Breast Cancer in Men: Warning Signs and Chest Changes You Shouldn’t Ignore

Breast Cancer in Men: Warning Signs, Risk Factors and When to Seek Medical Advice

Every October, breast cancer awareness campaigns encourage people to recognise symptoms, seek timely medical advice and understand the importance of early detection. However, one aspect of the conversation often receives less attention: men can develop breast cancer, too.

Although male breast cancer is rare, accounting for approximately 0.5–1% of breast cancer cases worldwide, a lack of awareness can delay diagnosis. Men may not recognise the warning signs, while the possibility of breast cancer may not be considered immediately when they report changes in their chest.

In India, male breast cancer remains an uncommon but important health concern. Cases are frequently diagnosed at an advanced stage, highlighting the need for greater awareness of symptoms, risk factors and the importance of timely medical evaluation.

Most men diagnosed with breast cancer are older adults, with the condition occurring most frequently in the 60–70 age group. However, younger men can also develop the disease. Recognising unusual changes early and seeking professional advice can help ensure that appropriate investigations and treatment are not delayed.

Dr Anmol Chugh, plastic surgeon and founder of Seena Strong, explains why breast cancer awareness should extend to men and what changes they should watch for.

“Breast cancer in men is rare, about one in every hundred cases. That rarity works against them. Doctors don’t expect it and patients certainly don’t, so it tends to be found later than it is in women, often when it has already progressed. That delay is a big part of why outcomes are worse. Most men are diagnosed in their mid-sixties, though younger men aren’t immune,” says Dr Chugh.

Men have breast tissue, including ducts in which cancer can develop. While their breast tissue is less extensive than that of women, it is still susceptible to cancer. Limited awareness of this fact can make it harder for men to recognise symptoms and seek medical attention promptly.

Is Every Lump or Enlargement in a Man’s Chest a Sign of Cancer?

Not every lump or change in the male chest indicates cancer. Several benign conditions can cause breast enlargement or tenderness, with gynecomastia being one of the most common.

Gynecomastia is the enlargement of glandular breast tissue in men. It can develop because of hormonal changes, ageing, certain medications and underlying health conditions. Weight changes may also affect the appearance of the chest, although excess fat around the chest is different from an enlargement of glandular tissue.

According to Dr Chugh, most changes in the male chest are not cancerous.

“The good news is that most changes to appearance in men’s chests are not cancerous. The most common diagnosis is gynecomastia, an enlargement of breast tissue, which is largely harmless. Hormonal imbalances, certain drugs, weight gain and age can all play a part in its development. It often manifests itself as two soft rubbery discs under the nipples on both sides, and can sometimes cause pain. Its occurrence is fairly common, and I see it on a regular basis, and for most of these men their concern is their image and self-esteem, rather than their health,” he explains.

Although gynecomastia is generally benign, men should avoid assuming that every new lump or enlargement is harmless. A healthcare professional can assess the affected area, identify possible causes and determine whether further testing is necessary.

What Chest Changes Should Men Never Ignore?

A new lump in the breast area is one of the most important warning signs of male breast cancer. However, symptoms are not limited to lumps. Changes involving the nipple, skin or underarm area can also require medical attention.

Dr Chugh advises men to seek prompt assessment if they notice any of the following:

A new or firm lump: A persistent lump, particularly one that feels hard or is located to one side of the nipple, should be examined.

Changes in the nipple: A nipple that begins turning inward or changes its usual appearance warrants medical evaluation.

Unusual nipple discharge: Discharge that occurs spontaneously, particularly if it contains blood, should not be ignored.

Skin changes: Dimpling, puckering, persistent redness, scaling or changes in the texture of the skin may be warning signs.

Underarm swelling: Swelling or a lump in the armpit may indicate enlarged lymph nodes and should be assessed.

Persistent changes in the breast area: Unexplained swelling, thickening or a noticeable difference in the appearance of one side of the chest deserves attention.

Dr Chugh stresses that these symptoms do not necessarily mean cancer is present, but they should not be left unchecked.

“What worries me looks different. A firm lump that doesn’t hurt, especially if it’s off to one side or sits away from the nipple, needs to be looked at soon. The same goes for a nipple that turns inward, any discharge that’s bloody or comes on its own, dimpled or puckered skin, redness or scaling that won’t clear up, and swelling under the arm. None of these means cancer for certain. But none of them is something to monitor for a few months and hope for the best,” he says.

Pain is not always present in breast cancer. Therefore, the absence of discomfort should not be treated as reassurance when a new or unusual lump appears.

Who Is at a Higher Risk of Male Breast Cancer?

Although breast cancer can affect any man, certain genetic, medical and family-history factors can increase the risk.

These include:

Inherited gene mutations: Changes in the BRCA2 gene are associated with a particularly increased risk of male breast cancer. BRCA1 mutations can also increase risk.

Family history: Having close relatives with breast cancer, especially male breast cancer, or a family history of breast and ovarian cancer may indicate an inherited predisposition.

Klinefelter syndrome: This genetic condition is associated with an increased risk of breast cancer in men.

Liver disease: Certain serious liver conditions can affect hormone levels and influence risk.

Previous chest radiation: Radiation exposure involving the chest, particularly at a younger age, can increase the likelihood of developing breast cancer.

Increasing age: The likelihood of developing the disease generally rises as men grow older.

Dr Chugh highlights the importance of understanding both inherited and medical risk factors.

“Some men carry a higher risk and ought to pay closer attention. A BRCA2 mutation raises the risk considerably, and BRCA1 does so to a smaller degree. Klinefelter syndrome, serious liver disease and earlier radiation to the chest do as well. So does a strong family history of breast or ovarian cancer. Men often overlook that this includes their father’s side of the family, not just their mother’s,” he says.

A family history does not mean that a man will inevitably develop breast cancer, and the absence of a known family history does not eliminate the possibility. Men with inherited mutations or a strong family history should discuss their individual risk with a healthcare professional. Genetic counselling may be appropriate in certain cases.

How Is Breast Cancer Diagnosed in Men?

When a man reports a suspicious lump or another concerning change, the first step is usually a clinical examination. The doctor may also ask about the duration of symptoms, relevant medications, previous medical conditions and family history.

Depending on the findings, investigations may include:

1. Clinical examination: The doctor examines the breast tissue, nipples and surrounding areas, including the underarms.

2. Imaging tests: Diagnostic mammography or ultrasound may be recommended to examine the affected tissue and determine whether the findings require further investigation.

3. Needle biopsy: If a lump or imaging result appears suspicious, a biopsy may be performed to collect a tissue sample. Laboratory examination can establish whether cancer is present and, if so, help determine its type.

The choice of tests depends on the symptoms and clinical findings. Not every chest lump requires a biopsy, but suspicious changes should be investigated appropriately.

Dr Chugh encourages men not to postpone an appointment because of embarrassment or uncertainty.

“If you notice something, see your doctor. Get an examination, and probably a mammogram or ultrasound, and a needle biopsy if it turns out to be something. It’s quick, it’s routine, and it’ll give you an actual answer instead of leaving you hanging for weeks,” he advises.

He also emphasises the importance of examining tissue removed during procedures for gynecomastia.

“Whenever I remove tissue from a man during gynecomastia surgery, it goes to pathology, every time. Once in a while the report turns up something nobody anticipated, which is why I never think of these operations as purely cosmetic. And if a man does need a mastectomy, reconstruction is an option, and it’s worth raising early,” Dr Chugh adds.

A pathology examination can help identify unexpected abnormalities. For men diagnosed with breast cancer, treatment depends on the type and stage of the disease and may include surgery, radiation therapy, hormone therapy, chemotherapy or targeted treatments. Breast reconstruction may also be discussed where appropriate.

When Should Men Consult a Doctor About Chest Changes?

Men should arrange a medical assessment if they discover a new lump, persistent skin changes, nipple inversion, unexplained discharge or swelling in the underarm area. Prompt evaluation is particularly important when symptoms are new, persist or continue to worsen.

These changes can have causes other than cancer, but waiting several months to see whether they disappear is not advisable. Men should also feel comfortable discussing breast-related symptoms with their doctors, just as they would report any other unexplained physical change.

Routine breast cancer screening is not generally recommended for men at average risk. However, those with significant inherited risk factors or a strong family history may benefit from an individualised assessment and advice from a specialist.

Dr Chugh concludes that awareness and timely action are essential.

“Knowing your own body isn’t a skill that belongs to one gender. If something in your chest feels new or different, get it checked. The worst that can come of an unnecessary appointment is a bit of awkwardness. The worst that can come of waiting is far harder to undo.”

The Takeaway

Breast cancer may be far less common in men than in women, but it should not be overlooked. Understanding the difference between common benign conditions and symptoms that require medical attention can help men make informed decisions about their health.