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Can men get breast cancer?

While breast cancer primarily affects women, thousands of men are diagnosed with the disease in the United States each year.

At the time of diagnosis, the average age for a male breast cancer patient is 67, versus age 62 for females. The five-year survival rate for male breast cancer is slightly lower than for female breast cancer. There are a number of different reasons for the lower survival rate. One is patient age, and the health challenges that come with it.

In addition, male breast cancer is typically more advanced when it is diagnosed. The tumor tends to be larger and the cancer is more likely to have spread to regional lymph nodes. Doctors attribute these later diagnoses to a general lack of awareness of male breast cancer, as well as the absence of widespread screening for the disease.

Types of male breast cancer

Like female breast cancer, male breast cancer can be classified by the molecular receptor status of the cancer cells.

Receptors are molecules that cancer cells produce on their surface. They can bond with, or recognize, specific proteins and hormones in the patient¡¯s body. Researchers have identified receptors that fuel the growth of breast cancer cells when they bond with a specific protein or hormone. Interrupting this bond with cancer drugs can slow or stop the disease¡¯s growth.

The three main receptor types for breast cancer (in both men and women) are:

• HER2-positive, a protein that promotes cell growth and multiplication. HER2-positive cancers have much higher levels of the HER2 protein than normal.
• Hormone receptor-positive, which recognizes the hormones estrogen and progesterone.
• Triple-negative, which doesn¡¯t recognize HER2, estrogen or progesterone. Because there is no molecular receptor to interrupt, this is the most difficult breast cancer subtype to treat.

About 90% of breast cancers in men are hormone receptor-positive, while another 9% are both hormone receptor-positive and HER2-positive.

Risk factors

Anything that increases the chance of a person developing cancer is a risk factor. Doctors have identified several risk factors for male breast cancer.

• BRCA mutations: Normal BRCA1 and BRCA2 genes suppress the development of tumors. People with a mutated BRCA gene have a higher risk of breast cancer. Between 8%-15% of male breast cancer patients have a BRCA mutation, compared to 5%-10% of female breast cancer patients. In addition to causing breast cancer, BRCA mutations are also linked to ovarian cancer, pancreatic cancer and melanoma.
• Family history of breast cancer: The risk of breast cancer is doubled for men who have a parent, sibling or child with the disease.
• Age: As men age, their chances of developing breast cancer increases.
• Obesity
• Gynecomastia, or enlarged breasts caused by a hormone imbalance or certain medications
• Radiation exposure, often as part of treatment for another cancer
• Race: African-American men have a higher risk of male breast cancer than non-Hispanic white men.

Symptoms

The symptoms of male breast cancer are very similar to symptoms of breast cancer in women. They include: 

• Lump or mass in the breast
• Lump or mass in the armpit
• Breast skin changes, including skin redness and thickening of the breast skin, resulting in an orange-peel texture
• Dimpling or puckering on the breast
• Discharge from the nipple
• Scaliness on nipple, which sometimes extends to the areola
• Nipple changes, including the nipple turning inward, pulling to one side or changing direction
• An ulcer on the breast or nipple, sometimes extending to the areola
• Swelling of the breast

Diagnosis

The first diagnostic procedure for male breast cancer is typically an imaging exam. Breast imaging is usually carried out with a mammogram or ultrasound. Occasionally, doctors will use magnetic resonance imaging (MRI) or other specialized examinations. Learn more about imaging exams.

Biopsy

If the imaging exam shows an unusual or suspicious mass or skin thickening, doctors will need a tissue sample to make a definitive diagnosis. The process of retrieving and examining this tissue under a microscope is called a biopsy.

For breast cancer, patients usually undergo an image-guided core needle biopsy. During this procedure, a live image of the breast tissue is used help doctors guide the needle to the suspected cancer tissue. In many cases, this biopsy is performed during the initial imaging exam in order to speed up the diagnosis.

If the biopsy reveals cancerous tissue, additional images and biopsies may be needed to determine the exact scope of the disease. This part of the diagnosis shows whether the cancer has spread to nearby lymph nodes or other parts of the body.

Molecular diagnosis

If the patient is diagnosed with breast cancer, doctors will also analyze the cancer cells to determine the disease¡¯s molecular receptor subtype. By understanding the subtype, they can develop a comprehensive, personalized treatment plan.

Treatment

Treatment for male breast cancer is similar to treatment for female breast cancer, but some parts may be different because men have less breast tissue. This can affect surgical options and how the cancer spreads. Treatment depends on the cancer type, stage, hormone receptor status and the patient¡¯s overall health.

The main treatments include surgery, chemotherapy, radiation therapy and targeted therapy. While the common side effects of these treatments may vary from person to person, most are manageable with support and care.

Surgery

Surgery is often the first treatment for male breast cancer. It involves removing the tumor(s) in the breast. Doctors also remove lymph nodes to check if the cancer has spread, which is used to stage the cancer (staging). The two main types of breast surgery are mastectomy and lumpectomy.

• Mastectomy
  A mastectomy is the removal of the entire breast, including the nipple and areola. In some cases, axillary lymph nodes may also be removed to check if the cancer has spread beyond the breast.
• Lumpectomy
  A lumpectomy removes only the tumor and a small amount of surrounding healthy tissue. This treatment may be an option for men with small tumors relative to the rest of the breast. Radiation is typically offered after a lumpectomy to lower the risk of the cancer coming back.

Because some men have very little breast tissue, a full mastectomy might be recommended instead of a lumpectomy. However, if the tumor is small compared to the breast, breast-conserving surgery may still be possible, as long as the tumor can be completely removed with clear margins (meaning no cancer cells are found at the edge of the removed tissue) and the breast can look acceptable after surgery.

Axillary surgery

Axillary surgery focuses on checking or removing the lymph nodes in the armpit during breast surgery to see if the breast cancer has spread. There are two main types of axillary surgery:

• Sentinel lymph node biopsy: Using a special dye or radioactive tracer, a surgeon locates the first lymph node (the sentinel node) that would likely contain cancer if it has spread. The node is removed and sent to a lab to see if cancer is present. This helps accurately stage the cancer and plan treatment
• Axillary lymph node dissection: An axillary lymph node dissection may be done if the lymph nodes are found to contain cancer. This involves removing several lymph nodes from under the arm to help prevent the cancer from spreading.

Surgery side effects

• Pain or swelling in the chest
• Scarring and possible loss of chest shape
• Numbness or tingling from nerve damage
• Lymphedema (arm swelling) if lymph nodes are removed

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Patients can receive chemotherapy as pills, injections, or intravenously (IV). If chemotherapy is given intravenously, sessions usually last 30 minutes to several hours, depending on the specific drug or drug combination.

Most chemotherapy treatments for male breast cancer are delivered in cycles¡ªcommonly once every one to three weeks for three to six months. The exact schedule depends on the drug regimen prescribed and the patient¡¯s overall health.

• Neoadjuvant chemotherapy (before surgery) is sometimes used to shrink larger tumors so they¡¯re easier to remove and helps reduce the risk of the cancer coming back.
• Adjuvant chemotherapy (after surgery) helps reduce the risk of the cancer coming back.

Chemotherapy for male breast cancer is especially recommended if:

• The tumor is large or aggressive
• Cancer has spread to the lymph nodes
• The cancer is HER2-positive or triple-negative
• The patient is younger or otherwise healthy enough to tolerate it

Chemotherapy side effects

• Fatigue
• Hair loss
• Nausea or vomiting
• Increased risk of infection
• Mouth sores
• Temporary or long-term fertility issues

Learn more about chemotherapy and chemotherapy side effects.

Radiation therapy

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.

Radiation therapy can be a standalone treatment or offered in combination with other therapies. It can be used to shrink tumors before surgery or chemotherapy. It can also be used to destroy any cancer cells that might remain after other treatments, especially if:

• The cancer was large
• It was close to the chest wall or skin
• Lymph nodes were involved
• The surgical margins were not clear (cancer cells were found near the edges)
• The tumor was removed with a lumpectomy

Men who have a mastectomy may still need radiation if their cancer was advanced or involved multiple lymph nodes.

Radiation therapy side effects

• Skin redness or peeling in the treatment area
• Fatigue
• Chest wall discomfort
• Rarely, long-term risk of damage to nearby organs (like lungs or heart)

Learn more about radiation therapy

Targeted therapy

Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.

Patients can receive targeted therapy as pills, injections, or intravenously (IV). If targeted therapy is given intravenously, sessions usually last 30 minutes to several hours, depending on the specific drug.

Most targeted therapy treatments for male breast cancer are given on a regular schedule¡ªoften once every one to three weeks, for several months. The exact timing and length of treatment depend on the specific medication and the patient¡¯s overall treatment plan.

Targeted therapies may be used:

• Alongside chemotherapy
• After surgery to reduce recurrence
• If cancer has spread (metastatic disease)

Newer targeted drugs may be considered depending on genetic testing or advanced cancer type.

Targeted therapy side effects

• Fever or chills
• Heart problems (especially with HER2 drugs like trastuzumab)
• Diarrhea
• Skin rashes

Learn more about targeted therapy and targeted therapy side effects.

Hormone therapy

According to the National Institutes of Health, about 90% of male breast cancers are hormone receptor-positive, which means they grow in response to hormones like estrogen.

Hormone therapy works by interfering with the hormones that certain cancers need to grow. These treatments either block hormones from attaching to cancer cells or lower the amount of hormones the body makes. Common approaches include medications that block estrogen or prevent its production. In many cases, hormone therapy is prescribed as a long-term treatment, often for five to 10 years after initial cancer therapy, to reduce the risk of recurrence.

Hormone therapy side effects:

• Hot flashes
• Weight gain
• Leg cramps
• Low sex drive or erectile dysfunction
• Mood swings or depression
• Blood clots (rare but serious)

Immunotherapy

The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system¡¯s ability to eliminate cancer.

Some male patients may be diagnosed with triple-negative breast cancer, which is rare but possible in men. In these cases, immunotherapy may be used. This treatment works by stimulating the immune system to better detect and destroy cancer cells, and it is often combined with chemotherapy for more effective results.

Immunotherapy side effects

• Fatigue
• Skin problems such as rashes, itching and dryness
• Fever and chills
• Nausea
• Diarrhea

Learn more about immunotherapy

Survivorship care for men with breast cancer

After treatment, it¡¯s important to continue care to stay healthy and watch for signs that the cancer has come back. Male breast cancer survivors should:

Get regular checkups

• Physical exams and blood tests
• Mammograms (for men with remaining breast tissue)
• Imaging tests, if needed

Monitor for recurrence

• Report any new lumps, chest pain, or swelling right away
• Track symptoms or side effects that don¡¯t go away

Manage long-term side effects

• Lymphedema care
• Sexual health support
• Mental health counseling, if needed

Maintain a healthy lifestyle

• Eat a balanced diet
• Exercise regularly
• Limit alcohol and avoid tobacco

Prepare for possible fertility and hormonal changes

• Some men may experience lower testosterone levels
• Ask your doctor about sperm banking or hormone testing before starting treatment if fertility is a concern

Learn more about cancer survivorship