Male Breast Cancer: Less Common Than For Women, But Still Serious

Lifetime risk is about 1 in 1,000

Male Breast Cancer: Less Common Than For Women, But Still Serious

Contributor: Jame Abraham, MD

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It’s not unusual for a patient to ask if men can get breast cancer, and the answer to the question is yes. In 2017, about 2,470 new cases of invasive breast cancer will be diagnosed, and about 460 men will die from breast cancer, according to the American Cancer Society.

But breast cancer is about 100 times less common among men than among women. For men, the lifetime risk of getting breast cancer is about 1 in 1,000. The number of breast cancer cases in males relative to the population has been fairly stable over the last 30 years.

The most common symptoms of male breast cancer are:

  • A lump or swelling that is usually, but not always, painless
  • Skin dimpling or puckering
  • Nipple retraction
  • Redness or scaling of the nipple or breast skin
  • Discharge from the nipple

Risk factors

There are myriad risk factors that increase the odds of a man developing breast cancer, but many men will develop the disease without experiencing any of these. Many risk factors are similar for men and women, including age, family history and genetic mutations.

One risk factor that increases the risk of breast cancer for both men and women is aging. In general, the risk of breast cancer goes up as a man ages, with an average age of diagnosis of 68.

Family history is important, too, as breast cancer risk is higher if other members of the family have had the disease. About 20 percent of men with breast cancer have a family history of it.

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Genetic mutations, such as the BRCA2 gene, increase the risk of breast cancer for anyone, with a lifetime risk of 6 in 100. BRCA1 mutations, in particular, can increase the risk for breast cancer in men; the risk is about 1 in 100. Other important mutations are the CHEK2 and PTEN genes, which may be responsible for some breast cancers in men.

There’s a congenital condition called Klinefelter syndrome that affects 1 in 1,000 men. In normal men, the cells have a single X chromosome with a Y chromosome, while women’s cells have two X chromosomes. Men with Klinfelter syndrome have cells with a Y chromosome, plus at least two X chromosomes. These men also have smaller-than-usual testicles, and they’re often infertile because they’re unable to produce functioning sperm cells. Compared with other men, they have lower levels of the male hormone androgen and more of the famale hormone estrogen. For this reason, they often develop swelling of the breast tissue, called gynecomastia. Some studies have shown that among men with this syndrome, the risk of getting breast cancer was about 1 percent, or 1 in 100.

Having been exposed to radiation in the past is also a risk factor for breast cancer in men. A man who had radiation to the chest for lymphoma or any other conditions has an increased risk of developing breast cancer.

Heavy alcohol consumption and liver disease increase the risk of breast cancer in men. Other risk factors include estrogen therapy or other hormonal therapy for prostate cancer, obesity, testicular condition such as undescended testis and some occupations, such as steel mill workers.

Managing male breast cancer

In general, the way male breast cancer is managed is similar to tactics used with female breast cancer. The disease could be diagnosed via a clinical examination, mammogram or ultrasound and, if an abnormality is found, the man will be considered for a biopsy of the lesion.

Definite treatment will include surgery that may include removal of the breast, lump and lymph node surgery, and possibly chemotherapy and anti-estrogen therapy.

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Overall prognosis depends upon the stage and other features of breast cancer.

Male breast cancer survivors face many challenges, since it’s a rare condition. Most of the data related to male breast cancer is derived from female breast cancer. We have only very limited data about specific treatment, prognosis and outcome of male breast cancer.

It’s important for men with breast cancer to take care of themselves. This includes being compliant with their cancer treatment and having appropriate follow up.

Adopting a healthy lifestyle that includes eating healthy, exercising and avoiding tobacco and alcohol is imperative. It’s a good idea to look for clinical trials; unfortunately, however, many breast cancer trials exclude men. My hope for patients is that this will change in the future.

This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.

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