




































Special Edition: Junior Clinical Research (2022), Vol. 2 No. S2 
 https://doi.org/10.47488/dhrp.v2iS2.71 

 

 
DHR Proceedings ǀ http://dhrproceedings.org 106 2022, Vol. 2 No. S2 106-115 

 

COMMENTARY 

Breast Cancer in Men 
 

 

Michael Garza1,2, Adamari Morin1,2, Abigail Godinez1,2, Ian Luna1,3, Marianna Silva1,2, Danica 

Escobedo1,3, Melissa Gonzalez1,2, America Perales1,2, Nathalie Palacios1,2, Camila Urquizo1,2 

 
12nd Annual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health 

Institute for Research & Development 
2Mission High School, Mission, TX 
3Pharr San Juan Alamo High School, Pharr, TX 

 

All correspondence should be addressed to Program Director, 2nd Annual Junior Clinical Research Internship Program, DHR 

Health Institute for Research & Development, 5323 S McColl Road, Edinburg Texas, 78539 

 

Received 08/04/2022 

Accepted for publication 08/15/2022 

Published 08/16/2022 

 
 
Introduction   

 
 Breast cancer is the rapid growth and division 

of cells in the breast’s anatomy [1]. It’s well-known 

and well-studied because of its common occurrence 

and high incidence in women [2]. Estimates made by 

the National Cancer Institute show that breast cancer 

is the most frequently diagnosed cancer in the United 

States in 2022[3]. However, it's unknown to many that 

men can also develop breast cancer [4]. While cases 

are rare, its presentation and prognosis in men, the 

development of the disease, the genetic mutations that 

show higher risk of breast cancer in one sex over the 

other, and slight but notable differences in the 

pathophysiology of male breast cancer compared to 

female breast cancer are topics worthy of discussion 

and further study [5]. 

 

 Male breast cancer is a relatively 

misunderstood and understudied disease due to its 

rarity in the sex [6]. Less than 1% of all breast cancers 

are found in men, and less than 1% of all cancers found 

in men are breast cancers [7]. Still, the disease is a 

serious topic worthy of discussion as rates of male 

breast cancer have steadily risen each year all across 

the globe [8]. This may be in part due to risk factors 

such as obesity and hormonal imbalances being more 

prevalent in the present day [9]. Additionally, genetic 

mutations such as BRCA1 and BRCA2 can predispose 

some men to develop male breast cancer, and are more 

likely to develop the disease if they have a blood 

relative who has developed breast cancer [10]. Most 

men do not properly screen themselves for the disease 

and most are completely unaware of what symptoms 

of the condition may present as. This leads to 

diagnosis at later stages of the disease [11, 12]. 

Stigmatization also plays a role in delayed diagnosis 

and treatment leading to a significantly higher 

mortality rate when diagnosed with breast cancer than 

women [13-16]. Unfortunately, because of the rarity 

of the disease and its lack of understanding even in the 

medical community, primary care providers and other 

physicians who are unaware of how to recognize, 

manage, or treat male breast cancer may delay 

treatment or refer patients to another doctor who is 

inexperienced in diagnosing the disease [17]. More 

research on the disease in men is needed and 

awareness should be raised in the community and 

medical field. 

 

Prognosis 

 
 Since male breast cancer is found in less than 

1% of any type of cancers in men and less than 1% in 

breast cancer in the Unites of States, there is little 

information about its etiology. A research study that 

investigated the differences between men and women 

in regards to mortality and survival rates in breast 

cancer found that breast cancer in men is diagnosed in 

a higher stage than in women, since it is detected later 



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on [18]. Unlike women, screening allows for breast 

cancer to be detected and treated earlier than it is for 

men.  

 There are 2 main subtypes, one being the 

complex subtype which seems to be similar to the 

female luminal breast cancer. Then there’s the male 

simplex subtype that does not exist in female breast 

cancer. Breast tissue consists of milk-producing 

glands (lobules), ducts that carry milk to the nipples, 

and fat [10]. During puberty, women begin developing 

more breast tissue, and men do not. But because men 

are born with a small amount of breast tissue, they can 

develop breast cancer. If men have been diagnosed 

with breast cancer, they might need more tests to see 

if the cancer might have spread [19]. 

 Some possible symptoms of breast cancer in 

males include lumps or masses in the breast area. 

However, it's important not to rely on these alone. You 

should also see your doctor if you notice any unusual 

changes in size, shape and feel of one or both of your 

breasts. It's important to remember that the symptoms 

of breast cancer in males aren't the same as those of 

women. Knowing the common symptoms can help 

you get early treatment and make sure that you're 

getting regular checkups from your doctor. As we 

know, BC in males is quite rare. However, there are 

several explanations that may help men understand 

how breast cancer can happen in men. We have age, 

overall health, estrogen levels, family history, genes, 

radiation therapy, and testicular issues [20].  

 

 First of all, those men who are 60 years or 

older are more likely to develop breast cancer. It is not 

common for men to experience gynecomastia. 

However, a condition known as gynecomastia is a 

condition that occurs in a few men, that is an 

enlargement of the male breast gland or fat tissue in 

the chest area. If you have a first degree relative 

(mother, sister, or daughter) with BC, you have an 

increased risk of developing the disease yourself. 

Estrogen is a hormone produced by the ovaries. 

Certain drugs, cirrhosis and Klinefelter syndrome 

increase estrogen levels, increasing the risks of several 

health problems, including BC. Scientists have 

identified several genes that affect your risk of 

developing breast cancer. These include changes in the 

BRCA1 and BRCA2 genes.  Those who have had 

radiation therapy in the chest or torso, have a higher 

risk of developing BC. Last but not least, the removal 

of the testicles increases a man’s risk of breast cancer 

because he does not produce testosterone. Testicle 

injuries also increase the risk [21].  

Prevalence  

 
According to the American Cancer Society, 

2,700 men are diagnosed with breast cancer, meaning 

one in every 833 men will be victims and nearly 530 

die from the disease [22]. This is actually less than one 

percent of male population and much lower than the 

rate of breast cancer in women, making it very easy to 

ignore. However, male breast cancer has been proven 

to be more prevalent depending on race. It has been 

shown to be higher in non-Hispanic black races and 

whites [23]. They are 1.2-1.5 times more likely to get 

diagnosed with breast cancer. Another main factor is 

age. Even though it is a disease that is present in all 

ages, it is much more common in individuals who are 

60+ years old. Mortality rates also increase with age, 

but most cases are treated while in stage II [24].    

  

In addition, location also seems to play a 

significant role. It has been shown to be more common 

in metro areas, according to the national cancer 

database [25]. In fact, numbers in metro areas are 

larger than rural and urban populations combined. 

This especially applies to east and central regions 

rather than western ones. In the past years, this disease 

has been shown to increase in both male and females. 

Over the last 10 years, the rate has gone from 7% to 

10.3 % [26]. The good news is that, although breast 

cancer in men is gaining more prevalence, death rates 

have remained low and are progressively decreasing.  

 

Risk Factors 
 

Proneness to breast cancer amongst men 

starts increasing at the age of 50. Risk factors include 

genetic mutation, family history of breast cancer, 

exposure to estrogen, alcohol, liver disease, 

Klinefelter’s syndrome, testicle disease or surgery 

[27]. There is a current lack of awareness regarding the 

role of obesity in male breast cancer. Men with a 35% 

high BMI have a greater risk than men with a low BMI 

[28]. Table 1 includes risk factors for male breast 

cancer. 

 

Genetics 

 
Genetics dictate all physical characteristics 

within all living organisms including, predisposition to 

diseases, allergies and mutations. Male breast cancer 

(MBC) is no different. Modern technology such as 

polymerase chain reaction (PCR), gene probes, 

oligonucleotide arrays, microchips and next-

generation sequencing technologies permit us to 

analyze genes and their roles within the body such as, 



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DHR Proceedings ǀ http://dhrproceedings.org 108 2022, Vol. 2 No. S2 106-115 

susceptibility to certain conditions [30]. If the patient 

has a positive family history from MBC, then the 

genetic likelihood for them contracting is increased 

compared to another man with a negative family 

history with 10% of all MBC cases caused by inherited 

gremlin mutations. Genes are classified as high-

penetrance, moderate-penetrance and low-penetrance. 

Genes known to increase likelihood for developing 

MBC include BRCA1 & BRCA2 as high penetrance, 

the level of penetrance of a gene is determined by the 

rate of mutation and magnitude of impact. Known high 

penetrance genes involved in MBC include BRCA1 

and BRCA2 which when mutated point at a high risk 

to developing MBC whilst variants of the genes can 

have a <5% moderate risk factor and CHEK 2 & 

PALB2.  With recent findings pointing at a low-

penetrance group of MBC susceptible alleles but their 

low penetrance leaves ambiguity in their direct 

correlation to breast cancer [31]. Table 2 outlines the 

classes of male breast cancer genetic susceptibility and 

comparison of their different features and Figure 1 

shows the regularity of gene mutations in MBC 

tumors. 

 

Treatments 
 

There are different ways breast cancer in men 

can be treated, it can be as simple as taking medication 

to as complicated as needing radiation. Treatments in 

male and female breast cancer are similar but most 

male patients will undergo radiation therapy and 

mastectomy, while female patients most commonly 

partake in chemotherapy and lumpectomy [33]. Male 

and female treatments involve: surgery, 

chemotherapy, radiation therapy, hormone therapy, 

and targeted therapy [34]. Surgery, in surgery 

treatment there are two main types: lumpectomy and 

mastectomy [35]. A lumpectomy surgery removes the 

tumor and small parts of normal tissue; while a 

mastectomy surgery removes the whole breast which 

may include part of the skin, nipple, areola, and lymph 

nodes. Chemotherapy, chemotherapy is a treatment 

that can be taken by pill or injection, the drug helps 

prevent growth of more cancer cells by either stopping 

the cells from dividing or killing them. Hormone 

therapy, hormone therapy is a treatment that is used 

only for hormone sensitive cancers, it stops hormones 

or blocks hormone receptors from attaching to cancer 

cells to prevent or decrease the production of 

hormones [36]. Radiation therapy, radiation therapy is 

a treatment that involves high energy x-rays and 

radiation to kill or keep cancer cells from growing. 

There are two types of radiation therapy: external and 

internal radiation. External radiation uses a machine 

that delivers radiation outside the body towards the 

cancerous area and internal radiation is a device that is 

temporarily placed on the cancerous area after surgery 

[37]. Targeted therapy, targeted therapy causes the 

least amount of harm to normal cells then other breast 

cancer treatments, this treatment uses drugs to identify 

specific cancer cells and attack protein that makes 

cancer cells grow in an abnormal way [38]. Clinical 

trials, clinical trials are a type of research study that 

helps improve ongoing treatments or collect 

information to help with new treatments. For many 

patients, clinical trials are the best treatment option. 

Some trials use patients that have yet to be treated and 

others whose cancer has not improved. Clinical trials 

are starting to take place all over the country helping 

to determine how cancer will get treated in the future. 

However, risk of having breast cancer and going 

through treatment can be reduced by keeping a healthy 

weight and exercising regularly. 

 

Awareness 
 

Since breast cancer in males is not as 

prevalent within the population, there is a lack of 

awareness that contributes to many late diagnoses 

[39]. A majority of 81% of men that have been 

diagnosed were not aware of the presence of their 

illness, while only 19% of men were aware that they 

had cancer [40]. These statistics occurred as a result of 

the lack of knowledge provided about the sickness and 

the symptoms that can occur. Depending on the 

growth of the cancerous cells, it can be easier to detect 

breast cancer in men if the growth is around the 

mammary papilla because the abnormal lumps would 

be more visible compared to those found in women 

[41]. However, since men's breast tissue is smaller in 

mass, the possibility of the cancerous cells multiplying 

behind the teat can increase the potential of being 

diagnosed late. While women have yearly checkups 

and a screening process with their physicians to make 

sure that these abnormalities are not occurring within 

the breast, males have no sort of confirmation to 

provide reassurance that they themselves are not 

developing abnormalities [42]. This information is 

extremely important to know to help the prevention of 

growth, but yet not many males are provided this 

information, and as a result, many lives are lost. 

Learning about breast cancer in men can reduce the 

risk of late diagnosis and help provide treatment in the 

early stages of development. By raising awareness and 

improving the educational process in which we inform 

males about the possibility of breast cancer, we can 

eliminate the social stigma of breast cancer in men, 

and prevent the progression of cancer development, 

helping to save many lives.  

 

 



Garza, et al  Breast Cancer in Men 
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The Stigma: A Woman’s Disease in Men 

 
When the general population fears a 

diagnosis, namely cancer, it tends to become a stigma 

in society. Stigmatization can lead to becoming 

isolated and excluded socially via loss of employment 

which can lead to loss of household and social status. 

A newly diagnosed male having what is traditionally 

misconceived as “a woman’s disease” can end up with 

a negatively impacted sense of self identity. 

Emasculation is also a likely result of a male breast 

cancer (MBC) diagnosis [43]. Another factor that 

promulgates the stigma is sexism. Breast cancer 

screening is established in preventive medicine care 

for female patients, while prostate cancer screening is 

the preventive medicine focus for male patients [44]. 

In a qualitative study on MBC for participants ages 53-

83, the participants expressed uncertainty in using 

tamoxifen for their hormone treatment. They felt there 

should be a need to study the effectiveness of the 

hormone based drug in males. Furthermore, there are 

many advertisements for solutions to chemotherapy 

induced problems with respect to body image such as 

the use of special bras and breast implants, and hair 

replacement for females, but not for males [45, 46]. 

Hair loss and alopecia due to chemotherapy are issues 

that cause distress in both males and females. Yet, very 

few academic or medical journal articles can be found 

on the topic of male alopecia due to MBC treatment. 

Study results reveal that males are not able to hide hair 

loss, and females have more tools available to decrease 

the appearance of hair loss. Also, males tend to make 

jokes to hide insecurities caused by hair loss [47]. 

Healthcare providers need to better understand the 

underlying of how patients deal with MBC as 

compared to females in order to better address their 

social and psychological needs.  By anticipating MBC 

patients’ emotional, psychological and physical needs, 

the effects of stigmatization may be minimized. 

 

Survival Rate 

 

If you haven't been diagnosed with male 

breast cancer and you have a BRCA1 or BRCA2 

mutation, your doctors may recommend that you 

receive periodic screenings for breast cancer and other 

cancers [48]. The 5-year survival rate for men with 

breast cancer is 84%. The survival rate depends on 

different factors, including the stage of disease when 

it is first diagnosed. Study shows that about 47% of 

cases are diagnosed at this localized stage. It is 

important to remember that statistics on the survival 

rate for men with breast cancer are at an estimate. The 

estimate comes from annual data based on the number 

of men with this cancer in the United States. Also, 

experts measure the survival statistics every 5 years. 

This means the estimate may not reflect the results of 

advancements in how men with breast cancer are 

diagnosed or treated from the last 5 years. Even if the 

cancer is found at the most advanced stage, new 

treatments help many people with breast cancer 

maintain a good quality of life for some time. Also it 

varies on how you respond to the treatment, and 

depends on how healthy you were before having breast 

cancer. Survival rates can describe any length of given 

time. However, researchers usually give cancer 

statistics as a 5-year relative survival rate. There is a 

5-year survival rate for men, the 5-year survival rate 

for men is 84%. There are different types of cancer so 

it depends what type of cancer you have to know the 

survival rate. The most common breast cancer found 

in men is the same kind found in women. Survival 

statistics also help doctors evaluate treatment options. 

Depending on where the cancer spreads, for example 

if it spreads to a distant part of the body the 5-year 

survival rate would be 22%. These epidemiologic 

factors, in addition to studies suggesting that men with 

breast cancer have elevated estriol production, indicate 

a relationship between male breast cancer and 

hormones in addition to the well-established 

relationship with genetics [49]. It depends on the type 

of cancer men have and some can have a lower chance 

of survival rate. The stage of cancer, because 

sometimes it is worse, for example it could be stage 5 

or 1. How you respond to the treatment is also very 

important. Our body’s respond differently to the 

treatment. Your age and how healthy you were before 

cancer helps a lot and most likely shows how you are 

going to react to the treatment. Treatment and 

management of male breast cancer typically follow the 

same rationale of breast cancer in females, which 

consists of resection followed by adjuvant endocrine 

therapy, chemotherapy (CT), or radiotherapy [27]. 

Many people do not realize that men have breast tissue 

and that they can develop breast cancer. The cells in 

our body can become cancer and can spread to other 

areas. If you haven't been diagnosed with male breast 

cancer and you have a BRCA1 or BRCA2 mutation, 

your doctors may recommend that you receive 

periodic screenings for breast cancer and other 

cancers. 

 

Conclusion  

 
 Although breast cancer is one of the least 

common types of cancer amongst males, risk is still 

present. With approximately 530 deaths a year and a 

mortality rate of 0.29%, the uncommonness of the 

disease does not invalidate its risk of mortality [13,22]. 

Furthermore, current statistics regarding male breast 

cancer are not believed to accurately encompass 

reality due to the lack of awareness and societal 



Garza, et al  Breast Cancer in Men 
https://doi.org/10.47488/dhrp.v2iS2.71 

 

 
DHR Proceedings ǀ http://dhrproceedings.org 110 2022, Vol. 2 No. S2 106-115 

discredit (neglection) within the male population. This 

causes a vast amount of undiagnosed patients to go 

unseen or be diagnosed at a late stage contributing to 

less than 1% of breast cancers diagnosed in men [50]. 

The low prevalence complicates any further studies on 

the psychosocial effects of the disease in men, 

pathophysiological differences in men and women, 

and the causes behind higher mortality rates. 

 

 Although little research has been conducted 

regarding the effects of treatment on males with MBC, 

a recent survey found worse mental and physical 

health in breast cancer survivors [51]. Poorer mental, 

physical, and emotional health was correlated with 

obesity, diabetes, and activity limitations in patients 

with MBC [52]. With MBC being primarily hormone 

receptor positive, including the androgen receptor 

(AR) and prevalence of BRCA2 germline mutation, 

female breast cancer and MBC are different 

molecularly (different gene mutations and subtypes) 

and in histology [10]. Due to inadequate research in 

men, diagnosis and treatments are shy of current 

scientific advancements available to women [5]. MBC 

survival rates are overall 4.6 % lower than that of 

female breast cancer patients [26]. Despite biological 

differences, current treatments for males are mostly 

based on studies done in women [53]. However, 

discovery and application of different treatments such 

as poly-ADP-ribosome polymerase (PARP) 

inhibitors, sex-steroid biosynthesis pathway, and AR 

activation (targeted agents) are promising for the 

treatment of MBC [10]. As the rate of MBC incidence 

increases yearly, global cooperation and further 

research is imperative for the further advancement of 

treatment and awareness [26]. There is evidence that 

spreading awareness amongst patients and medical 

professionals leads to an increase in early-stage 

detection leading to overall and disease-free survival 

[10, 26]. There is an opportunity to develop education 

and awareness campaigns and research done on the 

disease as a whole, making it easier to inform the 

public and healthcare providers on how to properly 

diagnose, manage, and treat breast cancer in men. 

 

Acknowledgments 

Dr. Monica Betancourt-Garcia, MD, Scientific 

Director; Melissa Eddie, MS, Program Manager; 

Xochitl Lopez, BS, Program Coordinator 

 

 

 

Funding 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set! Region One 

ESC GEARUP College Now, Career Connected and 

Region One ESC PATHS 

 

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https://doi.org/10.47488/dhrp.v2iS2.71 

 

 
DHR Proceedings ǀ http://dhrproceedings.org 114 2022, Vol. 2 No. S2 106-115 

Table 1: Risk Factors for Male Breast Cancer 

 

28 Centers of Disease Control and Prevention. (n.d.). Breast Cancer in Men. CDC. Retrieved August 2, 2022, from https://www.cdc.gov/cancer/breast/men/ 
 29American Cancer Society. “Risk Factors for Breast Cancer in Men - What Causes Breast Cancer in Men? - Can Breast Cancer in Men Be Prevented?” American 

Cancer Society, 27 April 2018, https://www.cancer.org/cancer/breast-cancer-in-men/causes-risks-prevention/risk-factors.html. Accessed 2 August 2022 

 

 

Strong  

Risk Factors 

Moderate  

Risk Factors 

Weak  

Risk Factors 

Family history of breast cancer. 

Having breast cancer family 

members increases the risk of 

developing this disease. 

 

Genetic mutation. Men who inherit 

BRCA2 have a 6% greater risk of 

breast cancer 

 

Liver disease. Male breast cancer 

risk increases as scarring of the 

liver lowers androgen levels and 

raises estrogen levels. 

 

Testicle disease or surgery. Having 

orchitis, an injury, swelling, or 

surgery to remove a testicle has a 

higher risk of breast cancer.  

 

Klinefelter’s syndrome. A rare 

genetic condition that has caused 

the male to have an extra X 

chromosome. 

 

Exposure to estrogen. Hormone 

therapy for prostate cancer can 

increase your risk of breast cancer 

Older age. As you get older the risk of 

having breast cancer increases. Male 

breast cancer is often diagnosed in their 

early 60s. 

 

Radiation therapy treatment. Men who 

are treated for cancer in the chest may be 

at increased risk of developing breast 

cancer. The hormonal changes that 

occur after radiation treatment in men 

can cause abnormalities in breast tissue 

 

Obesity. Men who have obesity or are 

overweight are mostly likely to get 

breast cancer 

 

Hormone therapy treatment. 

Prostate cancer treatment with 

drugs containing estrogen increases 

men’s breast cancer risk. 

 

Alcohol. Drinking alcohol is linked 

to an increased risk of breast cancer. 

This may be due to the effects of 

heavy drinking on the liver, which 

can influence how Hormone 

receptors work in the body. 

 



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Table 2: Classes of male breast cancer genetic susceptibility and comparison of their different 

features 
  

High Penetrance Moderate Penetrance Low Penetrance 

Genes BRCA2, BRCA1 CHEK2, PALB2 2q35, 6q25.1 (ESR1), 

10q21.2, 11q13.3, 

12p11.22, 14q24 

(RAD51L1) and 16q12.1 

(TOX3) 

Population frequency <0.1% MAF 1% MAF >10% 

Cancer  

risk  

(odds ratio) 

>10.0 >2.0 0.76–1.57 

Functional effect Direct effect of 

mutation 

Direct effect of variant Direct effect of variant; 

linkage disequilibrium 

with causal variants 

Strategy for 

identification 

Resequencing of 

candidate genes 

Resequencing of 

candidate genes 

Case–control studies; 

genome-wide association 

study (GWAS) 
31 P. Rizzolo, V. Silvestri, S. Tommasi, R. Pinto, K. Danza, M. Falchetti, M. Gulino, P. Frati, L. Ottini,Male breast cancer: genetics, epigenetics, and ethical aspects, 

Annals of Oncology,Volume24,Supplement8,2013,Pagesviii75-viii82,ISSN0923-

7534,https://doi.org/10.1093/annonc/mdt316.(https://www.sciencedirect.com/science/article/pii/S0923753419315996) 

 

 

 

 

 
Figure 1. Regularity of gene mutations in MBC tumors and BC (Breast Cancer) and The Cancer 

Genome Atlas genetics program (TCGA) samples 
32 Campos FAB, Rouleau E, Torrezan GT, Carraro DM, Casali da Rocha JC, Mantovani HK, da Silva LR, Osório CABT, Moraes Sanches S, Caputo SM, Santana Dos 

Santos E. Genetic Landscape of Male Breast Cancer. Cancers (Basel). 2021 Jul 15;13(14):3535. doi: 10.3390/cancers13143535. PMID: 34298749; PMCID: 

PMC8305894 

 


