Low awareness of male breast cancer results in missed early detection opportunities

Breast cancer can affect men just as much as women but men are less aware of their risk, often leading to missed opportunities for early detection, experts said. While male breast cancer patients are physically able to recognize lumps sooner than female patients, the lack of awareness results in lower rates of early detection.

“Male breast cancer patients have less breast tissue than female breast cancer patients, so they can be detected early because most of them are palpable,” said Kang Eun-hye, a professor of breast and endocrine surgery at Seoul National University Hospital (SNUH), on the hospitals’ YouTube channel.

“Men are born with the same mammary gland tissue as women,” said Kim Hong-kyu, a professor of breast and endocrine surgery at SNUH.

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During puberty, female hormones stimulate the development of women's mammary glands, while men retain only a portion of their mammary tissue. However, since men also have mammary tissue, they remain susceptible to certain conditions, including breast cancer.

Of course, the number of male breast cancer patients is significantly lower than that of female patients. “If there are 200 female breast cancer patients, only one or two are male,” said Kang, noting that male breast cancer accounts for just 0.5 to 1 percent of female breast cancer cases. Despite the difference in incidence rates, the causes of breast cancer in men and women are quite similar.

"Male breast cancer is similar to female breast cancer in terms of how it develops. The risk of breast cancer increases when there is an imbalance between the male hormone testosterone and the female hormone estrogen," Kim said. "Genetic factors play a slightly larger role in male breast cancer than in female breast cancer, with the BRCA1 and 2 genes being responsible for about 80 percent of cases."

In addition to the imbalance between testosterone and estrogen and BRCA1 and 2 gene mutations, other factors have been suggested to contribute to male breast cancer. "Cirrhosis of the liver, alcoholism, and obesity are known causes of male breast cancer," says Kim. Men with gynecomastia also face an increased risk of developing breast cancer.

Gynecomastia is a condition in which male mammary gland tissue develops similarly to that of women due to hormonal imbalance, according to Kim.

"Men with gynecomastia may face issues such as breast cancer. When a man has gynecomastia (a palpable lump in the chest), the first thing to check for is a malignant lesion," he said.

Although breast cancer treatment outcomes are similar for men and women at the same stage, men tend to have poorer outcomes due to lower awareness of the disease. “If the staging is the same, there is no difference in treating female and male breast cancer, and the survival rate is the same,” Kang said. “However, men have a lower survival rate because of a lack of awareness of male breast cancer, which often leads to late diagnoses and higher stages.”

Men should also be concerned about breast cancer if they feel a lump in their breasts or notice discharge from their nipples. Since breast cancer in men is highly genetic, it's important to recognize that a family history of BRCA1 or 2 genetic mutations increases the risk of developing breast cancer, making screening essential.

However, due to low awareness of male breast cancer, many men with genetic risk factors do not undergo breast cancer screening. “The proportion of male breast cancer caused by genetic factors is very high,” Kang said. “But even if parents are aware that their sons have BRCA gene abnormalities, it seems that they are not getting screened for breast cancer.”

Men are diagnosed with breast cancer in the same way as women. Mammograms, breast ultrasounds, biopsies, and systemic examinations are used to stage the cancer, and treatment is based on the type of breast cancer. The proportion of breast cancer types is slightly different between men and women. "In general, male breast cancer is more hormone-positive than female breast cancer," explains Kang.

Although there are patients with HER2-positive breast cancer or triple-negative breast cancer, there are slightly more hormone-positive breast cancer patients, resulting in a slightly different ratio of breast cancer subtypes compared to female breast cancer patients. The benefits of early detection for female breast cancer are equally applicable to male breast cancer, highlighting the need to improve awareness of male breast cancer.

"Anyone can get breast cancer. This is true for men as well," Kim said, adding, "We need to be aware of this, take care of our health, and get the necessary screenings."

Kang also emphasized, "Although the rate of male breast cancer is not high, it is often not considered at all. It is important to be aware of male breast cancer and to seek prompt medical attention if you notice any suspicious symptoms."