Breast cancer in men
This page tells you about breast cancer in men. You can find information about
Breast cancer in men
In men, breast cancer is very rare. There are about 300 men diagnosed each year in the UK, compared with more than 45,500 cases of breast cancer in women.
Should the information be the same for men?
Most of the information men with breast cancer need is the same as for women. The symptoms, diagnosis and treatment are all very similar to women with breast cancer.
Risks and causes
As with women, the single biggest risk factor for male breast cancer is increasing age. Most cases are diagnosed in men between the ages of 60 and 70. Other risk factors are high oestrogen levels, exposure to radiation, a family history or recognised breast cancer gene in the family, and a rare genetic condition called Klinefelter's syndrome.
Finding support
A diagnosis of breast cancer can be particularly difficult for men. You may feel confused and isolated. It is so common to hear about breast cancer in women. But not at all common to hear about it in men. Your consultant may know other men with breast cancer that you could talk to. Or you could contact the charity Breast Cancer Care. They have male volunteers you can talk to on the phone.
In men, breast cancer is very rare. There are about 300 men diagnosed each year in the UK, compared with more than 45,500 cases of breast cancer in women. That's about one man for every 150 women diagnosed.
Some men with breast cancer feel that the information available is biased towards women. That is understandable, but when you look at the figures, you can see why breast cancer information is aimed at women.
The important thing is that most of the information men with breast cancer need is the same as for women. The symptoms, diagnosis and treatment are all very similar to women with breast cancer. The risks and causes do vary slightly and we've covered that below. Obviously there are areas where women need different information to men - such as breast reconstruction or the different types of breast shapes (prostheses) available. Some treatments can affect men's fertility and sex life. There is information in our coping with cancer section about the effect of cancer treatment on sex for men. There is important information below on finding support, as this can be much more difficult for men with breast cancer, simply because this is a rare situation.
For all other types of information, men with breast cancer should be able to use this whole breast cancer section freely, picking and choosing the information they feel will be of use to them.
As with women, the single biggest risk factor for male breast cancer is getting older. Most cases are diagnosed in men between the ages of 60 and 70. Other risk factors are
- High oestrogen levels
- Exposure to radiation
- A family history or recognised breast cancer gene in the family
- A rare genetic condition called Klinefelter's syndrome
All men produce some oestrogen. This is perfectly normal. But high oestrogen levels have been linked to breast cancer. High oestrogen levels can occur in
- Obesity - oestrogen is partly made in the fat (adipose) tissues of the body
- Chronic liver conditions, such as cirrhosis
- Genetic conditions
Men who have been exposed to radiation repeatedly, over a long period of time, are more likely to develop male breast cancer. This is particularly true if they were young when the radiation exposure took place.
Men who have female relatives with breast cancer have an increased risk of breast cancer. This is particularly true if the women are close relatives (mother or sisters). And if the women were diagnosed at a young age (below 40). Men, as well as women, can inherit faulty genes that can cause breast cancer. Between 5 and 10 out of every 100 breast cancers diagnosed in women (5 to 10%) are thought to be due directly to an inherited faulty gene. In men, this may be more common. We think that between 10 and 20 out of every 100 diagnosed (10 to 20%) are due to inherited faulty genes. In men with breast cancer the BRCA2 faulty gene is more common than BRCA1.
Klinefelter's syndrome is a rare genetic condition where a man is born with an extra female chromosome. So he is XXY instead of XY. Men with Klinefelter's are about 20 times more likely to get breast cancer than the average man. This makes their breast cancer risk the same as for the average woman.
The most common symptom for men with breast cancer is a lump in the breast area. This is nearly always painless. Other symptoms can include
- Oozing from the nipple (a discharge) that may be blood stained
- Swelling of the breast
- A sore (ulcer) in the skin of the breast
- A nipple that is pulled into the breast (called nipple retraction)
- Lumps under the arm
The tests for breast cancer in men are much the same as for women. You may have a painless scan using sound waves, called an ultrasound. Or you may have a mammogram. If your scan shows up an area that could be cancer, your specialist will want to take a sample (biopsy) of breast tissue for examination under a microscope. If these tests show that you have breast cancer, you will probably have other tests to make sure the cancer has not spread. These tests are covered in the page about further tests for breast cancer.
There are different types of breast cancer. The most common type in both women and men is invasive ductal carcinoma. The early, precancerous condition called 'ductal carcinoma in situ' (DCIS) is diagnosed in men quite rarely. DCIS means that there are cancer cells in the breast. But they are all still contained inside the ducts of the breast and cannot spread. Inflammatory breast cancer and Paget's disease are also found very rarely in men.
The same treatments are used for breast cancer in men as for women. These are all covered in detail in the CancerHelp UK section on treating breast cancer. Treatment is decided by the stage of your cancer. This means how far the cancer has grown by the time it is diagnosed. The staging for men's breast cancer is the same as for female breast cancer.
To treat your cancer, you may have one or more of the following treatments
- Surgery
- Radiotherapy
- Hormone therapy
- Chemotherapy
- Biological therapy
Removal of the breast (mastectomy) is the most common operation. There is not very much breast tissue in men, so it isn't usually possible to leave any behind. Usually, you will have the lymph nodes checked under the arm on the same side. This is to see whether they contain cancer cells.
As the cancer is always close to the muscle of the chest wall in men (because there is so little breast tissue), your specialist is likely to suggest radiotherapy after surgery. This is to reduce the risk of the cancer cells growing back in the chest wall in the future.
Chemotherapy and hormone therapy treat the whole body - the drugs circulate through the bloodstream and attack breast cancer cells wherever they are. These treatments are used for some men to try to lower the risk of the cancer coming back.
About 9 out of 10 male breast cancers (90%) are oestrogen receptor positive, so hormone therapy is commonly used. Your specialist will arrange tests on your cancer cells when you are first diagnosed. This shows if they have hormone receptors on the surface of the cancer cells. If they do, the breast cancer is likely to respond to hormone therapy. Breast cancer cells can have oestrogen receptors or progesterone receptors. Most male breast cancer cells do have hormone receptors. This is known as being hormone receptor positive.
The most common hormone therapy for male breast cancer is tamoxifen. The side effects are much the same as in women. Tamoxifen can make you feel sick when you first start taking it, but this usually wears off quite quickly. The most common side effect for men and women is hot flushes. Tamoxifen may also cause weight gain, difficulty sleeping, low mood and depression. In men, tamoxifen may also cause a loss of sex drive. This has been reported in up to 3 out of 10 men taking tamoxifen. There is information about how to cope with the effects of cancer treatment on your sex life in the section of CancerHelp UK on coping with cancer.
Other hormone therapies are used to treat breast cancer. These are covered in the hormone therapy for breast cancer page.
Your cancer cells will also be checked for receptors called HER2 receptors. If your cancer cells have a lot of these receptors, you may be prescribed a biological therapy. You can look on our page about biological therapy for breast cancer for more information.
You may have chemotherapy if there are cancer cells in your lymph nodes. Or if your cancer does not have hormone receptors and so is not thought to be sensitive to hormone therapy. Chemotherapy, hormonal therapy or biological therapy may also be used to treat breast cancer that has spread to other parts of the body.
Of course it is difficult for anyone diagnosed with breast cancer. But as male breast cancer is rare it can be particularly difficult, so you may feel very confused and isolated. It is so common to hear about breast cancer in women. But not at all common to hear about it in men. So it can be difficult even to believe that the diagnosis is right.
As male breast cancer is rare, men are often treated in large, specialist centres where there is expertise in dealing with the disease. So your consultant may know other men with breast cancer you could talk to. Or you could contact the charity Breast Cancer Care. They have male volunteers you can talk to on the phone. You could also check out Cancer Chat - Cancer Research UK's discussion forum. It is a place for anyone affected by cancer to share experiences, stories and information with other people who know what you are going through. Or you could try one of the web based contact networks, such as MyWavelength. This is a free support network where you can get in touch with other people with the same type of cancer.
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