Men are not immune to breast cancer
Like women, men have breast tissue and can therefore develop breast cancer. Cases are rarer, however, with male breast cancer accounting for less than 1% of all breast cancer cases in Canada and Quebec. The disease affects one in 934 men (compared to one in eight women). In Canada, this represents about 270 men affected annually and 55 others who die from it.
Breast cancer in men is similar to that in women
Breast cancer develops in the same way in men as in women; therefore, most of the information available on this page applies to both, including information on the development and progression of the disease, prevention, screening and diagnostic tests, and treatments.
Although breast cancer in men is similar to that in women, it still has some distinct characteristics, in particular due to biological differences.
Risk factors for breast cancer in men
The causes of breast cancer in men are not yet fully understood, but researchers have found that certain factors can increase the risk, i.e., the likelihood of developing breast cancer during one’s lifetime.
It is important to note that some people who develop the disease have no known risk factors. Conversely, others have one or more risk factors and will never develop breast cancer.
As with breast cancer in women, many of the risk factors in men are associated with the body’s sex hormone levels. The main risk factors for breast cancer in men are:
- Aging: The risk of breast cancer in men increases with age. Although breast cancer can develop in adults of any age, it usually affects men over 60.
- Having a family history of breast or ovarian cancer: The risk of breast cancer increases if other family members (blood relatives) have had breast or ovarian cancer. About one in five men with breast cancer have a close relative, male or female, with the disease.
- Carrying a hereditary gene mutation associated with an increased risk of breast cancer: Men with a mutation in the BRCA2, BRCA1 or PALB2 genes have an increased risk of breast cancer. A man can be a carrier of these genetic mutations without necessarily having a history of breast and/or ovarian cancer in his family.
To learn more about hereditary breast cancer in men, we invite you to consult our educational video entitled Homme: cancer du sein et cancer héréditaire (men: breast cancer and hereditary cancer (in French only).
- Having Klinefelter’s syndrome: One in 1,000 men is affected by this congenital disease, present at birth, characterized by cells with at least two X chromosomes, instead of just one. Men with Klinefelter’s syndrome have lower levels of androgens (male hormones) and more estrogen (female hormones), which is why they often develop gynecomastia (benign breast growth in men). A man with this syndrome has a 20 to 60 times higher risk of developing breast cancer than other men.
- Being exposed to ionizing radiation: A man whose chest area has been treated with radiation (for example, to treat a cancer such as lymphoma) has an increased risk of developing breast cancer.
- Drinking alcohol: Heavy alcohol consumption increases the risk of breast cancer in men. This could be due to its effects on the liver.
- Having liver disease: In severe liver disease (such as cirrhosis), the liver no longer performs its role properly in regulating sex hormone levels, leading to a drop in androgen levels and a rise in estrogen. This hormonal dysregulation makes men more likely to develop gynecomastia and increases their risk of developing breast cancer.
- Taking hormone therapy: Undergoing a treatment that raises estrogen levels in the body and/or lowers androgen can increase the risk of breast cancer in men. This could be the case for hormone therapy for the treatment of prostate cancer, or for gender-affirming hormone therapy, for example. Because research on breast cancer risk in transgender people is relatively new, it’s unclear exactly what the risk of breast cancer is in these people. Learn more about breast cancer in 2SLGBTQIA+ people here. If you are taking hormone therapy, the benefits may outweigh the increased risk of breast cancer. Talk to your doctor about the benefit-risk ratio.
- Being obese (1): The fat cells in the body convert male hormones (androgens) into female hormones (estrogen). This means that obese men have higher levels of estrogen in their bodies, which increases their risk of developing breast cancer.
- Having certain testicular conditions: Certain conditions, such as an undescended testicle (cryptorchidism), complications from mumps in adulthood (inflammation of the testicles), or surgical removal of one or both testicles (orchiectomy), can increase a man’s risk of breast cancer.
Data from the United States indicate that, as with Black women, Black men are more likely to develop breast cancer than White men.
Signs and symptoms of breast cancer in men
Various signs and symptoms may appear during the development of breast cancer. It is important to be aware of these so that you can detect them when examining your chest:
- Painless lump in the chest
- Chest pain or swelling
- Enlarged lymph nodes
- Nipple discharge or bleeding
- Recent retraction of the nipple (turned inward)
- Crusting, peeling, persistent eczema, or ulceration of the skin or nipple
Changes in the breast can also be caused by non-cancerous (benign) conditions. If you notice such a change, or if in doubt, consult a general practitioner or a specialized nurse as soon as possible. Do not wait for your next medical appointment. During the consultation, the health professional may perform a clinical examination, assess your personal risk of breast cancer or prescribe diagnostic tests if deemed necessary.
If you have questions or concerns about the signs and symptoms of breast cancer, contact a healthcare professional or call the Peer Support Helpline at 1 855 561-PINK (7465). You can also consult our directory of services for resources specific to your needs.
To learn more about good breast health practices, download or order our free educational material here.
Types of cancer in men
The most common type of male breast cancer is ductal carcinoma, which develops in the ducts and is most often invasive. Other types of breast cancer are also diagnosed in men, but they are rarer.
The majority of breast cancers in men express the hormone receptors ER and AR (androgen receptor).
Treatments for breast cancer in men
Every case of breast cancer is different. If you have breast cancer, your healthcare team will develop a personalized treatment plan based on several factors, such as the characteristics of your cancer, your overall health, and your personal choices.
Breast cancer in men is often treated in the same way as in postmenopausal women. Your healthcare team may recommend a treatment plan that includes one or more of the following:
- Surgery: Surgery is the most common treatment for breast cancer in men. Depending on the case, a modified radical mastectomy or a lumpectomy may be performed. An axillary lymph node dissection may also be carried out to remove lymph nodes in the armpit.
- Hormone therapy: Most breast cancers in men involve hormone receptors. Hormone therapy is therefore often a treatment option. Although different types of hormone therapies may be considered, tamoxifen is the most common drug offered to men with hormone-dependent breast cancer. It may be prescribed after surgery to reduce the risk of the cancer coming back or for advanced breast cancer.
- Chemotherapy: Chemotherapy may be a treatment option for breast cancer in men when the disease has spread to the lymph nodes or if the risk of recurrence is high. The chemotherapy drugs used are similar to those used in postmenopausal women with breast cancer.
- Targeted therapies: Men with HER2-positive breast cancer can usually receive trastuzumab (Herceptin) in combination with chemotherapy. Palbociclib (Ibrance) may also sometimes be used to treat men with advanced breast cancer.
- Radiation therapy: Externalbeam radiation therapy may be used after surgery to treat breast cancer in men.
Clinical studies on breast cancer in men
More studies are needed to better understand and treat breast cancer in men. Clinical studies rarely include them, and the findings in women are often extrapolated to men. This is changing, however, and more and more breast cancer clinical trials are recruiting men. Find out more about clinical trials here.
Survival in men with breast cancer
As with breast cancer in women, survival rates have improved significantly over the years. For the same stage, the survival rate is lower for men than for women.
In addition, due to the lack of a screening program, men are often diagnosed at a later age and stage of cancer than women, resulting in a lower overall survival rate. In Canada, the five-year net survival for breast cancer in men is 76% (all stages), which means that approximately 76% of men diagnosed with breast cancer will survive at least five years after diagnosis (five-year net survival is 89% for women).
(1) Obesity is a medical term that corresponds to a body mass index (BMI) of 30 or higher. While this term may be perceived as stigmatizing for some people, our content is based on research data, and we use it in a neutral and respectful way, only when necessary.
References
Réseau canadien du cancer du sein
Cancer du sein chez l’homme, Société canadienne du cancer
Mount Sinai Hospital—Marvelle Koffler Breast Centre
Black Men Have Higher Incidence Rates for All Types of Breast Cancer | American Cancer Society
White and Black Men With Breast Cancer Receive Similar Treatment but Black Men Have Worse Outcomes
Guénel P, Cyr D, Sabroe S, Lynge E, Merletti F, Ahrens W, Baumgardt-Elms C, Ménégoz F, Olsson H, Paulsen S, Simonato L, Wingren G. Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study. Cancer Causes Control. 2004 Aug;15(6):571-80. doi: 10.1023/B:CACO.0000036154.18162.43. PMID: 15280636.