Male breast cancer

Male breast cancer is exceptionally rare and only accounts for less than 0.25% of male malignancies and ~0.5-1% of all breast cancer (both genders). The diagnosis is sometimes delayed due to the patient's hesitancy to seek advice. Workup from a radiological point of view is the same as for women including the use of needle biopsy to confirm the diagnosis.

The average age of diagnosis of male breast cancer is 60-70 years, which is later than female breast cancer. 

Most commonly men present with a painless subareolar mass. Male breast cancer is also reported to present at a relatively advanced stage compared with female breast cancer 8.

Histologically, the vast majority are invasive ductal carcinoma (85-90%) or ductal carcinoma in situ

Recognised risk factors include:

  • exposure to ionising radiation: especially to the chest wall
  • cryptorchidism
  • testicular injury / infectious orchitis ref
  • increased levels of oestradiol
    • consider this risk in transgender patients
  • Klinefelter syndrome
  • liver dysfunction: cirrhosis
  • prostate cancer
  • family history: ~30% of cases can have a positive family history
  • chest trauma
  • age
  • certain racial groups: may have a comparatively higher incidence
  • BRCA2 gene mutation 2

Please note gynaecomastia is not a risk factor per se.

  • can occur anywhere within the breast but favours the subareolar area or the upper outer quadrant
  • favours a slightly eccentric location in relative to the nipple 7

The genetic predisposition for breast cancer can be inherited from both mother and father. First line family history includes both genders.

Typically seen as a subareolar mass (often round, oval, or lobulated) and at times can be masked by the presence of concurrent gynaecomastia 3. Calcifications tend to be fewer in number and coarser than female breast cancer 1.

The overall prognosis tends to be worse than for female breast cancer which may due to men presenting at later stages (i.e. when the mass has grown to a palpable level).

Breast imaging and pathology
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Article information

rID: 9029
System: Oncology, Breast
Synonyms or Alternate Spellings:
  • Male breast carcinoma
  • Breast cancer in men
  • Cancer of the male breast
  • Carcinoma of the male breast

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