Breast Cancer in Men

Disclaimer:
This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Breast Cancer in Men?

Breast cancer in men is a rare malignancy (<1% of all breast cancers, ~2,700 US cases annually in 2025) affecting breast tissue, primarily ducts, as men have minimal lobular tissue. It mirrors female breast cancer in types (ductal carcinoma, 85%; lobular, rare; DCIS; inflammatory) and molecular subtypes (ER/PR+, HER2+, triple-negative). Men are diagnosed at older ages (median 68) and often at later stages (II-III) due to lower awareness, leading to worse outcomes compared to stage-matched women.

Symptoms

Symptoms include a painless lump or thickening in the breast/chest, changes in breast size/shape, skin dimpling or puckering, nipple inversion, spontaneous nipple discharge (especially bloody), red/scaly/swollen skin on the breast/nipple/areola, and peau d’orange texture (in inflammatory cases). Advanced disease may cause axillary lymph node swelling, breast pain, bone pain (from metastases), fatigue, or weight loss. Symptoms are often mistaken for gynecomastia or infections, delaying diagnosis by 6-12 months.

Causes

Risk factors include older age (peak at 60-70), family history (20% of cases have first-degree relatives with breast cancer), BRCA2 mutations (5-10%, higher in Ashkenazi Jewish men), and conditions increasing estrogen (Klinefelter syndrome, liver disease, obesity, testicular disorders). Radiation exposure and alcohol use contribute minimally. In 2025, genomic profiling identifies BRCA1/2, PALB2, and CHEK2 mutations as key drivers, with hormonal imbalances (high estrogen/testosterone ratio) playing a significant role.

Diagnosis

Diagnosis mirrors female protocols: clinical breast exam, patient history, mammography (diagnostic, not screening, due to low incidence), ultrasound for mass characterization, and MRI for high-risk or staging. Biopsy (fine-needle, core, or surgical) confirms malignancy, with immunohistochemistry for ER/PR (positive in 90%), HER2, and Ki-67. Multigene assays (e.g., Oncotype DX) assess recurrence risk. Blood tests (CA 15-3) monitor advanced disease. In 2025, AI-enhanced imaging and liquid biopsies improve diagnostic sensitivity in men, though access remains limited.

Treatment

Treatment aligns with female breast cancer, adjusted for stage and subtype. Most men undergo mastectomy (due to limited breast tissue) with sentinel lymph node biopsy, as lumpectomy is less feasible. Adjuvant radiation is common for local control. Systemic therapies include chemotherapy (anthracyclines, taxanes for high-risk), hormone therapy (tamoxifen for ER/PR+, preferred due to efficacy), targeted therapy (trastuzumab for HER2+), and immunotherapy (pembrolizumab for TNBC). Advanced cases use ADCs (sacituzumab govitecan) and PARP inhibitors (olaparib for BRCA mutations). In 2025, rituximab + chemotherapy combinations (from the ETHAN study) improve HER2+ outcomes, and radiopharmaceuticals show promise in metastatic disease.

Future Outlook

In 2025, male breast cancer’s 5-year survival is approximately 85%, lower than women (90%) due to later diagnosis (30-40% present with stage III-IV). Early-stage survival approaches 95% with targeted therapies like CDK4/6 inhibitors and immunotherapy. Research focuses on increasing awareness, genomic screening for BRCA mutations, and adapting female-centric trials (e.g., ETHAN study) to men. By 2030, improved screening and novel therapies (e.g., mRNA vaccines, AI-driven diagnostics) could achieve 95% overall survival, with emphasis on early detection and male-specific clinical trials.

Sources

The information for breast cancer in men is sourced from the National Cancer Institute’s “Male Breast Cancer Treatment (PDQ®)” for comprehensive details on understanding, symptoms, causes, diagnosis, and treatment; OncologyTube’s “Male Breast Cancer Treatment: New Advances in 2025” for advancements and clinical insights; PMC’s “Male Breast Cancer: Evaluating the Current Landscape of Diagnosis and Treatment” for a comprehensive review of the disease landscape; YouTube’s “Male Breast Cancer Treatment: New Insights from ASBrS 2025” for updates from the American Society of Breast Surgeons; and Breast Cancer Research Foundation’s “Male Breast Cancer Statistics and Research” for statistics and research directions.