Can Breast Cancer in Men Be Found Early?

Finding breast cancer early improves the chances that male breast cancer can be treated successfully. However, 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.

Differences in early detection of breast cancers in men and women

There are many similarities between breast cancer in men and women, but there are some important differences that affect finding it early.

Breast size

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, 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 (outcome) 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 many men do not think that they can get it at all. Some men ignore breast lumps or think they are caused by an infection or some other reason, and don't 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.

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) and ultrasound is usually only done if a lump is found. 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), ovarian cancer, pancreatic cancer, and/or prostate 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 including prostate cancer, pancreatic cancer, and testicular cancer have been linked to BRCA mutations. .

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.