Male Breast Cancer: A Public Health Blind Spot in Oncology

Abstract Introduction: Male breast cancer is a rare but clinically significant malignancy, representing 0.6–1% of all breast cancer cases. Its low incidence contributes to delayed diagnosis, advanced disease at presentation, and poorer outcomes compared with female patients. Despite biological similarities to female breast cancer, most clinical guidelines and therapeutic strategies are extrapolated from female-focused studies, creating gaps in evidence-based care for men. Purpose: This review aims to synthesize current knowledge on the epidemiology, risk factors, clinical presentation, pathology, treatment, psychosocial impact, and ongoing research gaps in male breast cancer, highlighting the need for sex-specific management strategies. Materials and Methods: A comprehensive literature review was conducted, including population-based epidemiologic studies, genetic and molecular analyses, clinical trials, and psychosocial research focused on male breast cancer. Key databases were searched for studies reporting incidence, risk factors, diagnostic approaches, treatment outcomes, and survivorship issues in men. Results: Male breast cancer incidence is rising globally, particularly among older men, with BRCA2 mutations, hormonal dysregulation, Klinefelter syndrome, obesity, and radiation exposure identified as significant risk factors. Clinically, men typically present with retroareolar masses, nipple changes, or axillary lymphadenopathy, often leading to delayed diagnosis. Histologically, invasive ductal carcinoma predominates, with high rates of hormone receptor positivity and luminal A subtype predominance. Standard management includes mastectomy or, selectively, breast-conserving surgery, adjuvant radiotherapy, systemic chemotherapy, and endocrine therapy—primarily tamoxifen. Men face unique psychosocial challenges, including stigma, sexual dysfunction, and body image concerns. Persistent gaps include limited male-specific clinical trials, underrepresentation in guidelines, and inadequate awareness among patients and providers. Emerging approaches focus on molecular profiling, targeted therapies, and male-specific survivorship care. Keywords: Male breast cancer, BRCA2, hormone receptor-positive, invasive ductal carcinoma, mastectomy, endocrine therapy, psychosocial impact, epidemiology, genetic predisposition, targeted therapy.