An Overview of Breast Cancer in Males

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While it is rare, men can develop breast cancer. In the United States, approximately 2,700 men develop breast cancer each year, and it is estimated that 1 out of every 1,000 get the disease sometime in their lifetime. In comparison, about 1 in 8 people assigned female at birth develop breast cancer.

Outcomes of breast cancer treatment vary depending on the stage (how much cancer there is and how far it has spread), grade (aggressiveness of the tumor), tumor type (which area of breast tissue it originated in), receptor status (which is critical for treatment), and a person's overall health. 

Invasive ductal carcinoma (IDC) is the most common male breast cancer. IDC originates in the duct and breaks into, or invades, the surrounding fatty tissue.

People assigned male at birth do not usually have benign (noncancerous) breast lumps. It’s best to notify your healthcare provider if you find a lump, have discomfort, or notice changes in the appearance of the breast. 

This article provides an overview of symptoms, causes, diagnosis, treatment, and outlook of male breast cancer. It also provides information about coping with the disease.

male v. female breast composition
Verywell / Jessica Olah

Symptoms

Breast cancer typically does not cause signs or symptoms until it reaches a relatively advanced stage. In people assigned male at birth, pain or discomfort or changes in the appearance of the breast and surrounding areas may be the first indication of breast cancer.

Signs and symptoms of breast cancer in this population include:

  • Pain or tenderness in the breast or nipple
  • A lump in the breast
  • A lump in the lymph nodes (underneath the armpit)
  • Lymph node tenderness
  • Dimpling or thickening of the skin of the breast
  • A sore on the nipple or breast
  • Nipple discharge
  • Change in nipple appearance
  • Discoloration of nipple

Because breast cancer might not be on your mind, you may think the changes you are experiencing are from a pulled muscle or a small injury. It is important not to ignore these problems. Report any breast lumps to your healthcare provider since benign lumps are not uncommon in women, but are rare in men.

Keep in mind that even if breast cancer is not the cause of your symptoms, whatever is causing them may worsen without treatment.

Causes

There are a few conditions that are associated with breast cancer in those assigned male at birth, but males can develop the disease even without having any predisposing factors. The condition increases with advancing age, and the most common age of breast cancer diagnosis in this population is around 71.

The following are known risk factors for male breast cancer.

Family History and Genetics

Those who have close family members (regardless of gender) with breast cancer are at increased risk of developing the condition. Inheriting the breast cancer variants of the BRCA1 or BRCA2 gene increases the chance of developing breast cancer.

Variants in the CHEK2, PTEN, and PALB2 genes (non-BRCA mutations that raise breast cancer risk) may also be associated with male breast cancer.

It's estimated that roughly 20% of those assigned male at birth who develop breast cancer have an identifiable genetic risk factor, with BRCA2 mutations being the most common. Genetic testing for those diagnosed with breast cancer can be helpful for several reasons:

  • To guide therapy with metastatic breast cancer (some treatments are only effective for people who have BRCA mutations)
  • To screen for other types of cancer (for example, BRCA2 mutations are also associated with an increased risk of prostate cancer, pancreatic cancer, etc.)
  • To alert family members about their own potential risk for cancer

Klinefelter's Syndrome

Klinefelter's syndrome is a rare genetic problem that is associated with a 20%–30% increased risk in male breast cancer. This syndrome occurs when someone assigned male at birth is born with an extra X chromosome, resulting in 47 chromosomes instead of 46. It is often represented as "47,XXY."

Because they have a Y chromosome, children with this syndrome develop stereotypical male characteristics and genitals. But the extra X chromosome associated with Klinefelter's syndrome often causes smaller testicles and enlarged breasts, with the possibility of impaired fertility.

History of Cancer Treatment

Radiation therapy and chemotherapy are associated with an increased risk of cancer. Radiation and chemotherapeutic medications are used to destroy cancer cells, but they can also cause alterations in normal cells, increasing the risk of disease and cancer.

While uncommon, there is a slight increase in secondary cancer among survivors who were treated for cancer.

Radiation therapy to the chest, such as in treatment for lymphoma, for example, is more likely to be associated with breast cancer than radiation to other areas of the body, such as the brain or abdomen.

Cancer treatment that alters hormone levels, such as androgen deprivation therapy for prostate cancer and orchiectomy for testicular cancer, is also associated with an increased risk of breast cancer in those assigned male at birth.

Hormone Imbalance

Hormone imbalance, whether caused by disease or medication use, can increase the risk of breast cancer in those assigned male at birth. Often, hormonal therapy is necessary for the treatment of illness or to improve a person's quality of life.

Keep in mind that transgender women and transfeminine people who use estrogen therapy have an increased risk of breast cancer compared to cisgender men, and that risk is estimated to be about the same as those assigned female at birth. If you are a transgender woman or transfeminine person, be sure to discuss screening mammograms with a doctor.

Lifestyle Risk Factors

Smoking is one of the leading causes of breast cancer. Heavy alcohol use also is associated with breast cancer, possibly, in part, because alcohol can increase estrogen levels.

Excessive weight is another risk factor as well, as it alters hormone levels in the body, increasing the production of hormones that promote breast cancer initiation and growth.

Breast Size and Your Risk

Gynecomastia, the enlargement of male breasts, is a common condition that affects approximately 70% of adolescents assigned male at birth. It resolves about 45% of the time in those cases. However, 25% have gynecomastia that lasts into adulthood.

Medications, being overweight, and liver disease can cause gynecomastia in adults assigned male at birth. Gynecomastia is not thought to increase risk of breast cancer, but you should discuss it with a healthcare provider, as there may be a medical cause behind it.

Diagnosis

While those assigned female at birth who are over 40 are advised to get screening mammograms, people assigned male at birth are not generally advised to have this test because it is low yield for people who have a low risk of breast cancer.

That said, if you have a strong family history of breast cancer, then you may need genetic testing and periodic screening tests to identify breast cancer.

The diagnosis of breast cancer in cisgender men is usually initiated after symptoms develop. In these cases, a mammogram may be used for diagnostic purposes. A healthcare provider may also order a breast magnetic resonance imaging (MRI) scan and a biopsy (removing a sample tissue for testing in a lab) to identify the tumor, and determine its stage, grade, and type.

You may also need to have imaging and/or a biopsy of nearby lymph nodes so your medical team can check whether the tumor has spread.

Breast Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Treatment

The treatment of breast cancer is similar across the gender spectrum in some ways, but different in others. Treatments are broken down into two broad categories: local and systemic.

Local Treatments

Local treatments treat cancer at the sight at which it originates (or locally treat isolated metastases, which is cancer that has spread to other areas of the body). These include surgery and radiation.

  • Surgery is almost always part of the breast cancer treatment plan, but other options may also be considered on a case-by-case basis.
  • Radiation therapy is used to prevent the recurrence of a breast cancer tumor after removal. As with chemotherapy (using medications to kill cancer), the need for radiation is estimated based on tumor characteristics and gene testing.

Systemic Treatments

Systemic (throughout the body) treatments address cancer cells wherever they happen to be in the body and include hormone therapy, targeted therapies, chemotherapy, and immunotherapy.

  • Hormonal treatment is the most common treatment as most breast cancers in those assigned male at birth are estrogen receptor-positive. It is typically prescribed after primary treatment (surgery or chemotherapy) or with metastatic breast cancer. The treatment of choice for assigned males is tamoxifen, usually given for five years. Treatment may continue for five additional years in high-risk cases. Options also include aromatase inhibitors plus ovarian suppression therapy, Faslodex (fulvestrant), Megace (megestrol), Lupron (leuprolide), and Zoladex (goserelin).
  • Chemotherapy can treat early-stage breast cancer before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy) to lower the risk of recurrence. Chemotherapy may be recommended if the risk of recurrence is significant based on the tumor size, lymph nodes' involvement, and gene expression profile testing (Oncotype DX).
  • Targeted therapy uses medications designed to hone in on specific characteristics of cancer cells or defective cancer genes. The treatment corresponds with molecular markers of individual cancer (identified with a biopsy), and guidelines for using these medications are the same as in women. Examples include targeted therapy for HER2, PIK3CA mutations, and hereditary BRCA mutations.
  • Immunotherapy involves medications designed to help the immune system fight cancer and is only approved for triple-negative breast cancer (tumors that are estrogen receptor-negative), and so is rarely used in males.

Bone modifying agents, often used for those who are postmenopausal with early-stage breast cancer, are not routinely recommended for males with the disease but may be given when necessary to prevent or treat osteoporosis.

Complications

Sometimes, breast cancer treatment can put you at a higher risk of infection. It can also make you tired or interfere with your ability to concentrate. While you are undergoing treatment, you may have some limitations (such as avoiding people who could have a contagious infection) or complications (such as feeling fatigue).

These effects should go away after your treatment is complete, but it may take months or even a year for the side effects of your treatment to wear off.

Follow-Up and Recurrence

Risk of recurrence of breast cancer, which can occur up to 15 years (and beyond) the initial diagnosis, persists for all breast cancer survivors. While late recurrences (recurrences five or more years after diagnosis) have not been studied in assigned males as they have been in assigned females, assigned females who have estrogen-receptor-positive tumors are actually more likely to have the cancer return after five years.

Potential symptoms of recurrence in assigned males include new lumps, bone pain, shortness of breath, chest pain, abdominal pain, and persistent headaches.

Follow-up differs across sex in a few ways. Assigned males who undergo a lumpectomy should have an annual mammogram of the involved breast. This is in contrast to breast MRIs recommended for assigned females.

Also, unlike assigned females, the risk that assigned males will develop breast cancer in their noninvolved breast is very low, and screening mammograms on the noninvolved breast are not recommended unless a hereditary mutation has been identified.

Outlook

The overall five-year survival rate is 80%–84%, However, the 5-year survival rate for men with breast cancer differs substantially based on how far the cancer has spread. The following are 5-year survival rates based on where cancer has spread:

  • Localized cancer has not spread outside of the breast. The survival rate is 95%–98%.
  • Regional cancer spreads outside the breast to nearby structures or lymph nodes. The five-year survival rate is 83%.
  • Distant cancer has spread to distant parts of the body, such as the lungs or brain. The five-year survival rate ranges from 19%–26%. 

About 47% of all cases are found and diagnosed at the localized stage.

Coping

Learning about the disease, getting timely treatment, and dealing with pain can make you feel more in control. But it is important that you also address your emotional responses to your diagnosis. You may feel anger, a sense of hopelessness, anxiousness, or a combination of these and other emotions. It's not uncommon to also feel depressed or even alone, as you may not know anyone who has ever been in your shoes.

The most important thing is that you acknowledge your feelings and that you become comfortable seeking and asking for help.

Think about doing the following:

  • Consider joining a breast cancer support group: While it's worth looking for one for assigned males in your community, it's possible that you might not find one. Though breast cancer support groups are often geared toward assigned females and issues that they face, you may still find benefit in participating in one even if you are one of a few assigned males (or the only one).
  • Lean on family and friends: You can choose to open up to one trusted person with whom you feel comfortable talking.
  • Seek the help of a therapist: If your feelings are overwhelming or are impacting your day-to-day life, therapy can be helpful.

Summary

While breast cancer in those assigned male at birth is rare, it does occur. Initial symptoms may include pain or a lump in the breast. Prevalence can depend on family history, genetics, Klinefelter’s syndrome, a history of cancer treatment, hormone imbalances, and lifestyle risk factors such as smoking. 

Diagnostic testing includes mammograms, magnetic resonance imaging (MRI), and biopsy. Treatment and based on the stage, grade, and type of cancer and may include surgery, radiation, and medications. Survival rates vary based on how much cancer there is and how far it spreads, the aggressiveness of the tumor, tumor type, and a person's overall health.

A Word From Verywell

Receiving a diagnosis of breast cancer can cause many emotions, including fear, anger, and anxiety. The shock of the diagnosis can be jarring for anyone. It may feel even more shocking for those assigned male at birth because it’s so rare. 

People assigned male at birth do not typically have benign breast lumps. It’s best to notify your healthcare provider if you find a lump, have discomfort, or notice changes in the appearance of the breast. 

Learning about the disease and seeking early treatment are great first steps when taking control of your health. For those who have not been diagnosed but have risk factors, talk with your healthcare provider about periodic screening tests.

Frequently Asked Questions

  • Is it normal for a male to have a lump in his breast?

    People assigned male at birth do not typically have benign breast lumps. It’s best to notify your healthcare provider if you find a lump, discomfort, or changes in the appearance of the breast. 

  • Is male breast cancer fast-growing?

    In general, no. The most common type of breast cancer in those assigned male at birth is invasive ductal carcinoma (IDC). About 47% of male breast cancers are found and diagnosed at a localized stage which means it has not spread yet. IDC it is not considered a fast-growing cancer as inflammatory breast cancer is.

  • What types of breast cancer do males get?

    Invasive ductal carcinoma (IDC) is the most common male breast cancer. The majority are hormone receptor positive.

24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yalaza M, İnan A, Bozer M. Male breast cancer. J Breast Health. 2016;12(1):1-8. doi: 10.5152/tjbh.2015.2711

  2. Siegel R, Miller K, Fuchs H, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. doi: 10.3322/caac.21708

  3. Patten D, Sharifi L, Fazel M. New approaches in the management of male breast cancer. Clin Breast Cancer. 2013;13(5):309-14. doi: 10.1016/j.clbc.2013.04.003

  4. Uslukaya Ö, Gümüş M, Gümüş H, Bozdağ Z, Türkoğlu A. The management and outcomes of male breast cancer. J Breast Health. 2016;12(4):165-170. doi: 10.5152/tjbh.2016.3073

  5. Salemis N. Benign cyst of the male breast. An exceedingly rare entity that may pose a diagnostic dilemma. Management and literature review. Breast Dis. 2021;40(3):207-211. doi: 10.3233/BD-201064

  6. Frey JD, Salibian AA, Schnabel FR, Choi M, Karp NS. Non-BRCA1/2 breast cancer susceptibility genes: A new frontier with clinical consequences for plastic surgeons. Plast Reconstr Surg Glob Open. 2017;5(11):e1564. doi:10.1097/GOX.0000000000001564

  7. Hassett MJ, Somerfield MR, Baker ER, et al. Management of male breast cancer: ASCO guideline. J Clin Oncol. 2020;38(16):1849-1863. doi:10.1200/JCO.19.03120

  8. Brinton LA. Breast cancer risk among patients with Klinefelter syndromeActa Paediatr. 2011;100(6):814–818. doi:10.1111/j.1651-2227.2010.02131.x

  9. Moskowitz C, Chou J, Wolden S, et al. Breast cancer after chest radiation therapy for childhood cancer. J Clin Oncol. 2014;32(21):2217-2223. doi:10.1200/JCO.2013.54.4601

  10. Ferzoco RM, Ruddy KJ. The epidemiology of male breast cancer. Curr Oncol Rep. 2016;18(1):1. doi:10.1007/s11912-015-0487-4

  11. De blok CJM, Wiepjes CM, Nota NM, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ. 2019;365:l1652. doi:10.1136/bmj.l1652 

  12. Fentiman IS. The endocrinology of male breast cancer. Endocr Relat Cancer. 2018;25(6):R365-R373. doi:10.1530/ERC-18-0117

  13. Breastcancer.org.Drinking Alcohol.

  14. Ooi B, Loh H, Ho P, et al. The genetic interplay between body mass index, breast size and breast cancer risk: A mendelian randomization analysisInt J Epidemiol. 2019;48(3):781-794. doi: 10.1093/ije/dyz124

  15. UpToDate. Patient education: Gynecomastia (breast enlargement in men) (beyond the basics).

  16. American Cancer Society. Tests for breast cancer in men.

  17. American Cancer Society. Treatment of breast cancer in men, by stage.

  18. American Cancer Society. Hormone therapy for breast cancer in men.

  19. Centers for Disease Control and Prevention. Side effects of cancer treatment.

  20. Pan H, Gray R, Braybrooke J, et al. 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. N Engl J Med. 2017;377(19):1836-1846. doi:10.1056/NEJMoa1701830

  21. American Cancer Society. Breast cancer survival rates in men.

  22. American Society of Clinical Oncology. Breast cancer in men: Statistics.

  23. Ellington T, Henley S, Wilson R, Miller J. Breast cancer survival among males by race, ethnicity, age, geographic region, and stage - United States, 2007-2016. MMWR Morb Mortal Wkly Rep. 2020;69(41):1481-1484. doi: 10.15585/mmwr.mm6941a2

  24. American Society of Clinical Oncology. Breast cancer - Metastatic: introduction.

By Brandi Jones, MSN-ED RN-BC
Brandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.

Originally written by Lisa Fayed