1) Dear Alice,

Are there any differences in breast cancer between men and women?

— Gender sensitive

2) Dear Alice,

I feel that I might have male breast cancer. But I don't know how this is possible. I am young, younger than 18. And I would like to know how male breast cancer is contracted. Plus if I do, I'm afraid of telling my parents. What should I do?

Dear Gender sensitive and Reader,

Believe it or not, everyone has breast tissue — those assigned female at birth as well as those assigned male at birth. Those assigned male at birth do have some breast tissue behind the nipples, and therefore are able to develop breast cancer. While diagnosis and treatment for breast cancer is similar for both sexes assigned at birth, the disease overwhelmingly impacts those assigned female at birth. In fact, it’s about 100 times more likely to occur in females than males and the lifetime risk for males getting breast cancer is 1 in 833. As for your concern specifically, Reader, it may be reassuring for you to know that although male breast cancer can happen at any age, it's extremely rare for males under 18. That being said, the presence of any atypical lumps, bumps, or changes in your breast tissue could also be due to a different non-cancerous condition or even just a stage of life. In any case, it’s recommended that you talk with a health care provider about what you've noticed to help you investigate further.

What does male breast cancer look like? It usually presents in the form of a small lump or thickening of breast tissue (similar to breast cancer cases in those assigned female at birth). Other symptoms might include:

  • Skin dimpling or puckering
  • Nipple turning inward (retraction)
  • Redness or scaling of the nipple or breast skin
  • Discharge from the nipple

Treatment is identical regardless of sex assigned at birth, as is the prognosis (or outlook). Assuming the same stage of breast cancer, those assigned male and female at birth have very similar survival rates. The risk for male breast cancer increases with age and is most commonly diagnosed between age 60 and 70. While the cause for male breast cancer is unknown, there are some factors that may increase a person's risk for it, including:

  • Age (the older you are, the greater the risk)
  • A family history of breast cancer
  • Estrogen treatments
  • Klinefelter syndrome (when a male is born with an extra X chromosome)
  • Liver disease or cirrhosis of the liver
  • Testicular disease or surgery (inflamed testicles or surgery to remove a testicle)
  • Obesity

List adapted from Mayo Clinic

Another potential cause of growths in the breast tissue is gynecomastia, which is a button-like growth under the nipple and areola. This condition is caused by a hormonal imbalance that can occur during adolescence. It’s also possible that growths in the breast tissue are a result of puberty, becoming swollen and tender. This is considered typical and gradually goes away with time. In any case, if you're worried about the changes you've noticed in your body, there's no shame in telling someone you trust about what you've noticed.

Though it may be difficult, Reader, it's a good idea to talk with your parents about what you've noticed. It might help to first figure out why you’re feeling scared — is there a concern that your parents will worry too much? Or are you afraid they won’t take you seriously? A good way to start the conversation may be to let them know you’ve noticed some changes in your body. Then you can let them know that you’re worried because, though rare, it’s possible for those assigned male at birth to develop breast cancer, and you’d like to get it checked out just to be sure there’s nothing to worry about. If that doesn’t feel comfortable, you could also try to talk to someone else you're close with, such as another family member, a friend's parent, or a school nurse. They may be able to help you talk to your parents about your concerns. Making sure your folks are aware of what you're experiencing can provide some much needed support and help you get any medical attention that may be needed.

If either of you are still interested in learning more about breast cancer in men, the American Cancer Society has even more information.

Alice!

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