Despite how different they look on the outside, the build of women’s and men’s breasts are more similar than most people know. The breasts of both biological sexes contain fatty tissue, breast cells, ducts, and nipples. Both males and females are also vulnerable to many of the same cancer-contributing influences, including advancing age, hereditary disorders, and previous exposure to radiation therapy, among other risk factors for breast cancer. Furthermore, whether born male or female, both sexes produce estrogen–a hormone suspected to be a more powerful breast cancer culprit than scientists realized.
But why do fewer men get breast cancer?
Less than 1 percent of all breast cancers occur in men. Similar to previous years, in 2024, about 2,790 men will get breast cancer, and approximately 530 will die. In comparison, about 297,790 women will develop it, and 43,170 will die. The question is, why the disparity?
Here are the reasons breast cancer is rarer in men:
1. Males have less breast tissue
Males have far less breast tissue than females. While women develop milk-producing mammary glands, their male counterparts do not. Men mostly have supportive fibrous tissue and fat called stroma.
Malignant tumors can originate in the lobules (lobular carcinoma) and ducts (ductal carcinoma in situ) responsible for producing and carrying milk. By comparison, although male breast tissue contains ducts and a few lobules (if any), they do not develop to produce and store milk after childbirth.
In essence, the less breast tissue a person has, the lower their risk of developing breast cancer. As the primary function of mammary glands in women is milk production, they contain complex breast tissue that can potentially lead to abnormal cell growth and cancerous tumors. Given that men have less breast tissue than women, they correspondingly face a much lower probability of getting breast cancer. This inverse relationship between the quantity of breast tissue and cancer risk is a biologically reasonable conclusion based on current scientific understanding of the human body and the causes of breast cancer.
2. BRCA mutations in males are more likely to cause prostate cancer
Mutations in the BRCA genes can increase an individual’s risk of developing cancer. While BRCA mutations impact men and women alike, the effects differ based on sex. In particular, although BRCA gene alterations modestly raise a man’s risk of breast cancer, the more significant threat is prostate cancer.
Because of the alarming incidence rate of prostate cancer (about 1 in 8 men) and the evidence linking BRCA mutations to increased risk, men should undergo genetic testing and counseling if they have a family history suggestive of breast and ovarian cancer syndromes. Understanding how BRCA status can influence cancer risks provides opportunities for early detection, as well as prevention efforts that can help improve outcomes.
3. Males produce less estrogen
In general, women produce more estrogen than men. This differential in estrogen levels provides a hypothetical explanation for why male breast cancer is rarer, revealed Dr. Cynthia Lynch, the Medical Director of the Breast Center at Cancer Treatment Centers of America in Phoenix, Arizona.
However, some men have high estrogen levels, resulting in a condition known as gynecomastia, where male breast tissue grows or swells. In rare cases, the underlying causes of overdeveloped or enlarged male breast tissue, including elevated estrogen levels, may contribute to breast cancer occurrence.
Some of the reasons men have high estrogen levels include:
- Medical conditions: Obesity, liver or kidney disease, Klinefelter’s syndrome, tumors, and hypogonadism can cause a relative rise in estrogen levels in men.
- Medications: Anabolic steroids, antipsychotics, and some anti-inflammatories can lead to higher estrogen levels.
- Lifestyle factors: Smoking, excessive alcohol intake, and stress can increase estrogen production.
Women naturally produce higher amounts of estrogen, as the hormone is instrumental in female sexual development and the reproductive cycle. Still, higher-than-normal levels, especially in pre- and postmenopausal women, can cause unwanted weight gain, fatigue, fibroids, and potential breast cancer. In contrast, testosterone is the primary sex hormone in males. While men also produce estrogen, it is in much smaller quantities and serves different functions than in women.
4. It’s uncommon for men to get screened for breast cancer
Unlike with women, healthcare professionals rarely advise men to undergo routine breast cancer screening. One contributing factor is the peculiarity of male breast cancer, leading many physicians to doubt or become awestruck when a man exhibits signs of the disease.
Without routine screening, many breast cancers in men are discovered later on, when symptoms appear. Some of the most common signs of male breast cancer include a lump or mass in the breast tissue, nipple discharge or inversion, and skin changes such as dimpling or redness. By the time these symptoms become noticeable, the cancer has presumptively spread beyond the breast tissue, making treatment more complex.
Semi-annual clinical exams are mostly suggested for men with a strong family history, genetic predisposition, or personal history of breast cancer. On the other hand, women between 40 and 44 have the option to begin mammogram screenings every year, while women 45 to 54 should schedule annual mammograms. As for women 55 and older, they have the option to continue yearly mammograms or do so every other year.
Are there different risk factors for female vs. male breast cancer?
While many risk factors apply to both sexes, some are specific to either men or women.
Hormonal influence
- Women: Prolonged exposure or elevated levels of estrogen and progesterone may lead to breast cancer development.
- Men: Testosterone imbalance and estrogen excess increase risk.
Genetic predisposition
- Women: BRCA1 and BRCA2 mutations significantly heighten breast cancer risk.
- Men: BRCA gene mutations also pose a risk, but CHEK2 and PALB2 mutations are more prevalent among men with breast cancer.
Age distribution
- Women: Breast cancer incidence rises with age, peaking in postmenopausal years.
- Men: Male breast cancer typically occurs at an older age, often diagnosed at 60 and up.
According to the National Cancer Institute, 68 is the median age of men diagnosed with breast cancer. Meanwhile, the average age for women is 62, and about one-third of all diagnoses occur in women younger than 55. Although breast cancer is more common in older individuals, keep in mind that it can also affect young men and women, including children in very rare cases.
Family history
- Women: Strong family history, particularly a maternal lineage with breast cancer, raises susceptibility.
- Men: Family history of malignant breast tumors, especially in first-degree relatives, also amplifies the risk of cancer in men, though less frequently observed.
Radiation exposure
- Women: Radiation exposure, often during initial breast cancer treatment, can increase a woman’s risk for recurrence.
- Men: Occupational exposure to ionizing radiation, such as in industrial settings, poses a heightened risk for male breast cancer. Men who undergo radiation therapy to treat other cancers, such as lymphoma or lung cancer, may receive radiation to the chest, which can increase the chances of developing breast tumors later in life.
Hormonal therapies
- Women: Hormone replacement therapy (HRT) and some birth control methods may raise breast cancer risk.
- Men: Testosterone replacement therapy (TRT) and feminizing hormone therapy used in transgender individuals may contribute to cancer development.
Lifestyle factors
- Women: Obesity, alcohol consumption, and lack of physical activity are established risk factors. Read 13 Healthy Living Strategies for Breast Cancer Prevention for more details.
- Men: Similar lifestyle factors apply, although the impact of obesity and alcohol intake are less pronounced in men compared to women.
Breast density
- Women: Dense breast tissue observed in mammograms is a breast cancer risk factor. It also poses challenges in cancer detection.
- Men: Breast density is not a significant risk factor for breast cancer in men.
Screening difficulties
- Women: Healthcare providers always recommend annual or bi-annual mammography screening to ensure early detection.
- Men: Lack of awareness and routine screening protocols contribute to delayed diagnosis in men, often resulting in more advanced stages.
Societal stigma
- Women: Breast cancer awareness campaigns have normalized discussions and encouraged early detection. In fact, when people think of breast cancer, images of pink ribbons and women often come to mind.
- Men: Societal perceptions of breast cancer as a predominantly female issue often deter men from seeking immediate medical attention.
What makes diagnosing and treating male breast cancer challenging?
The uncommon incidence of male breast cancer, as with other rare disorders, can cause unique challenges for those who develop it and the doctors who treat it.
1. Treatment options for male breast cancer are based on studies about women
Clinical studies focused on addressing breast cancer in women lead the approach used in male breast cancer patients. Although the protocols are similar, there are some distinct differences in how medical professionals administer care based on the patient’s sex. For example, hormone therapy interventions, which prove effective for many women, may require special consideration when prescribed to male patients, as men’s bodies respond differently than women’s.
2. Men are unaware of breast cancer’s symptoms
Many men are unfamiliar with the symptoms of breast cancer. They may mistake a lump in the breast as an exercise-related injury or cyst and not seek medical attention. They may also brush off symptoms like nipple discharge, skin changes around the nipple, and breast pain as “nothing serious.”
Deeper insights: Breast Changes: Are You at Risk of Breast Cancer?
3. Men do not conduct breast self-exams or seek screening
How many men in your life check themselves for breast cancer? The likely answer is zero. Due to male breast cancer’s rarity, the majority of men do not examine their breasts for changes, nor do they have themselves professionally checked for the disease, therefore remaining oblivious to the symptoms. Furthermore, when men do encounter symptoms, fears of emasculation and perceived stigmas may hinder them from getting medical help. In consequence, doctors often diagnose men with advanced breast cancer. Male patients generally have poorer outcomes compared to women due to such late diagnoses and older age.
4. Men may not know how to perform a breast self-exam in the first place
Unlike women, who are constantly reminded to check for signs of breast cancer, men are not taught the importance of performing self-exams. While malignant breast tumors are uncommon in the male population, it’s still an alarming health issue. Self-exams could help detect early signs of cancer, but most men do not know that they should do it monthly.
Learning the how-to’s of breast self-exam techniques could save lives. However, some men are uncomfortable with the idea of touching or examining their own breasts. Men should know that checking their breasts is basic preventative health; it is no different from checking the testicles for lumps.
5. Men may struggle to accept having a “woman’s disease”
Being diagnosed with breast cancer can be emotionally devastating, regardless of one’s gender. Patients may struggle with a sense of loss, particularly if surgery to remove one or both breasts is necessary. Some patients also find it difficult to cope with newfound body image and intimacy issues.
Dr. Aithal stressed that men, to be specific, may feel less masculine and are less inclined to seek support the way women often do.
The most common symptom of male breast cancer is a lump or swelling in the breast tissue. However, men may dismiss this warning sign, believing misconceptions like men do not develop breast cancer. Social taboos against discussing men’s breast health can also prevent them from reaching out to a healthcare professional.
“Breast cancer in males can be distressing,” said Dr. Sramila Aithal, a hematologist and medical oncologist at the Cancer Treatment Center of America in Philadelphia, PA. Strong feelings of shame, embarrassment, loneliness, and anxiety often overwhelm them due to their assigned sex at birth and the stigma around male breast cancer. In addition, many men neglect to show their emotions due to fears of seeming weak or effeminate. However, suppressing or hiding emotions can be detrimental to a man’s mental health, not to mention the repercussions of detecting breast cancer in advanced stages. Joining support groups is not an option for most men either, since most members are women, which may fuel embarrassment and anxiety further.
How do we reduce the stigmatization of male breast cancer?
Men may feel uncomfortable disclosing their symptoms or seeking support due to perceived stigma. They may also face unique challenges navigating a healthcare system focused on treating female patients.
“Given that this [disease] is primarily a malignancy in women, studies have identified that men can feel isolated in their diagnosis,” said Dr. Lynch.
Raising awareness about male breast cancer is one way to help reduce and eliminate feelings of isolation and embarrassment surrounding this diagnosis. Check out Male Breast Cancer Global Alliance, HIS Breast Cancer Awareness, and Male Breast Cancer Happens by Bret Miller and his family, which play active roles in spreading knowledge and offering incredible support systems for men with breast cancer.
Recommended follow-up read: The Stigma of Male Breast Cancer Through the Eyes of a Survivor
Additional facts about breast cancer
Knowledge is a powerful ally against breast cancer. Aside from the information above, it helps to know that:
- In recent years, incidence rates have risen by 0.6% per year. The increase is a bit steeper (1.0%) in women below 50 years old.
- Affecting 1 in 500 to 1,000 newborns, Klinefelter syndrome is a condition wherein men are born with two X chromosomes. They often lead to excess estrogen production, thus increasing their breast cancer risk.
- Female and male breast cancers share similar symptoms, including a lump on the breast, changes in the shape or size of the breast, swelling, redness or irritated skin, and any changes in the nipple.
- Black men with breast cancer usually have a worse prognosis than white men with the same disease.
- The likelihood of a man developing breast cancer is about 2 to 12 in 1,000 men (by age 70) with a BRCA1 gene mutation, and about 20 to 70 in 1,000 men (by age 70) with a BRCA2 gene mutation.
- According to a JAMA Oncology report, the five-year survival rate of male breast cancer is 77.6%, while the five-year survival rate of female breast cancer is 86.4%.
Takeaway
Everyone, whether male or female, has breast cells and tissue. Even though males do not have milk-producing breasts, their cells and tissue are not immune to cancer.
For women, continue breast self-exams and screenings, as breast cancer accounts for roughly 30% of all female cancers each year. Early detection is the best defense against breast cancer and can make the most difference in treatment outcomes.
Men and women experiencing unusual symptoms or have conditions that heighten their risk of breast cancer should not hesitate to meet with a doctor. The sooner the diagnosis, the easier to treat. If breast cancer is present, it’s essential to learn about all treatment options, such as the alternative breast cancer interventions we provide here at New Hope Unlimited. Our protocols aim to address cancer symptoms, stimulate tumor regression, and maximize survival rates for male and female patients.
Not all patients need chemotherapy or other conventional approaches with side effects. Call us at 480-666-1403 to schedule a consultation and expand your treatment options.
