Male breast health and breast cancer risk

Males account for a small but clinically significant component of overall breast conditions, both benign and malignant. This review summarizes current evidence on epidemiology, male breast anatomy, clinical presentation, diagnosis, management, and identification of risk factors for male breast disease. Benign male breast disease, including gynecomastia, prompts clinical evaluation and requires understanding of hormonal and pharmacological causes to guide diagnostics and management. Although male breast cancer is rare, accounting for less than 1% of all breast cancers, it carries important hereditary and clinical implications. Pathogenic germline variants in BRCA2 are the predominant genetic contributor, conferring a lifetime risk of ~7%, while BRCA1, CHEK2 and PALB2 variants confer lower risk. Males with breast cancer typically present with subareolar masses, nipple changes, or pain, often at older ages and later stages compared with females. Imaging evaluation, including mammography and ultrasound, is central to diagnosis and management. Screening recommendations for high-risk men remain limited due to sparse prospective data, with multigene panel testing and family history assessment guiding individualized risk assessment. Management strategies for male breast cancer generally parallel female protocols, despite unique biological features. By integrating considerations of benign and malignant conditions, this review underscores the importance of tailored evaluation, risk assessment, and individualized care for males, while identifying knowledge gaps to inform future research and improve outcomes in this under-recognized population.