male breast cancer
Meaning of male breast cancer: Rare enough to be overlooked, which is the main reason it tends to be found later than the same disease in women.
Definition of male breast cancer
Male breast cancer is cancer arising in the small amount of breast tissue that men retain behind the nipple. Most cases begin in the milk ducts, and the great majority carry receptors for estrogen, which shapes treatment. It is uncommon, tends to be diagnosed at an older age than in women, and is more often linked to an inherited gene fault.
Why do men have breast tissue at all?
Every fetus develops a rudimentary duct system before sex hormones take effect. In men that tissue never expands into lobules capable of producing milk, but the ducts remain, sitting in a small disc under the nipple. Cancer can arise there for the same reasons it does in women. Because the disc is small, a lump is easier to feel early, and yet it is also closer to the skin, the nipple and the chest wall, so a growth reaches those structures after less travel.
How does it present?
| Sign | What it reflects |
|---|---|
| A firm painless lump under the nipple | The commonest first finding |
| Nipple pulled inward | Tethering of tissue behind it |
| Discharge or bleeding from the nipple | Involvement of a duct |
| Skin dimpling or an ulcer | Extension forward to the skin |
| A lump in the armpit | Spread to lymph nodes |
How is it different from breast cancer in women?
The disease itself behaves similarly, and the same tests, surgery, radiotherapy and drug treatments are used. The differences are ones of context. There is no screening program, so it is found because someone notices a lump rather than on a scan. Diagnosis comes later in life on average. Nearly all tumors are hormone receptor positive, a higher proportion than in women, which makes hormone blocking treatment central. Inherited faults in the BRCA2 gene account for a meaningful share of cases, and a diagnosis often prompts genetic testing that has consequences for relatives of both sexes. Outcome for a given stage is broadly comparable to breast cancer in women, but average stage at diagnosis is higher.
What is often mistaken for it?
Gynecomastia, a benign enlargement of male breast tissue, is far more common and is usually a soft, rubbery, symmetrical swelling centered on the nipple. It follows hormone shifts at puberty and in later life, liver disease, and a long list of medicines. A cancer is more often hard, one sided and set off to one side of the nipple rather than around it. Imaging and a needle sample separate the two.
Also known as
Used in a sentence
The lesion was excised and reported as invasive ductal male breast cancer, estrogen receptor positive.
Good to know
Almost all male breast cancers are hormone receptor positive, and the diagnosis is a recognized reason to consider testing for an inherited BRCA2 fault that also affects relatives.