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Key Features

  • Rare; average age, 70 yr

  • Poorer prognosis than for female breast cancer (even stage I)

  • Hormonal influences likely play an important role

Clinical Findings

  • Painless lump beneath the areola, usually found after age 50

  • Nipple discharge, retraction, or ulceration

  • Gynecomastia not uncommonly precedes or accompanies male breast cancer

  • Increased incidence of breast cancer in men with prostate cancer

  • Examination usually shows a hard, ill-defined, nontender mass beneath the nipple or areola

  • Cancer staging is the same in men as in women

Diagnosis

  • Biopsy is required to confirm diagnosis

  • Differential diagnosis

    • Gynecomastia

    • Metastatic cancer from another site (eg, prostate)

    • Fatty breast enlargement of obesity

Treatment

  • Modified radical mastectomy in operable patients

  • Irradiation for localized, symptomatic metastases to skin, lymph nodes, or skeleton

  • Adjuvant chemotherapy is used for the same indications as in female breast cancer

  • Tamoxifen, 20 mg orally once daily, for advanced-stage male breast cancer

  • Castration produces regression in 60–70%

  • 5-year survival rate for node-positive disease: ~69%

  • 5-year survival rate for node-negative disease: ~88%

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