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Breast Cancer in Men: Treatments and Counseling

Can men get breast cancer? Yes. Although breast cancer is a disease usually associated with women, men get it too.

Because male breast cancer is rare, there is very limited information on how to treat men diagnosed with the disease. “In the absence of better information to guide us, we tend to treat men with breast cancer the same way we treat women,” says Tatiana M. Prowell, MD, breast cancer scientific liaison at the U.S. Food and Drug Administration (FDA).

“Men have historically been excluded from breast cancer trials. In the last few years, we’ve begun asking drug companies to allow men in clinical trials unless there is a valid scientific reason to exclude them,” Prowell says.

The response from companies, researchers, and patients has been very positive. Breast cancer awareness is growing, and now most breast cancer trials being designed include men. “For the first time, men can access investigational treatments in clinical trials and contribute to scientific advances and knowledge for others with this disease,” Prowell says.

Breast Cancer Symptoms for Men

Each year, about 2,000 cases of male breast cancer (1 percent of all cases) are diagnosed in the United States, resulting in about 500 deaths, according to the National Cancer Institute. Although it can strike at any age, breast cancer is usually diagnosed in men 5 to 10 years older than in women and is found most often among men ages 60 to 70.

Why does it often take so long to recognize the signs of breast cancer in men? Prowell says one reason for the late-age (and later stage) diagnosis may be that men and their doctors don’t think of themselves as being at risk of breast cancer.

“You’d think that because men have smaller breasts, they would get diagnosed at an earlier stage than women. In many men, though, diagnosis is actually delayed because men and their doctors aren’t expecting a breast lump to be cancer.”

Most men with breast cancer have painless lumps they can feel. The lumps can develop anywhere on the breast but often are underneath the nipple and areola complex—right in the center. Because men don’t have regular mammograms, their breast cancer may be discovered after a local injury, such as a fall or minor chest wall trauma, leads them to feel the breast area.

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“Men commonly attribute a breast lump to some sort of injury. The mass was already there, but they didn’t notice it until it got sore after they were bumped in the chest, for example,” Prowell explains.

Risk Factors

Men and women share some similar risk factors for breast cancer: high levels of estrogen exposure, a family history of the disease, and a history of radiation to the chest. Although all men have estrogen in their bodies, obesity, cirrhosis (liver disease) and Klinefelter’s syndrome (a genetic disorder) increase estrogen levels. All are known risk factors for male breast cancer.

If a first-degree relative – their mother, father, brother, sister, children – has breast cancer, men are also at slightly higher risk to develop the disease themselves.

Breast Cancer Treatments for Men

Treatment options for men are similar to women’s: mastectomy (surgery to remove the breast) or in some cases lumpectomy, radiation, chemotherapy, targeted therapies and hormone therapy.

Genetic Counseling Is a Must for Men

All men with breast cancer should be referred for genetic counseling, Prowell advises.

Even among men there are differences. African-American men are more likely than white men to have advanced stage tumors at diagnosis and to develop triple-negative cancers. Their types of tumors are more likely to recur and have fewer treatment options.

People should tell their health care provider if any man in their family has had breast cancer, Prowell says. “Even if your grandfather is deceased, if he had breast cancer, that’s important. Because male breast cancer is so rare, seeing even one man in a family lineage raises concerns about hereditary breast cancer.”

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This article appears on the FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

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