Breast cancer in men: Early detection is key to prevention

Breast cancer happens to men. Not often, but when it does, it’s serious.

Women are taught to pay attention to their breast health; men are not. But, as with women, the earlier you find your breast cancer, the better the chance for successful treatment.

“Male breast cancers tend to be very aggressive,” said Umar Butt, MD, a surgical oncologist at Medical City McKinney.

Because men have very little breast tissue, it is easier to feel small masses. But that small amount of tissue also means cancers don’t need to grow much to start spreading. By the time tumors are found in men, they often have already spread, according to the American Cancer Society. The extent of the spread is one of the most important factors in your prognosis.

But not me, right?

Because of its rarity, men are generally not on the lookout for lumps or other signs that something is wrong. Male breast cancer is so rare, in fact, that the American Academy of Family Physicians doesn’t recommend universal screening for men. Men account for fewer than 1% of all breast cancer diagnoses in America each year. Many men wrongly think breast cancer can only happen to women. And when they do spot a symptom, men may be embarrassed to show their doctor, or may believe they can simply ignore it and it will go away.

Galen Johnson, a patient at Medical City McKinney who was diagnosed with Stage 3 breast cancer, said that though he had learned about the importance of screening for prostate and colon cancers, he never knew he could possibly get breast cancer.

The American Cancer Society estimated that about 2,790 new cases of invasive breast cancer in men would be diagnosed in 2023 and that about 530 men would die from it. For men, the average lifetime risk of getting breast cancer is about 1 in 726. But each man's risk might be higher or lower, based on his risk factors. As with Black women, Black men with breast cancer, for example, tend to have a worse prognosis.

Amy Gunter, MD, a breast surgeon at Medical City Weatherford, says that ignoring a symptom is the wrong way to go.

“Any new lump should be seen by your primary care physician and, possibly, screened with a mammogram,” she said.

It’s important to understand that most breast lumps are benign and not cancer.

Am I going to get breast cancer?

Though we don’t yet fully know the causes of breast cancer in men, researchers have identified several risk factors, according to the American Society of Clinical Oncology (ASCO) 2020 guidelines. If you fall into the high-risk category, the American Academy of Family Physicians recommends you talk with your doctor. Being at risk does not mean that you will get cancer.

• The average age of men diagnosed with breast cancer is 67, according to ASCO. The American Cancer Society puts the age at 72.
• Family history of breast cancer. About 1 out of 5 men with breast cancer have a close relative, male or female, with the disease.
• Inherited gene mutations. A defect in the BRCA2 or BRCA1 gene raises the lifetime risk of breast cancer. Other gene mutations can also play a role.
• Klinefelter syndrome. Men with this rare genetic condition are significantly more at risk, between 20 and 60 times more, than men who don’t have Klinefelter.
• Radiation exposure. Men who have been treated with radiation in the chest are at risk.
• Heavy alcohol consumption.
• Liver disease.
• Estrogen treatment. Men who used an older hormonal therapy for prostate cancer may have a slight increase of risk. Research on breast cancer risk in transgender individuals is new, so the risk of taking high doses of estrogen as part of gender-affirming hormone treatment isn’t clear.
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• Testicular conditions. An undescended testicle, having mumps as an adult or having testicles surgically removed may increase risk.

Breast cancers can start in different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple. Some start in the glands that make breast milk or other areas. Men have these ducts and glands even though they aren't normally functional.

What am I looking for?

Symptoms to look for include:

• A lump or swelling, which is often painless
• Skin dimpling or puckering
• Nipple turning inward
• Redness, scaling or itchiness of your nipple or breast skin
• Discharge from your nipple
• Lumps or swelling under your arm or around your collarbone

“If you feel something in your chest and it’s not right, you need to get to the doctor and get it checked out,” said Johnson. “If I could convince one man to get this checked out and prevent this, it’s a worthwhile journey.”