By Fedhealth

Male breast cancer affects around 1 in 800 men globally. When KISS drummer Peter Criss declared, “You don’t need boobs to get breast cancer,” he challenged one of the most persistent myths in modern health. In 2007, Criss found a lump in his chest and was later diagnosed with breast cancer. After successful surgery, he became a vocal advocate for male breast cancer awareness, proving that this disease does not discriminate by gender.

Can Men Get Breast Cancer?

Yes. Men can get breast cancer because they have a small amount of breast tissue, similar to that of girls before puberty. This tissue does not typically develop further, but it can still become cancerous. Although male breast cancer remains uncommon, it is a real and underestimated threat that demands attention. It poses a serious health risk, particularly because awareness remain low and diagnosis often occurs late.

How Common Is Male Breast Cancer in South Africa?

Globally, according to the World Health Organization, approximately 99% of breast cancer occur in women and 0.5 – 1% in men. However, South Africa appears to have a relatively higher rate. According to the Council for Medical Schemes of South Africa, approximately 1.8% of breast cancer diagnoses in the country occur in men. Some experts suggest that this may be one of the highest male breast cancer rates globally, possibly linked to genetic, lifestyle, and healthcare access factors.

Why Prognosis Is Often Poorer in Men

The European Journal of Medical and Health Sciences confirm that the prognosis for male breast cancer is worse than the outcome of female breast cancer. Survival rates for male breast cancer are significantly lower and the 5 year survival rate is about 40% to 65%.

The main reasons include:

• Delayed diagnosis: Men tend to ignore early symptoms, often attributing them to muscle strain or ageing.
• Low awareness: Breast cancer campaigns largely target women, leaving many men uninformed.
• Stigma: Studies show that over 43% of men would question their masculinity if diagnosed with breast cancer.
• Comorbidities: Most men are diagnosed with breast cancer between ages 60 and 70, when other health issues may complicate treatment.

Because of these factors, men are more likely to present with advanced disease and lymph node involvement.

Risk Factors for Male Breast Cancer

While any man can develop breast cancer, certain factors increase the risk. The most significant include:

• Family history or BRCA2 gene mutations (6–8 % lifetime risk).
• Klinefelter syndrome (XXY chromosomes) — raises oestrogen levels.
• Previous chest radiation exposure (for conditions like lymphoma).
• Obesity, which increases oestrogen conversion in fat tissue.
• Cirrhosis of the liver and testicular dysfunction, both of which alter hormone balance.
• Gynecomastia (enlarged breast tissue) linked to medications or hormones.
• Use of oestrogen therapy or certain anti-androgen drugs.

Men with these risk factors should discuss preventive screening with their healthcare provider.

Male Breast Cancer Symptoms: What to Look For

Early detection significantly improves survival. Men should perform monthly self-checks of the chest and underarms, watching for:

• A painless lump or thickening near the nipple or under the skin.
• Nipple discharge, especially if blood-stained.
• Inverted or retracted nipple.
• Ulceration, skin dimpling, or swelling on the chest.
• Swollen lymph nodes under the arms.

If any of these signs appear, seek immediate medical evaluation. Early detection can save lives.

Diagnosis: How Male Breast Cancer Is Confirmed

Diagnosis begins with a clinical breast exam, followed by imaging and biopsy.

• Men aged 25 and older: Bilateral diagnostic mammography is the first step, followed by ultrasound if results are unclear.
• Men under 25: Ultrasound is preferred as the initial imaging tool.
• If suspicious findings are present, a core-needle or surgical biopsy confirms cancer and determines hormone receptor status (ER, PR, and HER2).

Mammography in men is highly accurate — 92–100 % sensitivity and 90–96 % specificity.

Treatment Options for Male Breast Cancer

Treatment of breast cancer in men – with some minor variations – mirrors treatment for breast cancer in women. The stage of breast cancer is an important factor in making decisions about treatment options. The primary options include:

1. Surgery: Most men undergo a mastectomy, often followed by radiation therapy.
2. Hormonal therapy: Around 90 % of male breast cancers are hormone-receptor positive, making tamoxifen the standard therapy.
3. Chemotherapy and targeted therapy: Used in cases of advanced or HER2-positive disease.
4. Follow-up imaging: Annual mammograms may be recommended if breast tissue remains.

According to Johns Hopkins Medicine, with early diagnosis and proper treatment, survival rates for men with breast cancer are comparable to women’s at the same stage. But key differences occur in diagnosis and screening – and the results are less favourable for men. Men have a 25% higher mortality rate for breast cancer compared to female breast cancer.

Can Male Breast Cancer Be Prevented?

There are no national screening guidelines for men because the disease is rare. However, men at high risk — such as those with BRCA2 mutations or strong family history — may benefit from periodic clinical exams and, in some cases, imaging.

Lifestyle modifications can also reduce risk:

• Maintain a healthy weight and active lifestyle.
• Limit alcohol consumption and avoid smoking.
• Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Avoid unnecessary exposure to oestrogen or radiation.

Bottom Line

There is a gap that needs to be filled in terms of public knowledge about male breast cancer. In South Africa, where male breast cancer accounts for up to 1.8 % of all cases, increased awareness can make a critical difference. Men should be encouraged to check their chests regularly, report abnormalities, and understand that breast cancer is not only a woman’s disease. Awareness and timely action can save lives.

References:

• American Cancer Society. (2025). Treatment of breast cancer in men, by stage. Retrieved from https://www.cancer.org/cancer/types/breast-cancer-in-men/treating/by-stage.html
• CANSA. (2022). CANSA fact sheet on breast cancer in men. Retrieved from https://cansa.org.za/files/2024/10/CANSA-Fact-Sheet-on-Breast-Cancer-in-Men-NCR-2022-web-October-2024.pdf
• Council for Medical Schemes. (2024). Male breast cancer. Retrieved from https://www.medicalschemes.co.za/do-men-get-breast-cancer/
• European Journal of Medical & Health Sciences. (2024). Stage and type of male breast cancer presented at Mankweng Academic Hospital from 2015–2023. Retrieved from https://www.ej-med.org/index.php/ejmed/article/view/2191
• Fedhealth. (2014). Commit to quit: Understanding smoking cessation. How to quit smoking. Retrieved from https://www.fedhealth.co.za/articles/how-to-quit-smoking-2/
• Johns Hopkins Medicine. (n.d.). Male breast cancer: A rare increasing trend. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/male-breast-cancer-a-rare-increasing-trend
• Thomas, E. (2010). Original research: Men’s awareness and knowledge of male breast cancer. The American Journal of Nursing, 110(10), 32–42. https://doi.org/10.1097/01.NAJ.0000389672.93605.2f
• UCLA Health. (2023). Male breast cancer. Retrieved from https://uclahealthib.staywellsolutionsonline.com/library/encyclopedia/3,16161
• World Health Organization (WHO). (2025). Breast cancer. Retrieved from https://www.who.int/news-room/fact-sheets/detail/breast-cancer
• YouTube. (2024). How to check for the signs of male breast cancer [Video]. Retrieved from https://www.youtube.com/watch?v=oH2w6ZCmkik