Let’s say you have a case of gynecomastia and you have decided to accept it and move on with your life. Then, one day, it occurs to you to wonder whether you might have male breast cancer, or MBC. After all, you have some excess breast tissue, so wouldn’t it make sense that this could be a risk for you?

Let us reassure you: even if you have enlarged breasts, your risk of getting MBC is low. According to the American Cancer Society, the disease is 100 times less common in men than it is in women. About 2,350 new cases of MBC are diagnosed each year in the United States.
Although the rate of occurrence of MBC is low, you should still educate yourself about the disease. Here are some leading risk factors you should know.
Genetic makeup: As with many other medical conditions, if you have a close male or female family member with breast cancer, your risk is slightly elevated. A mutation of the genes BRCA1 or BRCA2 would also put you at increased risk.
Age: Breast cancer is detected much more often in older men. The American Cancer Society notes that the average age of diagnosis for men is about 68 years.
Lifestyle: Heavy drinking increases the possibility you may get MBC, most likely due to alcohol’s effect on the liver. Obesity is thought to be another risk, since fat cells convert male hormones into estrogen and high levels of this hormone are linked to an increased risk of breast cancer.
Hormone therapy: Due to the link between estrogen and breast cancer, hormone therapy (for prostate cancer, for instance) for both men and women is not as common as it once was. Transsexual individuals who take high amounts of estrogen may be at increased risk.
Medical conditions: Certain medical conditions are associated with higher rates of MBC. Klinefelter syndrome, in which a man has two or more X chromosomes instead of just one, is an example. Impaired liver function due to disease or cirrhosis can also lead to the development of breast growths, benign and malignant.
Occupations: Environments that subject men to hot conditions, such as steel mills, are thought to increase the risk of MBC by exposing the testicles to elevated temperatures and impairing their function. Similarly, those who work around fumes from gasoline and other carcinogenic substances may experience higher rates of MBC.
Perhaps because the risk of MBC is low, or possibly because many men don’t realize there is a risk at all, breast cancer in men tends to be diagnosed when it has already spread. Also, many guys tend to ignore body changes, and even when they do notice something, simply refrain from checking it out with the doctor. The American Cancer Society advises men to be on the lookout for swelling, lumps, bloody nipple discharge and changes in breast skin or nipples.
The organization also suggests that men with a strong family history of breast cancer and/or known mutations of one of the BRCA genes might consider further measures. These could include physical exams, mammography and genetic testing.
In our three decades of working with more than two thousand patients with gynecomastia in New York City, we can count on one hand the men we have seen who have ultimately received a diagnosis of MBC. We therefore advise average guys with no symptoms not to worry. But if you have any cause for concern at all, see your doctor.

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