What is the difference between male and female breast cancer?

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Other than skin cancer, breast cancer is the most common cancer affecting females in the United States.

According to the American Cancer Society (ACS), females on average have a 1 in 8 chance of developing breast cancer. They predict that around 281,550 females will receive a diagnosis of invasive breast cancer in 2021.

Breast cancer is much less common in males, who account for around 1% of breast cancer diagnoses in the U.S. Approximately 2,650 males will receive a diagnosis of invasive breast cancer in America in 2021.

Prevalence based on ethnicity

White females are more likely to develop breast cancer than those of other ethnicities. However, Black females are more likely to develop aggressive breast cancer. They are also more likely to die from the illness.

The ACS notes that breast cancer is 100 times less common among white males than among white females. It is 70 times less common among Black males than Black females.

Black males have the highest incidence of breast cancer among males.

Based on figures from 2013 to 2017, the Centers for Disease Control and Prevention (CDC) and the ACS report the following incidence rates of breast cancer among people of various ethnicities:

There are two reasons why breast cancer is more common in females than males.

Breast development and anatomy

Most breast cancers begin in the milk ducts and the lobules, the structures containing the milk-producing glands.

Both male and female breast tissue consists of a few ducts under the nipple and areola until puberty. During puberty, females develop increased levels of certain hormones which cause these ducts to grow and lobules to form.

Males typically have low levels of these hormones, and as a result, the breast tissue does not grow as much. Although male breasts have ducts, they only have a few lobules and mainly consist of fat tissue.

Estrogen levels

The more that cells divide, the more chance there is of cancer occurring. Breast cells grow and divide as a response to the hormone estrogen, which females typically produce more of than males.

BreastCancer.org notes that breast cells in females are highly active and receptive to estrogen, while breast cells in males are inactive and not exposed to high estrogen levels.

Healthcare professionals do not fully understand the causes of breast cancer. However, there are known risk factors. Some vary between males and females, and some are shared.

Risk factors for males

Male-specific risk factors include:

• Klinefelter syndrome: Males with this syndrome are born with an extra X chromosome and have higher estrogen levels compared with other males. As a result, they can develop gynecomastia, which is the growth of breast tissue in males. This syndrome can increase the chance of developing breast cancer by 20–60 times.
• Genetic mutations: Mutations in the CHEK2, PTEN, and PALB2 genes can lead to breast cancer in males.
• Testicular conditions: These include having an undescended testicle, having one or more testicles surgically removed, or having mumps as an adult. Mumps can lead to a decrease in the size of the testicle.

Risk factors for females

Female-specific risk factors include:

• Being female: Females have a much higher rate of getting breast cancer than males.
• Menstrual factors: According to the National Breast Cancer Foundation, starting menstruation before age 12 and beginning menopause after 55 are breast cancer risk factors.
• Reproductive factors: Giving birth for the first time at an older age or never giving birth increases the risk.
• Dense breast tissue: The ACS notes that lumps can be more difficult to detect in females than males since female breast tissue tends to be denser.

Shared risk factors

While there have not been as many studies of male breast cancer as there have of female breast cancer, researchers have identified the most commonly shared male and female risk factors, including:

Age

According to the ACS, female breast cancer rates increase with age until the seventh decade. The typical age of diagnosis in females is 62. Although rates increase with age among females of all ethnicities, non-Hispanic Black females have higher incidence rates than non-Hispanic white females before age 40.

Male breast cancer rates also increase with age, and males are often diagnosed much later, at 72 years old on average.

Genetics

Inherited gene mutations, such as BRCA1 and BRCA2, can increase the chance of breast cancer in females and males.

The ACS states that males with the BRCA2 gene have a lifetime risk of approximately 6 in 100. Males with the BRCA1 gene have a lifetime risk of 1 in 100.

Females with the BRCA1 or BRCA2 genes have a 7 in 10 chance of developing breast cancer by age 80.

Family history of breast cancer

Approximately 1 in 5 males with breast cancer have a close family member who has had the disease.

The risk of developing breast cancer is about 1.5 times higher for females with one first-degree female relative affected by breast cancer than those with no family history of the illness. It is 2–4 times higher for females with more than one first-degree relative who has had breast cancer.

Other risk factors for breast cancer include:

• obesity
• smoking
• previous breast cancer
• alcohol consumption
• physical inactivity
• previous exposure to radiation

The CDC states that people can experience different symptoms of breast cancer depending on the person, and some may not have any symptoms at all.

Breast cancer symptoms usually include a lump, or multiple lumps, in the breast area or under the armpit. These lumps typically:

• occur in one breast
• appear under or around the nipple
• feel hard
• do not move around
• feel bumpy
• grow over time

The United Kingdom’s National Health Service (NHS) notes that most breast lumps are noncancerous.

In males, breast lumps can occur due to enlarged male breast tissue, a fatty lump called a lipoma, or a cyst. In females, they can occur as a result of tissue growth called fibroadenoma or a cyst.

Other symptoms of breast cancer include:

• discharge from the nipple
• a change in the feel and look of the skin, such as dimpling
• a rash, crusting, or scaly and itchy skin around the nipple
• changes to the nipple, such as turning inwards
• the surrounding skin becoming hard or thickened

If a person notices any symptoms of breast cancer, they should seek medical advice.

To determine if a person has breast cancer, a doctor will perform an examination and a symptom assessment. After the exam, they may order a mammogram and breast ultrasound.

For a lump that the doctor suspects may be cancerous, they will request a biopsy to confirm.

If the results are positive, a doctor will advise the person on the best treatment plan. Imaging tests such as CT and MRI scans can help a doctor diagnose the stage of breast cancer and determine if it has spread elsewhere in the body.

Doctors use the same treatment options for both female and male breast cancer, including:

• surgery to remove either a part or all the breast
• chemotherapy
• hormone therapy
• radiation therapy

Treatment may require a combination of therapies.

While there is no guaranteed way to avoid getting breast cancer, there are ways a person can reduce their chances of developing the disease.

Prevention starts at home with frequent self-examinations. To perform a breast exam, a person should:

1. Examine the breasts in a mirror from all angles. Look for any changes in color or texture or lumps that were not there before.
2. Raise the arms and look for the same changes.
3. Examine the nipples to see if there is any discharge.
4. 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.
5. Use the fingers of the left hand to examine the right breast in the same way.
6. Repeat steps 4 and 5, either standing or sitting.

Other prevention methods include:

• genetic testing for those who have a family history of breast cancer
• exercising to stay physically fit and maintain a moderate weight
• eating a healthy diet that includes more fruits and vegetables

Learn more about reducing breast cancer risk here.

A person can contact a doctor at any time to learn more about their risk of developing breast cancer and for prevention advice.

People should also contact a doctor if they notice any symptoms of breast cancer, such as an unusual lump or a change in the shape, feel, or appearance of the breast.

Breast cancer can develop in anyone. However, due to differences in breast development and lifetime exposure to estrogen, it is more common in females than males.

Males and females share some risk factors that can increase the chance of developing breast cancer. Other risk factors are specific to a person’s sex.

People should contact a healthcare professional if they notice any symptoms of breast cancer.