When thinking of breast cancer, one automatically thinks of Female Breast Cancer (FBC). However, although rare, Male Breast Cancer (MBC) exists too. But why doesn’t society recognise this?

Breast cancer becomes increasingly more difficult to treat when it is at a later stage or metastasised. Recent studies show a lack of awareness of MBC amongst males; resulting in less self-examination compared with females. This decreases their chance of survival following diagnosis (NHS 2017).

Approximately 390 men are diagnosed with MBC in the UK each year (CancerResearchUK 2017). MBC displays similarities to FBC, namely late onset, post-menopausal, oestrogen receptor/progesterone receptor-positive FBC (Silvestri et al 2016). However, many characteristics of MBC do not overlap with FBC, which could be the reason why the rates of the two diseases, for mortality and survival have not improved (Rizzolo et al 2013).

Because MBC is so rare, little is known about the manner in which the disease is caused and there have been no randomised control trials for males (Yu et al 2015).

75% of male patients come across a painless mass. However, due to the lack of awareness, there is usually a postponement of around six to ten months from the beginning of symptoms to diagnosis. The symptoms of breast cancer also tend to present later in males than in females, leading to a worse prognosis for males (Fentiman 2009).

Risk factors of MBC include increasing age, obesity, males in families with the BRCA2 gene and high oestrogen levels (Macmillan 2014). All men produce small amounts of oestrogen. However, increased levels can be associated with a higher risk of breast cancer. Higher levels of oestrogen can be seen in men with obesity, chronic liver conditions and some genetic conditions (Cancer treatment 2016).

As with females there is a hereditary risk factor; males that are related to a female who has suffered with breast cancer has an increased risk of developing the disease. The risk is further increased if this female relative suffered with breast cancer below the age of 40. Both males and females can inherit mutated genes that increase the risk of breast cancer. Between 10 and 20 males out of 100 diagnosed with breast cancer are due to inherited mutations compared with 3 out of 100 females (CancerResearchUK 2017).

National campaigns and charity events have brought discussion and detection of FBC into our homes, at the very least allowing sufferers and their families to not feel alone. But for MBC, the few campaigns that do exist are not in the public eye, resulting in a lack of understanding and an almost non- existent self-detection process (CancerResearchUK 2017).

A study was carried out in the United Kingdom focussing on the emotions associated with MBC. The results of this questionnaire-based study showed that 35% of their male participants suffered with depression due to altered body image and 61% of the males claimed they wanted more gender-specific information. The article concludes that there is a definite need for more awareness and information regarding MBC (Brain et al 2006).

In comparison to MBC, FBC is of a much higher incidence. However, because of this, there is a lack of male-specific or even gender-neutral information available to males. Almost all of the information available through charity organisations with the pink logos, the news and education are aimed mostly at the female population, including female only fundraising.

Dealing with breast cancer is complex and difficult enough with countless psychosocial consequences made increasingly difficult for the male population by branding breast cancer as pink. The literature available usually includes various guidelines on menstruation, breast reconstruction and bra fittings, causing male patients to see it as a female only disease. For males suffering with this rare disease, it can cause insecurity and cause a male to feel less masculine (Robinson, Metoyer and Bhayani 2008).

The incidence of MBC seems to be on the increase. However, the knowledge and awareness does not show the same pattern (Diana 2013, Hodgson 2004 and White 2011). The lack of awareness and the attitudes of males toward the subject of breast cancer may be one of the reasons for the higher mortality rate.