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There are certain health conditions that all men should keep an eye on, from prostate health to mental health. But when it comes to diseases like breast cancer, that’s something you don’t need to deal with, right? Well … not quite.
Believe it or not, men can — and do — get breast cancer.
How common is breast cancer in men?
On average, about 2,800 men are diagnosed with breast cancer each year in the United States.
This annual estimate is for cisgender men — men who identify with the sex they were assigned at birth. But transgender men can get breast cancer, too.
Dr. Rachel Yung, an oncologist at Fred Hutch Cancer Center, says that historically, gender in breast cancer research and treatment has been binary.
“Rates of breast cancer in men who were assigned female at birth or those identifying as non-binary are not well known,” Yung says.
The hope is that with more data and medical records capturing the diversity of sexual orientation and gender identity, doctors will be able to provide better numbers and information for this demographic.
In the meantime, men assigned female at birth who are considering gender-affirming surgery, and who may be at an increased risk of breast cancer — for example, because of family history — may want to meet with a breast surgeon and plastic surgeon to discuss the best approach.
What causes breast cancer in men?
The most common type of breast cancer in men are invasive ductal carcinomas. These cancers arise from the lining of the milk ducts of the breast and spread. This is also the most common kind of breast cancer in women.
There are a variety of risk factors that increase your chance of getting breast cancer, including exposure to excess estrogen, certain genetics changes and obesity.
Excess estrogen exposure
Gynecomastia, or having more breast tissue, is caused by increased estrogen in the body.
You could have higher estrogen levels because you’re taking high levels of testosterone or anabolic steroids, which are precursors for estrogen.
Why do estrogen levels matter? Well, estrogen stimulates breast cells to grow and divide. The more cell divisions that occur, the higher the risk for a mutation. And the more mutations … the higher the likelihood that one will promote cancer.
In addition, someone could have higher estrogen levels because of estrogen treatments, such as those in gender-affirming medications.
Genetics
Genetics can also play a role in your risk factor in developing breast cancer. Yung says that some men can inherit a gene mutation, such as a pathogenic BRCA1 or 2 variants, which can increase their risk of developing breast cancer.
“There are also cases where there is a lot of breast cancer in the family, but a gene mutation can’t be found,” she says. “Even then, the family members may still be at risk.”
The good news? You can test for these genes, and if a mutation is found, there are specialty clinics that help personalize medical care and cancer screening, regardless of sex or gender.
Obesity
Obesity also increases your risk of breast cancer. The fat cells in the body can convert androgens — hormones typically found more in cisgender men — into estrogen, increasing the estrogen levels in the body.
Other risk factors, such as aging, certain testicular conditions, radiation exposure, alcohol use and liver disease can also increase your risk.
How to find and prevent male breast cancer
Remember — just because you fit into any of these criteria doesn’t mean you’ll get breast cancer. While possible, breast cancer in men is still uncommon.
“If a man has an increased risk of developing breast cancer, they can discuss breast cancer screening with their primary care provider or a breast cancer prevention specialist,” says Yung.
Finding breast cancer early increases the chance of a successful treatment. Yung says that a typical breast cancer screening includes noting any changes in your breast tissue to your doctor and undergoing a clinical breast exam.
“Usually, a breast specialist would help decide about screening imaging for men,” says Yung.
Keep track of any changes you notice in your breast tissue, especially if you’re at a higher risk of developing breast cancer. If you see a rash, nipple retraction or a lump, let your doctor know. If they’re concerned, they can order breast imaging like a mammogram or an MRI.
“Breast cancer screening is different than diagnostic testing and is used only if there isn’t a particular concern,” states Yung. “If someone finds a lump, it needs a full evaluation by a breast cancer or breast health specialist.”
Yung adds that breast cancer treatment is similar regardless of gender and typically includes surgery and can include radiation and medications.
Why should men think about breast cancer?
You should think about breast cancer, not because you’re likely to develop the disease, but because it’s essential to be aware of your body and potential risk factors.
“Male breast cancer is rare but can happen,” says Yung. “The most important thing is to say something if you notice a change on your chest, around the nipples or under your arm, and get it checked out.”
