To many people, it may seem impossible that a man could develop breast cancer. But men do have a small amount of breast tissue that, in rare cases, can become malignant. So can men get breast cancer? The answer is yes.
Even though male breast cancer accounts for less than 1 percent of all breast carcinomas, men do need to be aware of the signs and symptoms and report them to their doctor promptly. A mix of many factors, such as low awareness in men and clinicians and lack of screening, mean that men are often diagnosed at later stages of the disease when prognosis is poorer. Here’s what you need to know.
The most common type of breast cancer in both men and women is invasive ductal carcinoma (IDC), which originates in the ducts that carry milk to the nipple and spreads to nearby tissues. (While men usually don’t lactate, there are some milk ducts present in their breast tissue.) About 98 percent of male breast cancers are IDC.
Men can also develop invasive lobular carcinoma, which begins in the glands that make breast milk. However, men have even fewer glands than milk ducts in their breast tissue, so it’s far less common in men than IDC. Other types of breast cancer that rarely affect men include inflammatory breast cancer and Paget’s disease of the nipple.
Men who have breast cancer may or may not experience signs of the disease. But symptoms of breast cancer in men are similar to those seen in female breast cancer:
Keep in mind that these issues do not always indicate breast cancer. For example, swelling of the breasts may be a benign condition such as gynecomastia (enlarged breasts in men), while a lump could be a noncancerous cyst or benign soft tissue tumor.
Male breast cancer and female breast cancer typically occurs later in life, though the average age of diagnosis in men (71) is higher than women (62). Men of any race or ethnicity can develop breast cancer, though it’s more common in white males. Unfortunately, many of the same racial disparities seen in women with breast cancer also exist in male breast cancer, with men of color having a longer time to treatment, less access to screening, and worse disease-related mortality than white men.
Several factors can increase a man’s risk of developing breast cancer, but increasing age is the most common. In fact, age is often the only identifiable risk factor in those diagnosed with the disease. Other factors include:
Family history: About 1 in 5 men with breast cancer have a close male or female relative with the disease.
Genetics: Men can carry gene mutations associated with a higher risk of breast cancer. That includes BRCA1 and BRCA2 mutations, though it is rare for men to be BCRA carriers. Men who do have a BRCA1 carrier mutation have a 4 percent higher risk of developing breast cancer, while those with a BCRA2 carrier mutation have a 6 percent higher risk. A man can also carry several other genetic mutations that can increase the likelihood of breast cancer, including PTEN, TP53, PALB2, and CHEK2.
Obesity: Obese men are at greater risk of breast cancer because they have more estrogen in their body than thinner men. This is because fat cells convert androgens (male hormones) into estrogens (female hormones). Nearly all men with breast cancer have estrogen receptor–positive breast cancer, meaning the cancer cells have a type of receptor that enables them to use estrogen to grow and spread.
Klinefelter syndrome: Men with this congenital disease are born with an extra X chromosome and have an increased risk of breast cancer anywhere from 20 to 60 times the risk of men in the general population. Those with Klinefelter syndrome, which affects 1 in 1,000 men, have lower levels of androgens and higher levels of estrogens. Symptoms of the disease, such as curved pinkies and flat feet, can be so mild that men may not know they have it. Researchers believe that up to 65 percent of people with Klinefelter syndrome are never diagnosed.
Liver disease: Lower estrogen levels and higher androgen levels are also seen in people with severe liver disease, such as cirrhosis. The liver helps balance levels of sex hormones in the body, which become uneven when the organ isn’t functioning properly.
Alcohol: Drinking heavily raises the risk of male breast cancer due to alcohol’s harmful effects on the liver.
Testicular conditions: A man may be more likely to develop breast cancer if he has testicular problems such as an undescended testicle or if one or both testicles have been removed.
Radiation exposure: The risk of breast cancer is higher in both men and women who have had radiation therapy for cancers in the chest, such as lymphoma. Men who undergo radiation to treat gynecomastia have a 7-fold risk of male breast cancer.
Male breast cancer patients have a 19 percent higher mortality rate than women and, unlike female breast cancer in women, survival rates for male breast cancer have not significantly improved in the last 30 years. This is due in part to delays in diagnosis of breast cancer, which are common: Forty percent of male breast cancers are stage 3 or 4 at the time of the initial diagnosis, when prognosis is poorer.
The overall five-year survival rate for men with breast cancer ranges from about 40 percent to 65 percent. Broken down by stage, survival rates are:
Stage 1: 75 to 100 percent
Stage 2: 50 to 80 percent
Stage 3: 30 to 60 percent
Stage 4: 20 to 30 percent
Traditionally, breast cancer research has focused primarily on women, partly because female breast cancer is far more common in women but also because men are not usually actively recruited to breast cancer clinical trials. This means that when men are diagnosed with breast cancer, they are treated similarly to women, but because of research, we know that their disease can be different.
BCRF seeks to change these trends by funding research focused on advancing our understanding of male breast cancer, how best to treat it, and more. The Foundation long funded the pioneering International Male Breast Cancer Program, which yielded several important studies on the underlying biology of male breast cancer. And today, BCRF is supporting the work of Dr. Jose Pablo Leone, who, which BCRF funding, launched one of the first clinical trials to test different treatment strategies in men. Learn more about his work on our podcast.
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