Male Breast Cancer

While breast cancer primarily affects women, about 2,500 men are diagnosed with the disease in the United States each year.

The five-year survival rate for male breast cancer is slightly lower than for female breast cancer, as the chart below shows by cancer stage.

There are a number of different reasons for the lower survival rate for male breast cancer patients. One is patient age, and the health challenges that come with that. At the time of diagnosis, the average age for a male breast cancer patient is 67, versus age 62 for females.

In addition, male breast cancer is typically more advanced when it is diagnosed. The tumor tends to be larger and the cancer is more likely to have spread to regional lymph nodes. Doctors attribute these later diagnoses to a general lack of awareness of male breast cancer, as well as the absence of widespread screening for the disease.

Types of male breast cancer

Like female breast cancer, male breast cancer can be classified by the molecular receptor status of the cancer cells.

Receptors are molecules that cancer cells produce on their surface. They can bond with, or recognize, specific proteins and hormones in the patient’s body. Researchers have identified receptors that fuel the growth of breast cancer cells when they bond with a specific protein or hormone. Interrupting this bond with cancer drugs can slow or stop the disease’s growth.

The three main receptor types for breast cancer (in both men and women) are:

• HER2-positive, a protein that promotes cell growth and multiplication. HER2-positive cancers have much higher levels of the HER2 protein than normal.
• Hormone receptor-positive, which recognizes the hormones estrogen and progesterone.
• Triple-negative, which doesn’t recognize HER2, estrogen or progesterone. Because there is no molecular receptor to interrupt, this is the most difficult breast cancer subtype to treat.

About 90% of breast cancers in men are hormone receptor-positive, while another 9% are both hormone receptor-positive and HER2-positive.

Male breast cancer treatment

Treatment for male breast cancer is very similar to treatment for female breast cancer. Options include surgery, chemotherapy, radiation therapy and targeted therapy. Because of the small breast size, most male breast cancer patients who get surgery undergo a full mastectomy (the removal of the entire breast) instead of a lumpectomy (the removal of just the tumor and a small amount of surrounding tissue).

Male breast cancer risk factors

Anything that increases the chance of a person developing cancer is a risk factor. Doctors have identified several risk factors for male breast cancer.

• BRCA mutations: Normal BRCA1 and BRCA2 genes suppress the development of tumors. People with a mutated BRCA gene have a higher risk of breast cancer. Between 8%-15% of male breast cancer patients have a BRCA mutation, compared to 5%-10% of female breast cancer patients. In addition to causing breast cancer, BRCA mutations are also linked to ovarian cancer, pancreatic cancer and melanoma.
• Family history of breast cancer: The risk of breast cancer is doubled for men who have a parent, sibling or child with the disease.
• Age: As men age, their chances of developing breast cancer increases.
• Obesity
• Gynecomastia, or enlarged breasts caused by a hormone imbalance or certain medications
• Radiation exposure, often as part of treatment for another cancer
• Race: African-American men have a higher risk of male breast cancer than non-Hispanic white men.