Male breast cancer

Dr Henry Knipe and Dr Jeremy Jones et al.

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 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.

Risk factors

Recognised risk factors include:

  • exposure to ionising radiation: especially to the chest wall
  • cryptorchidism
  • testicular injury / infectious orchitis ref
  • increased levels of oestradiol
  • 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.

Location
  • 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
Mammography

Typically seen as a subareolar mass (can be spiculated 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: Breast
Section: Pathology
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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