How is male breast cancer diagnosed?

Updated: Jun 30, 2016
  • Author: Bagi RP Jana, MD; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

Answer

Male breast cancer usually presents as a painless lump. In 75% of cases, the lump is a hard and fixed nodule in the subareolar region, with nipple involvement more common than in women. [6] Often, the disease is not detected until late in its course: more than 40% of patients have stage III or IV disease at diagnosis. [3] Lack of awareness that men develop breast cancer may possibly contribute to diagnosis of breast cancer in men at more advanced stages than in women. 

In patients with clinical features completely consistent with gynecomastia, breast cancer may be excluded on clinical grounds, and no further evaluation may be necessary. If findings are equivocal, however, mammography can be useful in diagnosis. [1] See Male Breast Cancer Imaging for further information on this topic.

Fine-needle aspiration biopsy can confirm the diagnosis. [7] Histologically, the majority of breast cancers in men are infiltrating ductal carcinomas, but the entire spectrum of histological variants of breast cancer has been seen. Papillary carcinoma is a distant second in frequency. Lobular carcinoma is uncommon. [1]  Most male breast cancers (~80%) are hormone receptor positive, 15% overexpress human epidermal growth factor receptor 2 (HER2), and 4% are triple negative (estrogen receptor, progesterone receptor, and HER2 negative). [8]


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