28 October 2019

Men with breast cancer face higher mortality rate than women

October is Breast Cancer Awareness Month, and although internationally men make up less than 1% of cases, they often ignore the signs until it’s too late.

Breast cancer affects both women and men, yet there’s a popular misconception that this type of cancer is a women’s issue. Now, a new study shows that men with breast cancer are more likely to die than their female counterparts, across all stages of the disease.

Even more concerning, the study indicates, is that this disparity persists even when clinical characteristics, such as cancer types, treatment, and access to care are considered.

The study was carried out by Vanderbilt researchers and published in JAMA Oncology. It looked at a 11-year registry of data from January 2004 to December 2014.

The cohort consisted of 16 025 male and 1.8 million female patients with breast cancer in the US. The five-year mortality rate for the male patients was 19% higher than their female counterparts.

Possible reasons

The following reasons may be responsible for the lower overall survival rates, the study’s senior author and associate director for Global Health and co-leader of the Cancer Epidemiology Research Program at Vanderbilt-Ingram Cancer Center, Xiao-Ou Shu, said:

  • Distinct cancer biology
  • Less effective treatment
  • Men not being compliant with hormonal treatment
  • Unhealthy lifestyles among men, including smoking, alcohol consumption, physical inactivity and obesity

Shu also pointed out that additional studies are needed to identify the causes, but that it would require international consortia, considering male breast cancer is so rare and accounts for less than 1% of breast cancer cases.

"It is so rare, it would be extremely difficult for any single institute to recruit a sufficient number of patients for research," said Shu.

About 85% of male breast cancer is ER-positive, a proportion that is higher than female breast cancer patients (75%).

"That is a cancer type where patients usually fare better because we have a hormonal treatment," Shu said, concluding by stressing the importance of conducting more studies that are specifically focused on male breast cancer.

Shu explained that in theory, men should have better outcomes and lower mortality than women if the treatment is equally effective.

"The question is whether there are some other biological differences between ER-positive male breast and ER-positive female breast cancer. We don't know," Shu commented.

Breast cancer in men is often ignored

According to the Breast Health Foundation, in South Africa, 1–3% of all breast cancers happen in men and it seems to be on the rise for men who work on electrical lines. Factors such as radiation, X-rays and electromagnetic waves have also been implicated in incidents, notes the foundation.

Since breast cancer in men is so rare, it often goes undiagnosed as men are less likely to go for screenings. But ignorance is a killer and there needs to be more awareness around this, and men need to do self-checks too. Most men don’t go to the doctor until they develop severe symptoms such as bleeding from the nipple, at which point the cancer might already have spread.

“The most common sign of breast cancer in men is a firm, non-painful mass located just below the nipple,” says CANSA to Men’s Health South Africa.  

The symptoms are similar to those of women, and treatment too, although men may have more of their breast tissue removed as their cancer is usually nearer the chest wall. You can perform a simple self-exam by looking out for:

  • Red spotted breasts
  • Nipple discharge
  • Inverted and painful nipples
  • Breast swelling
  • Shoulder pain leading to the shoulder muscles

Image: Getty


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CANSA’s purpose is to lead the fight against cancer in South Africa. Its mission is to be the preferred non-profit organisation that enables research, educates the public and provides support to all people affected by cancer. Questions are answered by CANSA’s Head of Health Professor Michael Herbst. For more information, visit

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