How Male Breast Cancer Is Diagnosed

Male breast cancer is a rare disease in which cancer cells develop in the breast tissue. Though breast cancer is often viewed as a disease that affects women, men account for about 1% of all breast cancer diagnoses in the United States every year.

Knowing the signs of male breast cancer is key to getting an early diagnosis. This requires meeting with a healthcare provider who can assess your symptoms and risk of disease. Medical tests such as a mammogram, breast ultrasound, or breast biopsy may be used to assess your problems.

Finding male breast cancer early gives you the best chance of getting care when treatment is most successful.

This article describes the methods used to diagnose male breast cancer, including self-checks, physical exams, and medical tests.

Self-Checks/At-Home Testing

Conducting a breast self-exam can help you identify changes in your body that may be early indicators of male breast cancer. Being familiar with the way your breast tissue normally looks can make it easier to notice a lump, swelling, or other changes.

Because men's breasts are smaller than women's breasts, men can usually feel lumps in their early stages. However, without doing regular self-checks, you may not notice a lump until the disease has progressed to a more advanced level.

While a lump under the nipple and areola is the most common symptom of male breast cancer, there are other signs of the disease. To conduct a self-exam for male breast cancer, follow this procedure:

• Step 1: Stand shirtless in front of a mirror. Put your arms on your hips and tighten your chest muscles. Look for physical changes such as a lump, oddly shaped or sized breasts, inward-turned nipple, dimpling, puckering, or redness.
• Step 2: Raise your arms above your head and examine your breast and armpits for physical changes.
• Step 3: Return your arms to your hips. Start with the nipple and move outward in a circular motion, use your fingertips to apply mild pressure to each breast. Feel for lumps or pebble-like growths. Continue to feel the underarms to test for enlarged lymph nodes there.
• Step 4: As you move outward on each breast, feel up to your collarbone, then down to the lowest rib on each side.

Contact your healthcare provider if you notice any signs of changes to your breasts, armpits, neck, or rib area. Nipple discharge or breast pain that develops without an obvious cause should also be discussed with your provider.

Physical Examination

If your healthcare provider suspects that you have symptoms of male breast cancer, a physical examination is the first step needed to determine your diagnosis.

This examination can be done by your general healthcare provider. It includes a complete personal and family medical history to determine your breast cancer risk. Be prepared to provide information regarding current medications, diet, and lifestyle to help your healthcare provider provide an accurate diagnosis.

You may have a higher risk of male breast cancer if you have any of the following risk factors:

• Age 60 to 70 years or older
• Family history of breast cancer
• Mutation in the BRCA1 or BRCA2 gene
• Klinefelter syndrome
• Radiation exposure
• Heavy alcohol consumption
• Liver disease
• Estrogen treatment for prostate cancer
• Obesity
• Testicular health conditions
• Smoking

If your healthcare provider suspects male breast cancer, they will also perform a clinical breast examination as part of your office visit. While the clinical breast examination is much like the self-examination, it is conducted by a healthcare professional whose training can help them identify subtle problems that patients can miss during a self-check.

A clinical breast examination includes the following actions:

• Visual inspection to identify differences in shape or size between breasts in different postures, such as raising your arms over your head, hanging your arms by your side, or pressing your hands on your hips
• Visual inspection of breast tissue texture for signs of a rash, enlarged pores, dimpling, inward-turned nipple, or other abnormal conditions
• Manual examination using the pads of their fingers to feel for unusual texture or lumps over the entire breast, underarm, and collarbone areas

Imaging

Imaging tests provide detailed pictures of your breasts and other areas inside your body. These non-invasive tests help your healthcare provider find breast cancer in its early stages.

The type of imaging test your healthcare provider uses depends on your symptoms. The most common types of imaging used to diagnose male breast cancer include:

• Diagnostic mammogram: A diagnostic mammogram uses low-dose X-rays to identify abnormal areas of tissue within the breast. This type of mammogram is more detailed than a screening mammogram. The procedure uses two plates that compress or flatten the breast to spread the tissue apart. Some people experience discomfort during the procedure due to the pressure exerted on the sensitive breast tissue.
• Breast ultrasound: A breast ultrasound uses inaudible sound waves to provide high-contrast images of the inside of your breasts. Unlike a mammogram, a breast ultrasound doesn't use radiation. A breast ultrasound uses a handheld instrument called a transducer, which is moved over the skin. While you may feel some pressure during the process, a breast ultrasound is less uncomfortable than a mammogram.
• Breast magnetic resonance imaging (MRI): A breast MRI uses powerful magnets and the injection of contrast dye to deliver a picture of your breasts without radiation or uncomfortable breast compression. A breast MRI is usually done while you lay on your belly on a table inside a long, narrow tube. Loud noises, like those of a washing machine, are made during the procedure. A breast MRI may be unsuitable if you are claustrophobic or have metal objects, like artificial limbs, in your body.
• Breast biopsy: A breast biopsy involves the surgical removal of a sample of breast tissue so it can be assessed for breast cancer. It may be used as a follow-up to abnormal findings in a mammogram, breast ultrasound, or breast MRI. Ultrasound is often used during these procedures to guide the radiologist to the targeted area.

There are three types of breast biopsies:

• Fine needle aspiration: A fine needle aspiration involves drawing fluid from a cystic lump in the breast.
• Core needle biopsy: A core needle biopsy removes a small amount of suspicious breast tissue using a hollow "core" needle, which is larger than a fine needle.
• Open (surgical) biopsy: An open, or surgical, biopsy involves a one- to two-inch cut on the breast to allow for the surgical removal of a tissue sample or an entire lump.

Differential Diagnosis

Male breast cancer is a very rare disease. However, the disease shares many of the same symptoms with several other conditions. Getting an accurate diagnosis as soon as you recognize symptoms is the best way to get the right treatment, alleviate your fears, and achieve the best outcomes.

The differential diagnosis of male breast cancer includes the following diseases:

• Non-cancerous cysts or soft tissue tumors
• Gynecomastia
• Pseudogynecomastia (excess fat tissue under and around the nipple)
• Breast fat necrosis
• Lymphadenopathy
• Breast hematoma
• Pseudoangiomatous stromal hyperplasia (benign lesion in the breast)
  
• Sarcoma
• Inflammation
• Infections such as bacterial abscess and granulomatous disease
• Other types of malignancy (particularly metastasis, tumors of the skin, liposarcoma)

Summary

Male breast cancer is a rare disease that accounts for about 1% of all breast cancer diagnoses in the United States yearly. It is caused by the growth of cancer cells in breast tissue.

The fact that breast cancer is so rare among men, means that those affected are often unaware of their disease risk. As a result, breast cancer is often found at later stages in men than it is in women, who are trained to know the signs of disease and seek early care.

Patient education can help men know their risk and look for early signs of illness. A diagnosis requires an exam by a healthcare provider. Medical tests such as a mammogram, breast ultrasound, or breast biopsy are needed for an accurate diagnosis. Finding the disease early supports the best treatment outcomes.

A Word From Verywell

A diagnosis of male breast cancer can carry both physical and emotional impacts. Having breast cancer can be challenging for men since the condition is regarded as a women's disease.

Don't ignore your emotional response to the disease. While feelings of despair, loneliness, and even embarrassment can be overwhelming, don't let these issues interfere with your attention to your physical care and treatment.

Realize that taking care of yourself includes getting the tools you need for emotional healing. Seek support from family and friends with whom you feel comfortable sharing your diagnosis.

If you're having trouble coping with your diagnosis, speak to your healthcare provider about the benefits of working with a therapist to help you heal emotionally as well as physically.