Male Breast Cancer: Symptoms, Causes, Diagnosis & Treatment

Janis

By Janis | Updated December 4, 2023

Male breast cancer is a relatively rare condition, affecting approximately 2,700 men in the United States each year, with an estimated lifetime risk of around 1 in 1,000. 

Despite being uncommon, male breast cancer is a serious health concern that shares similarities such as symptoms, risk factors, and treatment options with female breast cancer. 

It is essential to raise awareness about this condition, as early detection and proper medical care are crucial in successfully managing and treating the disease.

Routine diagnosis of this condition involves a combination of physical exams, imaging tests, and biopsies, followed by an accurate assessment of the cancer’s stage and subtype to plan appropriate treatment options.

Symptoms in Males

Skin changes play a vital role in detecting male breast cancer. Some of these changes include redness, scaling, or puckering of the skin around the nipple or on the breast. 

It’s essential to be aware of any skin changes and report them to your healthcare provider, as they may be indicative of breast cancer or other health issues.

Lump and Swelling

One of the most prevalent symptoms of male breast cancer is the existence of a lump in the breast area. This lump is usually painless and may be detected during a self-examination or a routine check-up. 

It’s important to note that not all lumps are cancerous, but it’s essential to consult with a healthcare professional if you discover one.

Apart from the lump, other signs related to swelling could be an increase in the size of one breast or an uneven appearance between both breasts. Swelling may also be felt in the lymph nodes under the arm or near the collarbone.

Thickening and Pain

In addition to lumps and swelling, male breast cancer can cause the breast tissue to thicken. This thickening differs from the overall growth of breast tissue and can be felt as an area of stiffer tissue compared to the surrounding area.

Though pain is not a typical symptom, some men may experience discomfort in the breast area due to tissue thickening.

Nipple Discharge and Skin Changes

Another symptom of male breast cancer is nipple discharge. This discharge can be clear or bloody and may come from one or both nipples. 

In some cases, nipple discharge may be accompanied by changes in the nipple, such as inversion or retraction.

Causes and Risk Factors

In this section, we will discuss estrogen and hormonal imbalances, genetics and family history, and lifestyle and medical factors that can contribute to male breast cancer.

Estrogen and Hormonal Imbalances

Estrogen, which is typically thought of as a female hormone, also plays a role in men’s health.

Hormonal imbalances, particularly increased estrogen levels, can contribute to the development of breast cancer in men. 

Obesity can lead to higher estrogen levels in the body, as fat cells produce estrogen. Additionally, males with cirrhosis or impaired liver function may also experience increased estrogen levels. 

Klinefelter syndrome, a genetic condition affecting male development, results in lower testosterone levels and higher estrogen levels, which can increase the risk of breast cancer in men.

Genetics and Family History

Men with a family history of breast cancer, particularly in close female relatives, may be at an increased risk for developing the disease themselves. 

In some cases, male breast cancer can be linked to mutations in the BRCA1 or BRCA2 genes, which are known to increase the risk of breast cancer in women. 

Lifestyle and Medical Factors

Some lifestyle and medical factors that can contribute to male breast cancer risk include:

Obesity 

As mentioned earlier, obesity can lead to increased estrogen levels in the body.

Excess body fat can lead to increased estrogen production in men, as fat tissue can convert androgens into estrogen. 

Alcohol consumption 

Excessive alcohol consumption can increase the risk of breast cancer in men, likely due to its negative impact on liver function and hormone levels.

Alcohol can raise estrogen levels in the body, which may contribute to the development of breast cancer in men. 

Radiation exposure 

Previous radiation exposure to the chest, such as from radiation therapy for a prior cancer, can increase the risk of male breast cancer.

Understanding the causes and risk factors associated with male breast cancer can help individuals take steps to manage their risk and seek appropriate screening and care.

Diagnosis and Detection

In terms of diagnosis, physical examination, imaging tests, tissue samples, and genetic tests can help identify abnormal areas in breast tissue and confirm breast cancer. Early detection and prompt treatment are vital.

Physical Exam and Mammogram

A physical exam may be the first step in diagnosing male breast cancer. During the exam, the doctor will carefully examine your breast tissue, looking for any lumps or changes in size or shape. 

They may also check for enlarged lymph nodes, which could indicate the presence of cancer. If the doctor finds anything unusual, they may recommend further testing.

A mammogram is an X-ray image of the breast that can reveal abnormalities in the breast tissue. This imaging test is often used for both men and women to detect early signs of breast cancer. 

It is highly advantageous to identify cancerous growths before they become too large or spread to other areas of the body.

Ultrasound and Biopsy

An ultrasound is another imaging test that utilizes sound waves to generate images of the breast tissue. This tool can help doctors determine whether a breast lump is solid or fluid-filled (such as a cyst) and can guide the biopsy process if necessary.

For further analysis and confirmation, a biopsy entails extracting a small sample of breast tissue. This procedure is the only decisive method to validate a diagnosis of breast cancer. 

The sample is sent to the lab, where a pathologist examines it under a microscope to identify any cancerous cells.

Genetic Testing and Clinical Trials

Genetic testing is a tool that can help identify inherited gene mutations that may increase a man’s risk of developing breast cancer. Mutations in genes like BRCA1 and BRCA2 are well known for increasing the risk of breast cancer in both men and women. 

Genetic counseling is often recommended for individuals with a strong family history of breast cancer. Clinical trials play a crucial role in the development of new diagnostic methods and treatments for various diseases, including male breast cancer. 

Types of Male Breast Cancer

While breast cancer in men is rare, it’s crucial to understand that it can occur and take various forms. Different types of breast cancer can behave quite differently and require different treatment approaches.

In the following section, we highlight the various types of male breast cancer, describing their characteristics and potential treatment options.

Ductal Carcinoma

Ductal carcinoma is the most prevalent type of breast cancer in men. This cancer originates in the cells lining the ducts of the breast. Infiltrating ductal carcinoma occurs when the cancer cells have spread beyond the duct lining, invading nearby breast tissue. 

Ductal carcinoma in situ (DCIS) is a non-invasive form of the disease, where the abnormal cells are contained within the ducts and have not yet spread to surrounding tissue.

Though rare compared to female breast cancer, male ductal carcinoma can still be aggressive and requires proper diagnosis and treatment. 

Lobular Carcinoma

Lobular carcinoma is a rare form of male breast cancer that originates in the lobules. While lobular carcinoma is the second most common type of breast cancer in women, it is extremely rare in men due to the difference in breast tissue structure, as men have fewer lobules in their breast tissue. 

However, it is crucial not to ignore any unusual changes in the breast area.

Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is an aggressive yet rare form of breast cancer that leads to the appearance of the breast as swollen, red, warm, and tender. 

Unlike other forms of breast cancer, IBC does not typically present as a lump and can easily be mistaken for an infection. Though very rare in men, it is essential to be aware of concerning symptoms.

IBC often grows rapidly and requires immediate treatment. The management of this cancer may involve a combination of therapies, including chemotherapy, radiation therapy, and surgery. 

Early detection and intervention are critical to improving outcomes for those diagnosed with inflammatory breast cancer.

Treatment Options

Each treatment option is personalized and planned based on factors including, but not limited to, the specific case, the stage of cancer, and the patient’s overall health. 

It is essential to discuss these options with your healthcare team to determine the most suitable treatment plan for your situation.

Surgery and Mastectomy

Surgery is often the first step in treating male breast cancer. 

The most common surgical procedure is a mastectomy, in which the entire breast and sometimes the lymph nodes in the armpit are removed. 

In some cases, a less invasive surgery called lumpectomy or breast-conserving surgery may be an option, where only the tumor and a small amount of surrounding tissue are removed.

Radiation Therapy and Chemotherapy

Radiation therapy is used to destroy cancer cells that might remain after surgery.

It may also be implemented before surgery to reduce the size of a large tumor.

Chemotherapy uses drugs to kill cancer cells throughout the body. It can be administered before surgery to shrink the tumor or after surgery to decrease the risk of cancer recurrence. 

Chemotherapy may be recommended for patients with advanced breast cancer that has spread to other parts of the body.

Hormonal Therapy and Targeted Therapy

Hormonal therapy is utilized for males with hormone-influenced breast cancers.

Most male breast cancers are hormone receptor-positive, which means they have proteins that bind to hormones like estrogen and promote cancer growth. 

Common hormonal medications are known to block estrogen from binding to cancer cells. Exercise caution and provide your healthcare provider with feedback regarding the adverse effects of taking this hormonal treatment.

Aromatase inhibitors are another class of hormone therapy drugs. They work by reducing the amount of estrogen produced in the body, which can help shrink hormone-sensitive tumors. 

Targeted therapy drugs are designed to interfere with specific molecules involved in cancer cell growth. These drugs can target cancer cells with specific genetic mutations or proteins, such as HER2-positive male breast cancer. 

For these patients, targeted therapy may be recommended in combination with other treatments.

Prevention and Management

Although uncommon, it is essential to be aware of the risk factors associated with Male Breast Cancer and understand how to prevent and manage this disease.

Regular Check-up and Screening 

A substantial risk factor for male breast cancer is a family history of breast cancer. If you have a close relative with the disease, your risk may be higher. 

It is essential to share this information with your healthcare provider, who can help you in understanding and managing your risk.

Balanced Diet and Weight

Maintaining a healthy weight and eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help reduce the risk of breast cancer. 

Excess fat in the body can lead to higher levels of estrogen, which increases the risk of developing tumors in the breast tissue. Engaging in regular physical activity can aid in maintaining a healthy weight and keeping the risk low.

Self-Check and Awareness

It is also crucial to be familiar with your breast tissue and any changes occurring. Be on the lookout for symptoms such as a lump, discharge, pulling in of the nipple, or pain in the nipple area. 

Prognosis and Outlook

Understanding these areas can help frame expectations and offer a patient emotional support. 

Survival Rates

Survival rates for male breast cancer depend on the stage of the disease at diagnosis and other individual factors. The 5-year survival rates of men with breast cancer are heavily dependent on factors such as type, the stage of cancer upon detection, and undergoing treatment. 

US statistics show that survival rates five years after being detected are around 95% if the cancer is localized; approximately 84% if spread regionally; and about 20% if the cancer has metastasized to distant parts of the body. 

The combined average indicates around 83% will survive for five years post-diagnosis compared to the overall population. 

It is important to remember that these are only statistical averages. Every individual case is different.

Early Stage

The outlook for early-stage male breast cancer is generally favorable. Some factors that can influence the prognosis include the tumor size, the extent of lymph node involvement, and the presence of certain genetic mutations. 

In stages I and II of male breast cancer, surgical treatment can be very effective and lead to a high survival rate, especially when combined with appropriate adjuvant therapies, such as radiation, chemotherapy, and hormonal therapy.

Metastatic Breast Cancer

When male breast cancer reaches the metastatic stage, it becomes more challenging to treat due to the dispersion of cancerous cells to other parts of the body. However, targeted treatments may help control the disease and prolong life expectancy

The prognosis for metastatic breast cancer varies considerably depending on the patient. Although metastatic cancer is rarely curable, ongoing advancements in treatment options continue to improve survival rates and quality of life for affected individuals.

Frequently Asked Questions

What are the common symptoms of male breast cancer?

Some common symptoms of male breast cancer include a painless lump or thickening in the breast tissue.

Changes to the skin covering the breast (such as dimpling, puckering, redness, or scaling) and alterations to the nipple (e.g., redness or scaling, or an inward-turning nipple) should be a sign to seek medical attention and diagnose the condition.

What causes male breast cancer?

While the exact causes of male breast cancer remain unclear, several factors can increase the risk. 

Aging – most cases are found after age 50 – and genetic mutations have been found to contribute to the development of this type of cancer.

How is male breast cancer diagnosed?

To diagnose male breast cancer, healthcare professionals may employ imaging tests like bone scans, computerized tomography (CT) scans, and positron emission tomography (PET) scans.

Further tests or biopsies may also be conducted to confirm the diagnosis.

What are the treatment options for male breast cancer?

Treatment options for male breast cancer include surgery (e.g. mastectomies or lumpectomies), radiation therapy, chemotherapy, hormone therapy, and targeted therapy. 

The suitable treatment plan would depend on the overall health of the patient and the stage and type of cancer.

What are the survival rates for male breast cancer?

Survival rates for male breast cancer depend on the stage at diagnosis and the individual’s response to treatment. Generally, when diagnosed at early stages, the prognosis is favorable. 

However, it is important to note that survival rates are only estimates and should not be used to predict individual outcomes.