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Early detection improves the chances that male breast cancer
can be treated successfully.
Differences between male and female breast
cancers
There are many similarities between breast cancer in men and
women, but some important differences affect early detection.
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. 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 have more often spread beyond the breast. The extent of
spread beyond the breast is one of the most important factors in the
prognosis (outlook) of a breast cancer.
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, while 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 about finding a breast lump and worry that someone
might question their masculinity. This may also delay diagnosis and
reduce a man's odds 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.
For men who are or may be at high risk
Mammography (x-rays of the breast) along with 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. Men
with such a history should discuss this with their doctor.
Genetic 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, you may 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. Mammography can be effective in finding early breast cancer
in men.
If you are thinking about genetic testing, it is strongly
recommended that you talk first to a genetic counselor, nurse, or
doctor qualified to explain and interpret these tests. 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 these
tests are 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 may also want to visit the National Cancer
Institute Web site (www.cancer.gov/cancertopics/Genetic-Testing-for-Breast-and-Ovarian-Cancer-Risk).
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
(going 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. To learn about state laws
against genetic testing discrimination, you may want to visit the Web
site of the National Conference of State Legislatures (www.ncsl.org/programs/health/genetics/ndishlth.htm).
Last Medical Review: 09/24/2008
Last Revised: 05/13/2009
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