Male Breast Cancer: Symptoms, Treatment and Support
When most people think about breast cancer, they naturally associate it with women. However, breast cancer can affect men too.
Although male breast cancer accounts for less than 1% of all breast cancer diagnoses, it remains an important condition that deserves greater awareness, improved research, and better support for patients and their families.
Recently, I had the privilege of speaking on male breast cancer at the national Association of Breast Surgery (ABS) Conference, where the condition was firmly placed on the national agenda. I am also contributing to the development of new national guidance for male breast cancer, helping to ensure that men receive the information, support and treatment options they deserve.
While significant progress has been made, there is still much work to do.
Can Men Get Breast Cancer?
Yes. Men naturally have a small amount of breast tissue behind the nipple and areola. Breast cancer can develop within this tissue, just as it can in women.
Male breast cancer is uncommon, but because many people remain unaware that men can develop breast cancer, symptoms may be overlooked or attributed to other causes.
Awareness remains one of the most important factors in achieving earlier diagnosis and treatment.
What Are the Symptoms of Male Breast Cancer?
The most common symptoms include:
A Lump Beneath the Nipple: most male breast cancers present as a firm lump beneath or close to the nipple. The lump is often painless, although not always.
Changes to the Nipple: men may notice
- Nipple inversion
- Changes in nipple appearance
- Nipple discharge, particularly if blood-stained
- Crusting or ulceration
Skin Changes: changes to the skin over the breast may include:
- Dimpling
- Thickening
- Redness
- Persistent irritation
Swelling Under the Arm: occasionally, patients may notice swelling in the armpit due to enlarged lymph nodes.
Any persistent or unexplained changes should be assessed by a healthcare professional.
Male Breast Cancer or Gynaecomastia?
Many men who notice a lump or change in their chest worry about whether it could be cancer. Fortunately, the most common cause of enlargement of the male chest is gynaecomastia, a benign condition caused by enlargement of normal glandular breast tissue.
While gynaecomastia is common and usually harmless, male breast cancer requires prompt assessment and treatment.
It is important to seek medical advice if:
- A new lump develops
- One side becomes noticeably different from the other
- Symptoms appear suddenly
- There are nipple or skin changes
- You have concerns about any persistent change
Most breast lumps in men are not cancer, but it is always sensible to have new symptoms assessed.
Who Is at Risk?
Several factors can increase the risk of male breast cancer, including:
- Increasing age
- A family history of breast cancer
- Inherited genetic mutations, particularly BRCA2 (about 10% of male breast cancers)
- Previous chest radiotherapy
- Certain hormonal conditions
- Obesity and other lifestyle factors
Having a risk factor does not mean someone will develop breast cancer, but understanding risk can help encourage awareness.
How Is Male Breast Cancer Treated?
Treatment depends on the type and stage of cancer, as well as a patient’s overall health and personal preferences.
Most patients receive care through a specialist multidisciplinary team, including surgeons, oncologists, radiologists, pathologists and specialist nurses.
Surgery
Surgery remains the cornerstone of treatment for most men with breast cancer.
Historically, mastectomy has been the most commonly performed operation. National data suggest that approximately 94% of men diagnosed with breast cancer currently undergo mastectomy.
However, I presented on this subject at ABS to challenge this status-quo. Evidence suggests that breast-conserving surgery may be a safe and appropriate option for selected men with smaller cancers. While lumpectomy is widely accepted in women, it remains uncommon in men despite studies demonstrating comparable oncological outcomes in carefully selected patients.
The aim is not to replace mastectomy, which remains an important and highly effective treatment, but to ensure that men are aware of all suitable surgical options and can have informed discussions about their care.
Endocrine (Hormone) Therapy
Most male breast cancers are hormone receptor-positive. This means many men benefit from endocrine therapy, most commonly tamoxifen, which helps reduce the risk of recurrence.
Radiotherapy
Radiotherapy may be recommended following surgery, particularly after breast-conserving surgery or where there is a higher risk of local recurrence.
Chemotherapy and Targeted Treatments
Some patients may require chemotherapy or targeted treatments depending on the biology and stage of their cancer. Treatment is always tailored to the individual.
Why Awareness Remains a Challenge
One of the key themes discussed at this year’s ABS Conference was awareness. Many men simply do not realise that breast cancer can affect them.
As a result, symptoms may sometimes be ignored or dismissed, leading to delays in seeking medical advice.
Improving awareness does not mean creating alarm. It means helping people recognise when something is not normal and encouraging them to seek advice sooner.
The earlier breast cancer is diagnosed, the more treatment options are often available.
The Need for Better Research
Another major challenge is the limited research available specifically for male breast cancer. Because the condition is rare, much of our current treatment guidance has historically been based upon evidence from female breast cancer.
While many principles of treatment are similar, men are not simply women with less breast tissue. Important questions remain regarding diagnosis, surgical management, survivorship, quality of life and psychological wellbeing. More dedicated research is needed to better understand the specific needs of men diagnosed with breast cancer.
Supporting Men Beyond Treatment
For many patients, the journey does not end once treatment is completed.
Men with breast cancer can face unique challenges relating to:
- Body image
- Confidence and identity
- Relationships and intimacy
- Returning to work and normal activities
- Feelings of isolation
Many patients describe feeling overlooked because breast cancer is still widely perceived as a disease that affects women.
Improving support services and ensuring that information is inclusive of male patients remains an important priority.
National Guidance for Male Breast Cancer
One of the most encouraging developments in recent years has been the growing recognition that men with breast cancer have specific needs that deserve greater attention.
At this year’s national Association of Breast Surgery Conference, I joined other experts from across the UK to discuss the challenges facing men with breast cancer and how we can improve care.
I am proud to be leading the development of new national guidance on male breast cancer through the Association of Breast Surgery.
The aim is to improve consistency of care across the UK, increase awareness among healthcare professionals and patients, support future research, and ensure that men have access to clear information about diagnosis, treatment and survivorship.
Guidelines alone will not solve every challenge, but they represent an important step towards improving care for men affected by breast cancer.
Useful Resources for Patients
If you have been diagnosed with male breast cancer, or are seeking further information, the following organisations provide excellent support and resources:
- Breast Cancer Now
- Macmillan Cancer Support
- Men’s VMU
- Moobs
These organisations offer trusted information, support services and guidance for patients and their families.
