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Breast cancer is the most common cancer in women¹. However, only 1 in 1,000 men will develop breast cancer in their lifetime. In this issue, Dr Wong Chiung Ing shares about male breast cancer and explains the difference.

Breast cancer is rare in men. Only 62 cases of male breast cancer were diagnosed by the National Cancer Centre Singapore over an 18-year period, compared to 1,300 cases of female breast cancers diagnosed annually².

While there are some similarities between male and female breast cancers, there are also key differences between the two.

Risk factors for breast cancer in males vs females

Higher incidence of breast cancer in females may be attributed to differences in breast development and higher estrogen levels in females.

Other female-specific risk factors for breast cancer include early onset of menstruation, late menopause, having your first child after the age of 35, and having fewer or no children.

While there are a number of female-specific factors that contribute to a higher risk of developing breast cancer, male breast cancer shares some common risk factors with female breast cancer:

• Age: The incidence of breast cancer in both males and females increases with age. The risk of developing breast cancer is higher in women over age 40, and men over age 60.
• Family history: A strong family history of cancer is associated with an increased risk of breast cancer among males and females. The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 and BRCA2 gene, which may be passed down to both women and men.
• High estrogen levels: Oestrogen is a hormone that can stimulate the development of breast cancer. While both men and women naturally have estrogen in their bodies, chronic disease, obesity, and some genetic conditions may lead to higher levels of oestrogen production.

Managing male breast cancer

Male breast cancer is treated the same way as female breast cancer. Depending on the patient’s general health and cancer stage, type, and characteristics, a multidisciplinary arsenal of treatments from surgery to systemic therapy, targeted therapy and radiation therapy can be tailored to the patient’s disease.

As with many other diseases, prevention is better than cure. Unfortunately, many male patients present with advanced stage disease because unlike female breast cancer, there is a lack of awareness among men about male breast cancer.

Understanding your family history and developing awareness of the warning signs and symptoms of breast cancer can help reduce risk of breast cancer.

Screening for male breast cancer

Breast self-examination (BSE) and population screening programmes help men and women detect any abnormalities early for early intervention and treatment.

Both men and women can conduct BSE regularly to check for any changes to your breasts. To conduct BSE, use the tips of your fingers and move them in a spiral from the outside to the inside of your breast to look out for any lump(s), pain, asymmetry and skin changes on the breast, and any discharge, retraction, rash on the nipple.

Women should start mammogram screenings every year from age 40, while those with a family history of breast cancer should begin screening earlier.

Mammograms are not routinely offered to men. However, if you have a family history of breast cancer or an inherited genetic mutation that increases your risk of male breast cancer, your doctor may recommend regular screening tests and follow-up.

Breast cancer is highly treatable, especially with effective treatment in early stages of disease. Whether you are male or female, early detection can go a long way in improving treatment outcomes.