19. Male breast cancer: aetiology, genetics and clinical management

Male breast cancer (MBC) is a rare disease with an older average age of presentation than in women. Predisposing factors include increased exposure to oestrogen and being a carrier of a BRCA2 mutation. Most MBC is ductal and the majority are oestrogen receptor positive. Modified radical mastectomy is the treatment of choice for local disease and adjuvant radio-, hormonal and chemotherapy should all be considered. Stage for stage, the prognosis for MBC is similar to that for female breast cancer. Despite a wealth of small retrospective studies on MBC, its rarity means there is a lack of prospective randomised controlled treatment trials, which needs to be addressed if significant advances are to be made in the treatment of this unusual and challenging disease.