Male Breast Cancer: What you Need to Know

Not Just a Pink Disease

Man holding pink breast cancer ribbon.

People often think about breast cancer as a female or pink disease. But the truth is, breast cancer affects both men and women. Since the prevailing idea is that breast cancer only affects women, men often face feelings of emasculation and shame resulting from a breast cancer diagnosis (7). One male breast cancer survivor shared that his post-surgery kit included a pink ice pack to “tuck into his bra” (9). Experiences like that only add to the stigma and shame associated with a male breast cancer diagnosis. And these are not the only obstacles that male breast cancer patients face.

According to UNLV, men often face barriers to both diagnosis and treatment (9). Due to a lack of awareness in medical providers, clear signs of male breast cancer can be misinterpreted and misdiagnosed. Sometimes doctors and patients disregard a breast lump as fat , related to injury, instead of breast cancer (2).

Another problem that male breast cancer patients contend with is a lack of male-focused breast cancer treatment. The FDA’s Breast Cancer Liaison, Tatiana M. Prowell, MD, admits “In the absence of better information to guide us, we tend to treat men with breast cancer the same way we treat women” (2). This lack of information is often a result of men being excluded from breast cancer clinical trials and limited male breast cancer trials due to a lack of participation (2). More recently, there has been a greater call for men to participate in clinical trials.

Men can also experience roadblocks to medical care access. A lack of awareness about male breast cancer extends beyond medical providers and patients. Since breast cancer treatment is female-focused, some insurance companies have created female-focused policy requirements. One male breast cancer survivor shared that he did not qualify for treatment because his Medicaid policy stated that the patient must receive a pap smear before having breast cancer treatment. Another insurance company denied a patient, stating that they do not cover sex-reassignment surgeries (9).

There must be greater education and awareness about male breast cancer to end stigma, provide better access to care, and more male-focused breast cancer treatment.

Understanding Male Breast Cancer

Although about 1% of all breast cancer cases occur in men, male breast cancer incidence rates have been rising, particularly in the United States and Canada (1). Since the 1960s, California and New York State have seen the highest increase in male breast cancer (3). In 2013 the lifetime risk of developing male breast cancer in the United States was 1 in 1000 (10). As of 2020, the lifetime risk of developing male breast cancer has increased to 1 in 833 (2). It is estimated that 2,620 men will be diagnosed with breast cancer this year and 520 will die (1).

Aside from a rising rate, there are other concerns relating to male breast cancer. Breast cancer in men is often diagnosed at a later stage (stage 3 or 4) compared to women (10). When breast cancer is diagnosed at a later stage, and survival rates decline. Also, stage for stage, male breast cancer patients have a greater than females (8). In particular, African American men are more likely to be diagnosed with advanced stage breast cancer, diagnosed at younger ages, and have higher mortality rates than men of other races (6). Some of the possible reasons that breast cancer is diagnosed later include a lack of knowledge about male breast cancer, the associated risks, and early detection methods.

Risk Factors for Male Breast Cancer

  • Aging
  • mutations
  • Family history of breast cancer
  • Estrogen exposure
  • Alcohol use
  • Liver disease
  • Klinefelter’s syndrome
  • Testicle disease or surgery
  • Obesity

Although many of the risk factors associated with male breast cancer are unmodifiable, you can still take steps to lower your risk. Exercise regularly and maintain a healthy body weight. The CDC recommends that adults exercise for at least 150 minutes a week or 30 minutes per day five days a week (4). Also, maintain a healthy balanced diet. Consider limiting your intake of refined sugar, processed meat, red meat, high-fat dairy products, refined oils, and alcohol.

Early Detection of Male Breast Cancer

Early detection is essential for better survival rates. Breast cancer that is diagnosed at the earliest stage has a 99% survival rate (5). Since breast cancer incidence rates in men are low, men do not routinely undergo screening for breast cancer. Men are not sent for mammograms nor do they receive clinical breast exams, unless breast cancer is suspected. The only screening method available to men is a monthly breast self-exam. Men theoretically have an easier time detecting unusual lumps in their breasts as they have less tissue, particularly around the nipple and .

Warning Signs of Male Breast Cancer

  • Lump in the breast, chest or underarm area
  • , puckering or redness of the skin on the breast
  • Change in the shape or size of the breast
  • Itchy, scaly sore or rash on the nipple
  • Inversion in the nipple or other parts of the breast
  • Nipple discharge

It is important to become familiar with your chest tissue, in order to identify potential changes in the breast tissue. If you notice any changes, you should speak to a doctor. Watch this video to learn more about how to complete a male breast self-exam.

Help end the stigma by speaking to your friends and family about male breast cancer and breast self-exams. You might just save a life!

Sources

1. American Cancer Society. Breast Cancer Facts & Figures 2019-2020. Atlanta: American Cancer Society, Inc. 2019.

2. Commissioner, Office of the. “Men with Breast Cancer Need More Treatment Options, Genetic Counseling.” U.S. Food and Drug Administration, FDA, 29 Oct. 2019.

3. Contractor, K.B., Kaur, K., Rodrigues, G.S. et al. Male Breast Cancer: Is The Scenario Changing. World J Surg Onc 6, 58 (2008).

4. “How Much Physical Activity Do Adults Need?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 14 May 2020.

5. Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.

6. Shin, Jacob Y et al. “The impact of race in male breast cancer treatment and outcome in the United States: a population-based analysis of 4,279 patients.” International journal of breast cancer vol. 2014.

7. Midding, Evamarie et al. “Men With a “Woman’s Disease”: Stigmatization of Male Breast Cancer Patients-A Mixed Methods Analysis.” American journal of men’s health vol. 12,6 (2018).

8.  Staff, NCI. “Men with Breast Cancer Have Higher Mortality than Women.” National Cancer Institute, 2 Oct. 2019, www.cancer.gov/news-events/cancer-currents-blog/2019/male-breast-cancer-higher-mortality.

9. Summers, Keyonna. “The Blue in the Pink: Busting Myths About Male Breast Cancer.” University of Nevada, Las Vegas, 2 Oct. 2019.

10. Yalaza, Metin et al. “Male Breast Cancer.” The journal of breast health vol. 12,1 1-8. 1 Jan. 2016.

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