy, he is now receiving hormone therapy. His story could have been very different had it not been for that chest x-ray. If you feel something, talk to your doctor about it."

Note from the author