Breast Cancer in men is rare and represents 1% of all male cancers. The median age for men to develop breast cancer is 65-71 years old (in females it occurs about 10 years earlier). African American males have highest incidence and Hispanics have the lowest.

Hormonal factors definitely play a role and there are many risk factors you should be aware of. Risk factors include, Klinefelter Syndrome, high estrogen states, low testosterone states, liver disease, testicular injury, head injury resulting in hyperprolactinemia, prostate cancer, young men treated for lymphoma with chest irradiation, genetic predisposition and family history.

"Presentation of breast cancer in males is usually as a mass, discovered by the patient in 60 percent of cases," says Candace Dyer, MD, director, The Breast Health Center at Kent. "Nipple discharge is always pathologic."

The most common diagnosis of breast mass is Gynecomastia (about 90 percent) and is usually bilateral. Diagnosis with men is similar to the diagnosis of women. First you will have a clinical exam (most common presentation) which usually prompts follow-up studies such as ultrasound and MRI. Biopsy should be concerned in men with unilateral enlargement of breast in the appropriate age group. Because of the low incidence, mammography is not used for screening in men.

Treatment for breast cancer in men is similar to treatment for women, except breast conservation is rarely utilized because of the small amount of breast tissue and because of the central location and close proximity to nipple areolar complex.

Radiation is recommended for locally advanced disease and possible bone metastases. Systemic therapy is usually tamoxifen (an estrogen antagonist). Chemotherapy is used for stage II, III, IV disease.

Prognosis for men is the same as for females in regards to staging, but males present more frequently with stage II or later disease, so overall may have a worse prognosis.