Can breast cancer in men be found early?
Early detection improves the chances that male breast cancer can be treated successfully.
Differences affecting early detection of male and female breast cancers
There are many similarities between breast cancer in men and women, but there are some important differences that affect finding it early.
The most obvious difference between the male and female breast is size. Because men have very little breast tissue, it is easier for men and their health care professionals to feel small masses (tumors). On the other hand, because men have so little breast tissue, cancers do not need to grow very far to reach the nipple, the skin covering the breast, or the muscles underneath the breast. So even though breast cancers in men tend to be slightly smaller than in women when they are first found, they more often have already spread to nearby tissues or lymph nodes. The extent of spread is one of the most important factors in the prognosis (outlook) of a breast cancer.
Lack of awareness
Another difference is that breast cancer is common among women and rare among men. Women tend to be aware of this disease and its possible warning signs, but most men do not realize they have even a small risk of being affected. Some men ignore breast lumps or think they are caused by an infection or some other reason, and they do not get medical treatment until the mass has had a chance to grow. Some men are embarrassed when they find a breast lump and worry that someone might question their masculinity. This could also delay diagnosis and reduce a man's chances for successful treatment.
Because breast cancer is so uncommon in men, there is unlikely to be any benefit in screening men in the general population for breast cancer with mammograms or other tests.
For men who are or may be at high risk
Careful breast exams might be useful for screening men with a strong family history of breast cancer and/or with BRCA mutations found by genetic testing. Screening men for breast cancer has not been studied to know if it is helpful, and mammography (x-rays of the breast) is usually only done if a lump is found. Although sometimes a mammogram may be done in men who come to their doctors with gynecomastia (benign breast enlargement), it isn’t clear how helpful that is, either. Men who are at high risk for breast cancer should discuss how to manage their risk with their doctor.
Genetic counseling and testing
If you have a strong family history of breast cancer (in men or women) and/or ovarian cancer that might be caused by a BRCA mutation, and/or if someone else in your family is known to have a BRCA mutation, you might want to consider genetic testing to determine if you have inherited a mutated BRCA gene. If the test detects a mutated BRCA gene, you and your health care team can watch carefully for early signs of cancer. Other cancers (besides breast and ovarian cancer) have been linked to BRCA mutations, including prostate cancer, pancreatic cancer, and testicular cancer.
Because breast cancer in men can be caused by BRCA mutations, men with breast cancer should also consider genetic testing.
If you are thinking about having genetic testing, it is strongly recommended that you talk first to a professional qualified to explain and interpret these tests, such as a genetic counselor or a nurse or doctor with special training. It is very important to understand what genetic testing can and can't tell you, and to carefully weigh the benefits and risks of testing before having it done. Test results are not always clear cut, and even if they are, it's not always clear what should be done about them. There may be other concerns as well, such as what the results might mean for other family members. Testing is also expensive and may not be covered by some health insurance plans.
For more information, see our separate document, Genetic Testing: What You Need to Know. You might also want to visit the National Cancer Institute Web site (www.cancer.gov/cancertopics/factsheet/Risk/BRCA).
There have been concerns that people with abnormal genetic test results might not be able to get health or other insurance or that coverage may only be available at a much higher cost, but many states have passed laws that prevent insurers from denying insurance on the basis of genetic testing. The federal government has also passed a law (that went into effect in May 2009) that bars discrimination by health insurers or employers based on genetic information, although it does not address life insurance or other areas.
Last Medical Review: 09/30/2013
Last Revised: 09/30/2013