The lump he ignored, male breast cancer in India: Why this 'silent disease' is often diagnosed too late

Though often seen as a woman’s disease, breast cancer can also affect men. Male breast cancer, although rare, accounts for less than 1% of breast cancer cases and about 0.5–1% of male malignancies. The lifetime risk is about 1 in 833 for men, compared to 1 in 8 for women.

The National Cancer Registry reports male breast cancer makes up 0.5%–1.5% of cancers in Indian men, with about 7,000 new cases yearly. Male breast cancer often goes unnoticed and is diagnosed late. Over half of Indian men with breast cancer are diagnosed at Stage III or IV, after the disease has spread. "Early diagnosis is challenging because most men don’t realize breast cancer affects them, often ignoring warning signs," says Dr. Ajesh Raj Saksena. “Delayed attention can cost a chance at a cure.”
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Who is at risk
Male breast cancer occurs most commonly in men between 60 and 70 years of age, but younger men are not entirely exempt. Occasional cases have been reported in men under 40, particularly those with genetic predispositions such as BRCA2 mutations, Klinefelter’s syndrome, prior chest radiation, or hormonal imbalances.
Risk factors also include a family history of breast, ovarian, or prostate cancer, chronic liver disease, and obesity, all of which can alter the balance of estrogen and testosterone in the body. “Lifestyle and genetics both play a role,” explains Dr. Saksena. “Men with a family history of breast, ovarian, or prostate cancer should be particularly vigilant.”

Symptoms men should never ignore
Early signs of male breast cancer are often subtle but noticeable.
Common red flags include:

• A painless lump or thickening beneath or near the nipple or the chest
• Changes in the nipple — redness, scaling, inversion, or discharge (especially if bloody)
• Skin changes such as dimpling, puckering, or ulceration
• A sore or ulceration that doesn’t heal
• Swelling in the armpit due to lymph node involvement

“If a man feels a firm, painless lump behind the nipple that wasn’t there before, he should not wait,” stresses Dr. Saksena. “Early diagnosis can make treatment simpler and success rates much higher.”

Diagnosis and types
Diagnosis typically involves a clinical examination, mammogram, ultrasound, and biopsy to confirm the presence of cancer and assess hormone receptor status. The most common type in men is invasive ductal carcinoma. Male breast cancers are usually hormone-receptor positive, so they respond well to hormone therapy. Triple-negative and HER2-positive cancers are uncommon in men.

Treatment options
Treatment for male breast cancer follows the same principles as in women but is adapted to the male anatomy.
Surgery, usually a modified radical mastectomy that removes the breast tissue and lymph nodes, remains the mainstay of treatment. Breast-conserving surgery is generally a challenge due to the small size and limited volume of the male breast, though it may be considered in carefully selected cases.
Other treatments such as hormone therapy, chemotherapy, radiation, and targeted drugs are used as indicated, based on the stage and tumor characteristics.

When diagnosed early, outcomes in men are usually excellent. Survival rates exceed 85% for early-stage cases, significantly better than the ~30% survival rate when diagnosed late. This significant difference underscores the importance of early detection and awareness, which remains critical.

Stories that inspire awareness
Real-life stories remind us that male breast cancer can affect anyone. Actor Richard Roundtree, famous for his iconic role in Shaft, was diagnosed with breast cancer at 51 and underwent a double mastectomy in 1993. His decision to speak publicly broke barriers and helped normalize conversations about men and breast cancer.
Similarly, Bret Miller, diagnosed at just 24 years old, turned his experience into advocacy. He founded the Bret Miller 1T Foundation, spreading awareness through his campaign, “Men Have Breasts Too,” which encourages men worldwide to check themselves and seek help early. “Stories like theirs highlight a powerful truth,” says Dr. Ajesh Raj Saksena. “Cancer does not discriminate by gender or age. Awareness and timely action are the best protection.”

“The message is simple,” concludes Dr. Ajesh Raj Saksena. “If you discover a lump or any physical change in your chest, act now—schedule a clinical breast exam with a specialist. Early detection is not just important; it can save your life and protect your future. Don’t ignore symptoms—take the first step toward protecting your health today.”

Male breast cancer: Quick facts you should know
5 Warning Symptoms

• Painless lump or swelling behind the nipple or in the chest area
• Nipple turning inward, scaling, or ulceration
• Bloody or clear nipple discharge
• Skin dimpling, redness, or thickening over the chest
• Lump or swelling in the armpit

“Any persistent lump or nipple change in men must be checked by a doctor — early diagnosis saves lives.”

5 ways male breast cancer differs from female breast cancer

• Much rare, accounts for less than 1% of all breast cancers
• Usually affects older men (60–70 years)
• Spreads faster to the nipple and the chest wall due to less breast tissue
• No routine screening, like mammograms, leads to detection in advanced stages
• More likely to be hormone-receptor positive, responds well to hormone therapy

Dr. Ajesh Raj Saksena, Senior Consultant, Surgical Oncology & Minimal Access Surgeon, Apollo Cancer Centre, Hyderabad