What’s the difference between male and female breast cancer?

Have you ever known a man who’s had breast cancer?  If you answered “no” that is not uncommon.  Breast cancer in men is a rare disease. In fact, less than 1% of all breast cancers occur in men.  It is estimated that in 2021, around 2,650 men will hear the words, “You have breast cancer,” and about 530 men will die from the disease. The lifetime risk of men being diagnosed with breast cancer is about 1 in 833. For women, the lifetime risk is 1 in 8.

Comparing and contrasting between male and female breast cancer

Breast cancer is so ubiquitously associated almost exclusively with women that we almost forget that men also can develop this disease. Since men do have breasts, why is their rate of breast cancer much lower than women’s?

There are several reasons why male breast cancer is uncommon when compared to the rate of women diagnosed with it. Here’s a look breaking down the reasons why men rarely develop breast cancer compared to women:

• While the breast tissue is similar in men and women, male breast tissue is mainly fat and fibrous tissue called stroma and has fewer ducts and lobules than female breast tissue.
• Various hormones in girls’ and women’s bodies stimulate breast tissue to grow into full breasts.
• Boys’ and men’s bodies normally don’t produce as much of the breast-stimulating hormones.
• As women’s breast mature during puberty, the breasts develop working lobules and milk ducts to produce and carry milk after childbirth.
• Breast cancer in women tends to develop in these ducts and lobules; men produce far fewer and smaller ducts and usually do not develop lobules.
• Both men and women can inherit the BRCA mutations that do significantly increase the risk of breast cancer for women (and possibly men too), but men with these mutations are at a higher risk of prostate cancer rather than breast cancer.
• The more cells grow and divide, the more chance there is of cancer occurring. Breast cells grow and divide as a response to the hormone estrogen, which females typically make more than men do. Breast cells in men are inactive and not exposed to high estrogen levels like females are.
• Men can be diagnosed with gynecomastia, a condition in which men have higher estrogen levels than usual that causes male breast tissue to grow or swell. Since gynecomastia is influenced by higher estrogen levels in men, this may predispose them to male breast cancer.

The rarity of male breast cancer has unique challenges

Since male breast cancer is rare, this presents unique challenges for men who develop it and for doctors who treat it.  There are few studies specifically addressing male breast cancer, therefore physicians often resort to treatment of male breast cancer guided by studies performed in women with this same disease.

Few men are taught how to perform a self-breast exam and are likely unaware of the symptoms of the disease. If they were to develop symptoms, due to lack of knowledge of breast cancer symptoms, men may ignore them.  But ignoring symptoms will often lead to a man being diagnosed at a later and more advanced stage of the disease than women are. That’s why the average of men diagnosed with breast cancer is 68 while the average age of women is 61.

Being diagnosed at a more advanced, later stage is why men often have poorer outcomes than women.

Another challenging aspect of men with breast cancer is the fact that it comes along with a stigma of shame, embarrassment, and feeling less masculine. Even men can face body image and intimacy issues especially if they require surgery to remove a breast. Men also are more reluctant to seek out support when faced with breast cancer making them having to suffer in silence and isolation.  All this together does not enhance their chances of beating back the disease.

Ways to reduce male breast cancer

When it comes to cancer, there are no guarantees on how to prevent it but there are certain steps a man can do to reduce his chances. One of the first steps is prevention as infrequent self-examinations of the breasts. Just like women, men should also perform a monthly breast exam – here’s how:

• Examine the breasts in a mirror from all angles looking for changes in color or texture or lumps that were not there before.
• Raise the arms and look for the same changes.
• Examine the nipples to see if there is any discharge.
• Lie down and examine the left breast with the fingers of the right hand. Press down in a circular motion on all parts of the breast and armpit areas, feeling for lumps.
• Use the fingers of the left hand to examine the right breast in the same way.

Men, who notice any changes in their breast tissue, should make an appointment with their doctor for further evaluation.

Other ways to reduce a man’s risk include:

• Men with a family history of breast should discuss with their doctor about genetic testing
• Exercise regularly to stay physically fit
• Maintain a healthy body weight
• Eat a healthy diet that includes more fruits and vegetables