How to Do a Male Breast Self Exam (MBSE)

Step by Step Guide to Check for Breast Cancer in Men

You've probably heard that women should perform self-breast exams, but did you know that men can do self-breast exams as well? While not talked about as often, male breast cancer happens. In fact, men with breast cancer tend to be diagnosed when they are in more advanced stages of the disease than women.

Male Breast Cancer

Breast cancer in men is uncommon, and many men are unaware that they are at risk; they view it as a woman's cancer. But if you have breast tissue you can get breast cancer, and men have breast tissue as well. That said, breast cancer in women is 100 times more common than in men. Each year in the United States, about 2,000 men are diagnosed with the disease. 

Breast cancer in men appears to be increasing. According to a 2017 study there has been an increase in breast cancer as a primary cancer (first cancer) in men, but also a marked increase in breast cancer as a second primary cancer in men who had previously been treated for lymphoma.

The Purpose of Male Self-Breast Exams

Because a clinical breast exam is not usually a part of a man's annual physical, nor do men go for mammogram screenings, most male breast cancers are discovered by the men themselves, either because of a change in the appearance or feel of their breast area. When a man is unaware of breast cancer symptoms, he may dismiss them; by the time he seeks care, the cancer may be advanced requiring more extensive treatment. History tells us this is true, and men tend to be diagnosed in later stages of the disease than women. Unfortunately, this also means that survival with breast cancer is lower for men than for women. (Survival, however, is similar for men and women diagnosed at the same stages, and the cause for higher mortality is later diagnosis).

Male breast self-examination (MBSE) is recommended each month, as it is for women, though we do not have good guidelines describing the best timing. Knowing your overall health, and what your breast normally feels like is the best way to monitor your breast health. 

Risk Factors for Male Breast Cancer

While many male breast cancers occur in men who have a family history of breast cancer, all men can benefit from knowing how to do a male breast self-exam. Unlike many screening tests, there is no risk with doing exams, with the possible exception of fear and medical tests needed to evaluate an abnormal exam. That said, men are much less likely to have "false positive" relative to women, as conditions such as cysts are uncommon.

It's also important for men to be aware of the signs and symptoms of male breast cancer.

Every man and women should learn about their history not only of breast cancer but all cancers. Breast cancer risk is higher if other blood relatives have had the disease, but breast cancer risk may also be increased for those who have a family history of colon cancer, prostate cancer, pancreatic cancer, melanoma, and more. Next time you have a family gathering, take the time to have this important discussion.

Just like women, men who carry a BRCA1 or BRCA2 gene mutation are more likely to develop breast cancer, yet there are many other ways in which genetics may increase your risk. Take a moment to learn more about how your genetic blueprint can impact your risk of any cancer. If you have a few people with breast cancer, a combination of one person with breast cancer and another with pancreatic cancer, or it seems like cancer runs in your family in any other way, consider visiting a genetic counselor. At the current time we only have tests for some of the gene abnormalities that predispose people to cancer, but a good genetic counselor can often determine if you are at higher risk of these yet-to-be-discovered abnormalities so that you can practice early detection if appropriate.

In addition to familial risk, men who may be at an increased risk include those who have received estrogen treatment, radiation exposure, and those who have diseases characterized by increased estrogen such as cirrhosis of the liver and Klinefelter's syndrome.

A Thought from Verywell

Men should be aware of any risk factors they have for breast cancer, be familiar with the symptoms, pay attention to any changes occurring in their breast anatomy, and ask their physician to perform a clinical breast exam as a part of their routine annual physical. 

Women reading this article can suggest that their husband or significant other ask about the incidence of breast cancer in their family. A history of breast cancer, especially a BRCA mutation, should be shared with a physician and there needs to be a discussion about the risk of developing a breast cancer.

Here are the steps in performing your male breast exam:


Make a Regular Monthly Date for Your MBSE.

The first and most important step in doing male self-breast exams is to simply set a day of the month to do these and find a pen.

Mark the date for your male breast self-exam on your calendar. This will help you stay on track and reduce anxiety about normal breast changes.

Since testicular self-exams are also important for some men, you may want to take a day to do both of these exams each month. It's important to note that cancer is not something that only hits in middle age, and testicular cancer often occurs in young men.


Start in Your Bath or Shower

While you can do your breast exams anywhere, doing them in the shower has some advantages.

Run a warm shower or bath. Use soap or bath gel to create a soapy, slippery layer over your breast area. Well-soaped skin will be easier to examine, as it allows your fingers to slide along your skin without rubbing.

(Ideally, in time, doing your exams in different places can be a good idea. For example, you may detect a lump while lying down that is hard to feel when standing up and vice versa).


Check Your Breast Texture

Raise your left arm over your head, and if possible, put your left hand on the back of your head. On your right hand, put your index finger, middle finger, and ring finger together as a group. You will use these three fingers to check your left breast. Check the texture of your left breast by starting at the outer edge. Place your three fingers flat onto your skin, press down and move in small circles. Repeat this all around your breast. Don't rush.

It works best if you use your fingers in this way rather than poking with a single finger. Very few men (or women) have breasts that feel like marshmallows, and it's easy to mistakenly feel "lumps" with the one finger method.


Check Your Nipple

Both men and women often forget to examine their nipples when doing self-breast exams, but this part of the breast is no less important.

Paget's disease of the nipple is an uncommon breast cancer which begins with redness, scaling, and flaky skin on the nipple. Cancers in the breast may also present with nipple drainage or a change in the normal contour of the nipple.

Check your nipple by gently squeezing it between your index and ring fingers. Look for any discharge, puckering, or retraction (pulling inward).


Check Both Sides

Reverse your hands and check your right breast, using the same methods as Steps 3 and 4. Both breasts must be checked.

Some people who are either strongly right hand or left hand dominant may have difficulty with examining their breast on the opposite side of the body. You may wish to ask your partner to examine your breasts (and you can repeat the favor).


Visual Examination

Rinse yourself off and dry with a towel. Stand before a mirror which is large enough for you to see both breasts. Take note of any asymmetry and skin changes (rash, puckers, dimples).

It's often recommended that you look in the mirror straight on, from each side, and again when bending over. This might be a good time to do a monthly skin exam looking for skin cancer as well. Learn how to do self-check skin exams to look for the early signs of skin cancer. While breast cancer is uncommon in men (1.6 percent of all cancers in men and 1 in 2 men are expected to develop cancer), roughly 30 percent of men will develop skin cancer of some type in their lifetime.


How to Handle a Lump

If you find a breast lump, what is the next step?

First of all, you can be reassured that most breast lumps in male breasts are not breast cancer.

The most common "lump" felt in males is gynecomastia or enlarged breasts. Gynecomastia is often bilateral, but not always, and just as women's breasts are rarely the same size, gynecomastia in men often occurs on one side more than the other. Gynecomastia during the teen years is the norm with roughly 50 percent of teenage boys having some breast enlargement. In men, gynecomastia is common as well and can be related to a number of different conditions.

If you do feel something abnormal, make an appointment to see your doctor right away. Tests such as mammograms, ultrasounds, and breast MRIs can be done for men just as they are for women.

If the diagnosis is uncertain, a biopsy of the lump or abnormal region will let you and your doctor know exactly what you are dealing with.

Many men feel embarrassed when talking about breast lumps, and men who develop breast cancer tend to feel alone in a sea of pink. At the same time, there is now much more support than in the past for male breast cancer and there is an active online community of men who can face the disease with other men to share with.

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