Can men get breast cancer?

Can men get breast cancer too – and how rare is it? DR TAN SING HUANG, Senior Consultant Medical Oncologist at OncoCare Cancer Centre, writes about her experience treating male breast cancer as well as the symptoms to watch out for.

One of my patients, 59-year-old Mr Y, felt a painless chest wall lump for a year. Eventually, it grew until it was visible in the mirror. A biopsy revealed it was breast cancer. Fortunately, it hadn’t spread.

Male breast cancer is rare but it does occur, accounting for 0.5 to 1 percent of breast cancers globally and about 0.2 percent of all cancers in men. The lifetime risk is roughly 1 in 1,000, and the likelihood increases with age. On average, men are diagnosed 5 to 10 years later than women, mostly in their 60s.

Female vs male breast cancer

Compared to female breast cancer, male breast cancers often present with larger tumours and are more likely to involve axillary (armpit) lymph nodes. Nevertheless, the majority of cases are diagnosed at an early (stage I to II) or locally advanced stage (stage III), rather than at the metastatic stage (stage IV). It is usually unilateral, meaning that it only affects only one breast.

Male breast cancer symptoms to know

Watch out for breast cancer symptoms including those found in the breast and armpit. Some of the most common male breast cancer symptoms are:

• A painless (occasionally tender) lump, usually behind the nipple
• Nipple changes such as scaling, discharge, bleeding or retraction
• Skin changes like redness, puckering or ulceration
• Enlarged lymph nodes in the armpit; if a suspicious lump appears, a mammogram, ultrasound and biopsy are essential

Who’s at risk?

Many men who get male breast cancer have no identifiable risk factors. However, certain conditions can increase the likelihood of developing it. These include hormonal imbalances (particularly a high oestrogento-testosterone ratio) that may result from oestrogen-containing drugs, liver cirrhosis, obesity, thyroid disease or Klinefelter’s syndrome.

Testicular disorders, previous chest radiotherapy and a family history of breast cancer – especially involving first-degree relatives or cases diagnosed at a younger age – are also factors. Inherited mutations in the BRCA1 or BRCA2 genes are another significant risk factor, and genetic testing is encouraged.

Treatment options for male breast cancer

Mr Y had a lumpectomy to remove his 11mm tumour along with nearby sentinel lymph nodes. While mastectomy is the usual approach, lumpectomy (breast conserving surgery) can sometimes be an alternative. His tumour was hormone receptorpositive (sensitive to oestrogen and progesterone) and HER2- negative. This is the most common subtype seen in breast cancers.

He didn’t need chemotherapy, but he did receive radiotherapy and started on tamoxifen, a daily tablet that helps block the effects of oestrogen. In other cases, chemotherapy may be needed either after surgery to reduce the risk of recurrence or before to shrink the tumour. Additional treatments often depend on tumour type. Immunotherapy can be used for triple-negative cancers and anti-HER2 therapy for HER2-positive cancers.

After surgery, most men need oral anti-hormonal therapy for either five or ten years. Tamoxifen is preferred but aromatase inhibitors/GnRH analogues may be used if tamoxifen is not feasible. Oral targeted therapies like PARP inhibitors in BRCA mutation carriers or CDK4/6 inhibitors may also be considered.

Staying vigilant post-treatment

Ongoing monitoring is certainly crucial, including yearly mammograms of the treated breast for those who had a lumpectomy, and a mammogram of the opposite breast for men with high-risk gene mutations. Screening for BRCA mutation carriers (without breast cancer) include:

• Monthly self-examination starting at age 35
• Annual clinical breast examination from age 35
• Annual mammogram starting at age 50, or 10 years before the age of the youngest person in the family when diagnosed with breast cancer – whichever comes first

When matched by stage and tumour type, survival in men is similar to women. Luckily, there are effective treatments even for advanced male breast cancer today. Options include antihormonal therapies, targeted drugs and immunotherapy. Lastly, male breast cancer may cause diminished self-esteem and depression, so support groups and encouragement from loved ones are integral in the treatment journey.

About the doctor

Dr Tan Sing Huang is a Senior Consultant Medical Oncologist who has more than 30 years of experience in managing a wide range of cancers. Her subspecialty interests include breast cancers, gynaecological cancers, lung cancers and gastrointestinal cancers.

OncoCare Cancer Centre
Locations at Gleneagles, Gleneagles Annexe, Mount Elizabeth Novena, Mount Elizabeth Orchard, Mount Alvernia, Royal Square Medical Centre and Thomson Medical Centre.
6250 8160 | oncocare.sg | enquiries@oncocare.sg

This article on male breast cancer symptoms and OncoCare Cancer Centre first appeared in the August 2025 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!

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