Breast cancer is usually thought of as a women’s disease, but men have breast tissue too—and they can get breast cancer. Globally, male breast cancer accounts for about 1–2% of all breast cancer cases, and its incidence appears to be slowly rising. In India, hospital‑based series report male cases forming around 0.5–1% of all breast cancers, with many men presenting late because they never imagined a breast lump could be cancer.​

This blog explains how common male breast cancer is, who is at risk, what symptoms to watch for, how it is treated, and why early detection is just as critical for men as it is for women.

Do Men Really Have Breast Tissue?

• Men have a small amount of breast tissue behind and around the nipple, made up of ducts, fat, and connective tissue.​
• Under normal male hormone levels, this tissue stays tiny, but it can still undergo benign changes (like gynecomastia) and, less commonly, malignant changes leading to breast cancer.

The most common male breast cancer type is invasive ductal carcinoma, similar to many female cases.​

How Common Is Male Breast Cancer?

Worldwide and in India:

• Global data estimate male breast cancer forms around 1–2% of all breast cancer diagnoses, with a yearly incidence increase of roughly 1% reported in some analyses.​
• Indian series from various centres report incidence ranges from about 0.4% to 4% of all breast cancers, with most clustering between 0.5–1%.​
• Median age at diagnosis is typically around 60–70 years, though Indian reports often show slightly younger averages, in the late 50s to early 60s.​

Because it is rare, awareness is low; as a result, many men delay seeking care for months, leading to advanced‑stage diagnosis and poorer outcomes.​

Risk Factors for Male Breast Cancer

Most cases occur sporadically, but several factors increase risk:​

• Age
  • Risk rises with age; most cases occur after 50–60 years.
• Family history and genetics
  • Having close relatives (male or female) with breast cancer, ovarian cancer, or certain BRCA1/BRCA2 mutations raises male risk.​
• Hormonal imbalances
  • Conditions that increase estrogen or decrease androgens—such as obesity, chronic liver disease, testicular damage, Klinefelter syndrome—are associated with higher risk.​
• Radiation exposure
  • Prior chest radiation (for lymphoma or other cancers) can increase later breast cancer risk.
• Lifestyle and occupational factors
  • Obesity, high ambient working temperatures, and some chemical exposures (e.g., exhaust fumes) have been reported as possible contributors.​

Not all men with these factors develop cancer; they simply represent higher‑than‑average risk.

Symptoms Men Should Never Ignore

Early signs of male breast cancer are often visible and palpable, but many men ignore them or assume they are due to fat or injury.​

Key warning signs:

• A painless lump or thickening beneath or near the nipple or in the central chest.
• Nipple changes:
  • Retraction (nipple pulling inward).
  • Redness, scaling, or ulceration.
  • Discharge from the nipple, especially if bloody.
• Skin changes over the breast:
  • Dimpling, puckering, or “orange peel” texture.
  • Persistent redness or ulceration.
• Swollen lymph nodes in the armpit or near the collarbone.

Gynecomastia (benign enlargement) usually feels like a rubbery, symmetrical thickening under both nipples; a hard, irregular, or unilateral lump should always prompt evaluation.

Why Is Male Breast Cancer Often Diagnosed Late?

Studies from India and abroad highlight persistent patterns:​

• Lack of awareness: Many men and families don’t realise men can get breast cancer, so they overlook or misinterpret lumps.
• Stigma and embarrassment: Cultural beliefs may make men reluctant to report “breast” issues.
• Misdiagnosis or delay: Lumps are sometimes misattributed to gynecomastia or lipomas without proper imaging or biopsy.

Reports from Indian centres show many men presenting with stage III or IV disease, larger tumours, and higher rates of lymph node involvement than typical female cohorts, contributing to lower survival rates.​

How Is Male Breast Cancer Diagnosed?

Evaluation closely parallels that in women:​

• Clinical examination – includes both breasts and lymph nodes.
• Imaging
  • Mammography and ultrasound of the male breast can distinguish solid masses from benign conditions.
• Biopsy
  • Core needle biopsy provides tissue for histology and receptor testing (ER, PR, HER2).

Most male breast cancers are hormone receptor‑positive (ER/PR+), which has treatment and prognostic implications.​

Staging investigations (chest imaging, liver and bone scans or PET‑CT) help determine spread and plan therapy.

Treatment Options for Male Breast Cancer

Treatment is similar to that for female breast cancer, tailored to stage and biology:​

• Surgery
  • Most men undergo modified radical mastectomy (removal of breast tissue and usually axillary lymph nodes), because male breasts are small and conserving surgery offers limited cosmetic benefit.​
  • Sentinel lymph node biopsy may be used in selected early‑stage cases.
• Radiation therapy
  • Applied post‑operatively when tumours are large, margins are close, or multiple lymph nodes are involved.
• Hormone (endocrine) therapy
  • Because a high proportion of male tumours are ER/PR+, tamoxifen is commonly used to reduce recurrence risk.​
  • Aromatase inhibitors and other endocrine regimens may be considered depending on case specifics.
• Chemotherapy
  • Recommended for higher‑stage disease, node positivity, high‑grade tumours, or specific molecular profiles.
• Targeted therapy
  • HER2‑positive male breast cancers may receive anti‑HER2 agents (e.g., trastuzumab) as in women.​

In Indian series, overall 5‑year survival in male breast cancer has been reported around 56–60%, but survival is significantly higher in early stages and hormone receptor‑positive disease.​

Early Detection and What Men Can Do

Men, especially those at higher risk, should:

• Know their chest:
  • Periodically feel the area around nipples and upper chest for new lumps or changes.
• Act quickly on changes:
  • Do not wait months hoping a lump will disappear—get it examined.
• Share family history:
  • Inform doctors if there is a strong family history of breast, ovarian, or prostate cancer; genetic counselling may be suggested.​
• Manage modifiable risks:
  • Maintain healthy weight, limit alcohol, manage liver health, and treat hormonal conditions.

For very high‑risk men (e.g., confirmed BRCA mutations), some guidelines consider periodic imaging or clinical breast exams, though population‑wide screening mammography is not routinely recommended for all men yet.​

FAQs

1) How can a man tell if a breast lump is cancer or just gynecomastia?
Gynecomastia usually presents as smooth, rubbery, often tender enlargement directly beneath both nipples, sometimes related to puberty, medications, or hormonal shifts. In contrast, male breast cancer more often appears as a firm, painless, unilateral lump or thickening, sometimes off‑centre, and may come with nipple inversion, skin dimpling, or bloody discharge. Only proper imaging and biopsy can make a definite distinction, so any persistent or suspicious lump should be evaluated by a doctor.​

2) Is male breast cancer more dangerous than female breast cancer?
Biologically, many male breast cancers are hormone receptor‑positive and could respond well to treatment. However, because men tend to be diagnosed later and with more advanced stage, overall survival outcomes have historically been poorer. When detected early and treated appropriately, male breast cancer can have survival rates comparable to similar female cases. The key problem is delay in recognition, which can be improved through awareness.​

3) Should men with a strong family history of breast or ovarian cancer undergo genetic testing?
Men with multiple close relatives affected by breast or ovarian cancer, especially at young ages, or with known BRCA mutations in the family, are often advised to seek genetic counselling and possible BRCA testing. Identifying a mutation can guide personalised cancer surveillance strategies for breast, prostate, and other associated cancers, and allows at‑risk family members to be informed and monitored. Decisions about testing should be made with a genetics specialist or oncologist.​