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Men get breast cancer too, usually a hormone-sensitive kind found as a lump near the nipple. It is treated much as in women, with surgery, radiotherapy and tamoxifen, and inherited BRCA2 mutations are found often enough that every man diagnosed is offered genetic testing. The main fix under way is including men in trials so their care stops being borrowed from women.
Male breast cancer is almost always invasive ductal carcinoma, oestrogen-receptor positive (in the large majority) and HER2-negative; lobular carcinoma is rare because men lack terminal lobules, and triple-negative disease is uncommon. Germline BRCA2 mutations are the strongest hereditary factor (BRCA1 less so), and testing is recommended for every man with breast cancer regardless of age or family history; other risks are Klinefelter syndrome, oestrogen exposure, radiation, obesity and liver disease. Men present later and with higher stage than women because there is no screening and awareness is low, and the tumour sits close to the skin and nipple.
Treatment follows the female algorithm with adjustments. Mastectomy is usual because of tumour position, though breast-conserving surgery is feasible in some; sentinel node biopsy, radiotherapy and chemotherapy indications mirror women's. Endocrine therapy differs: tamoxifen is the preferred adjuvant agent, because aromatase inhibitors used alone in men raise testosterone and oestradiol through feedback and appear less effective, so if used they should be combined with a GnRH agonist. CDK4/6 inhibitors, HER2-directed therapy and PARP inhibitors for germline BRCA carriers are used in men on the basis of extrapolation and small cohorts. The EORTC 10085 / International Male Breast Cancer Program (Ann Oncol 2018) was the largest characterisation effort, and the FDA's 2020 guidance 'Male Breast Cancer: Developing Drugs for Treatment' instructs sponsors to include men in breast cancer trials rather than excluding them by default.
Open problems are adjuvant endocrine adherence and side effects in men, the biology of male-specific ER-positive disease, and the paucity of prospective data.
About one in a hundred breast cancers occurs in a man; the lifetime risk is roughly one in a thousand men, higher with a BRCA2 mutation, Klinefelter syndrome or a strong family history (SEER; NCI).
Most cancers start in the ducts and drain first to the axillary nodes, which is why the armpit is checked and a sentinel node is sampled.
Same organ: Triple-negative breast cancer (TNBC), Breast cancer (all types), HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Ductal carcinoma in situ (DCIS), High-risk early HR-positive breast cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, HER2-low and HER2-ultralow metastatic breast cancer, Early HER2-positive breast cancer, HER2-positive breast cancer with brain metastases, Early triple-negative breast cancer, Metastatic triple-negative breast cancer, Basal-like 1 triple-negative breast cancer (BL1), Basal-like 2 triple-negative breast cancer (BL2), Mesenchymal triple-negative breast cancer (M), Mesenchymal stem-like triple-negative breast cancer (MSL), Luminal androgen receptor triple-negative breast cancer (LAR), Immunomodulatory triple-negative breast cancer (IM), Metaplastic breast carcinoma, Carcinoma with medullary pattern (medullary breast cancer), Adenoid cystic carcinoma of the breast, Apocrine carcinoma of the breast, Secretory carcinoma of the breast, BRCA-associated triple-negative breast cancer, Inflammatory breast cancer, Paget disease of the nipple, Phyllodes tumour of the breast, Invasive lobular carcinoma of the breast, Invasive breast carcinoma of no special type (invasive ductal carcinoma), Tubular carcinoma of the breast, Mucinous carcinoma of the breast, Papillary carcinomas of the breast (encapsulated, solid and invasive papillary), Invasive cribriform carcinoma of the breast, Invasive micropapillary carcinoma of the breast, Neuroendocrine neoplasms of the breast, Lobular carcinoma in situ (LCIS)
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Also on OnCo: Symptoms and red flags · Early detection roadmap.
Mastectomy (or breast conservation where feasible) with sentinel node biopsy; adjuvant radiotherapy by the same criteria as women; chemotherapy and HER2-directed therapy as indicated.
Tamoxifen for five to ten years; aromatase inhibitor only with GnRH agonist suppression if tamoxifen is contraindicated.
Endocrine therapy (tamoxifen, or aromatase inhibitor or fulvestrant with GnRH agonist) with a CDK4/6 inhibitor by extrapolation; chemotherapy for visceral crisis.
PARP inhibitor (olaparib adjuvant per OlympiA; olaparib or talazoparib for metastatic disease) and cascade testing of relatives.
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One cancer page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Query for this cancer: (TITLE:"Male breast cancer" OR ABSTRACT:"Male breast cancer" OR TITLE:"Breast cancer in men" OR ABSTRACT:"Breast cancer in men") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Male breast cancer, not a curated reading list.
Wainwright's review of published cases.
Early case series establish tamoxifen as the endocrine backbone.
Wooster and colleagues identify BRCA2; male breast cancer is one of its hallmark phenotypes.
Cardoso and colleagues (Ann Oncol 2018) characterise 1,483 men treated 1990 to 2010.
First ASCO guideline on male breast cancer; FDA guidance on including men in breast cancer drug development.
Trial included men.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
A swollen painful calf, or sudden breathlessness with chest pain; the tamoxifen boxed warning covers pulmonary embolism and stroke.
Breast Cancer Now lists headache, sickness and vomiting especially on waking, weakness or numbness down one side of the body, unsteadiness or loss of balance, seizures, difficulty with speech, vision problems, and changes in behaviour, mood or memory among the signs that breast cancer may have spread to the brain. A seizure, a sudden severe headache or new one-sided weakness is 999 whatever the cause.
The NHS says to call 999 or go to A and E if you have cellulitis with a very high temperature or you feel hot, cold or shivery, a fast heartbeat or fast breathing, purple patches on the skin which may be less obvious on brown or black skin, feeling dizzy or faint, confusion or disorientation, cold, clammy or pale skin, or unresponsiveness. These are symptoms of serious complications, which can be life threatening.
Fainting, dizziness or an irregular heartbeat; QT prolongation is a labelled warning and ECGs are checked in the first cycles.
Breathing very fast; confused, slurred speech or not making sense; blue, pale or blotchy skin, lips or tongue; a very high or very low temperature, feeling hot or cold to the touch, or shivery; a rash that does not fade when pressed: the NHS says call 999 or go to A and E, and do not drive yourself, ask someone to drive you or call 999.
A swollen painful calf, or sudden breathlessness with chest pain; venous thromboembolism including pulmonary embolism is a labelled warning.
See all on the product pages:AbemaciclibBone metastases and skeletal-related eventsBrain metastases (intracranial disease)Compression, decongestive therapy and exercise for lymphoedemaFebrile neutropeniaFulvestrantGoserelin / leuprolide (ovarian function suppression)Letrozole (and other aromatase inhibitors)Lymphadenectomy (lymph node dissection)Lymphoedema after breast cancer treatmentNeutropenic sepsis: the temperature rule and the 999 signsOlaparibPalbociclibRibociclibSeroma after breast surgerySurvivorship care and late-effects surveillanceTalazoparibTamoxifen·Printable cards in the navigator
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