Published Apr 14, 2026 | 7:00 AM ⚊ Updated Apr 14, 2026 | 7:00 AM
The median wait between first symptoms and confirmed diagnosis stood at six months.
Synopsis: A study from Hyderabad found that most men with breast cancer seek care late, with nearly 87 percent presenting at advanced stages after months of delay. Aggressive tumour profiles were common, but many patients responded well to targeted treatment when it was accessible. Researchers say stigma, low awareness and gaps in health systems continue to delay diagnosis and treatment.
It begins with a lump. A firm, painless mass that a man notices, perhaps in the shower, perhaps by accident. He waits. He assumes it means nothing. Six months pass before he walks into a hospital. By then, the cancer has spread.
This is not a hypothetical. This is what researchers at ESIC Medical College and Hospital documented when they studied 15 men treated for breast cancer between 2019 and 2025.
Their findings, published this year in the Journal of the Association of Physicians of India, describe a condition that medicine understands but society continues to miss.
Breast cancer in men exists in a blind spot. It accounts for under 1 percent of all breast cancer diagnoses globally, a number small enough to push it to the margins of public health campaigns, clinical training and national guidelines. In India, that marginalisation costs men months, sometimes years, of treatable time.
The Hyderabad study puts numbers to that cost. Nearly 87 percent of the men in the cohort arrived at the hospital carrying advanced disease. Sixty percent had stage III cancer. Another 26.7 percent had already reached stage IV. Only two of the 15 patients presented with early-stage disease.
The median wait between first symptoms and confirmed diagnosis stood at six months. Every single patient presented with a breast lump. Several had nipple retraction. Two arrived with ulcerated tumours.
“Late recognition, shaped by stigma, low awareness, and diagnostic inertia, contributes to advanced presentation, particularly in resource-limited settings,” the authors wrote.
Nobody had flagged anything earlier. Not the men themselves, and in many cases, not the doctors they may have encountered along the way.
What makes this study particularly striking is not just the late presentation but what researchers found inside the tumours themselves.
Eighty percent of patients carried hormone receptor-positive cancers, a profile that responds to endocrine therapy and follows a relatively understood path. But 40 percent tested positive for HER2, a protein that drives more aggressive tumour behaviour. A quarter of the cohort carried a triple-positive profile, combining oestrogen, progesterone and HER2 positivity.
That HER2 figure stands well above what registries typically report for male breast cancer populations. And the data showed a clear pattern: men with HER2-positive or triple-positive disease arrived sicker.
“Among seven patients with T4 disease, four were HER2-positive. All 13 patients with lymph node involvement were HER2-positive or triple-positive,” the authors noted.
In other words, the men who carried the most aggressive tumour profiles also carried the most advanced disease when they finally reached care. Whether the biology drove faster progression, or whether delays simply gave aggressive tumours more time to spread, the outcome was the same. These men arrived at a disadvantage.
Once in the system, most patients received treatment tailored to their biology. Thirteen of the 15 men underwent surgery. Doctors prescribed tamoxifen for hormone receptor-positive patients. Those with HER2-positive disease received trastuzumab, with pertuzumab added in selected cases. Patients with advanced hormone receptor-positive tumours received CDK4/6 inhibitors such as palbociclib.
Nine patients, 60 percent of the cohort, remained alive with disease under control at the last follow-up. That figure, given how late most of these men arrived, reflects what biomarker-guided treatment can achieve even against the odds.
“Multimodality, biomarker-guided therapy achieved durable control in many patients,” the authors wrote.
But the study also maps where the system stumbled. Radiotherapy was underused. Neoadjuvant chemotherapy, which can shrink tumours before surgery, reached only a handful of patients. Access to targeted therapies depended heavily on cost and what each institution could offer on any given day.
“Radiotherapy was underutilised, despite evidence that it reduces local recurrence and improves survival in high-risk male breast cancer,” the authors stated.
Four patients, over a quarter of the cohort, stopped engaging with the hospital entirely. Researchers attributed this to financial strain, travel distances, exhaustion and the absence of systems designed to keep patients connected to their care over time.
Two patients died. Both had metastatic disease. Both had arrived late.
“These losses reflect systemic barriers such as travel constraints, treatment fatigue, lack of community support, and financial burden,” the authors wrote, describing patterns seen across oncology settings throughout low- and middle-income countries.
These are not simply individual failures. They describe a system that treats cancer but does not always hold on to the people who carry it.
The researchers close their paper with demands rather than suggestions. They call for male-specific protocols inside national cancer guidelines, including those issued by the Indian Council of Medical Research.
They push for dedicated registries that track male breast cancer as its own category, generating data that currently does not exist at scale in India. They argue for gender-inclusive clinical trials, because most breast cancer research recruits women, leaving male patients with limited evidence to guide their treatment.
“We advocate for national policies that mandate inclusion of male-specific protocols in breast cancer guidelines,” the authors stated. “Establishing male breast cancer registries and enabling gender-inclusive clinical trials are essential next steps.”
The study covers 15 patients across six years at a single hospital. Its sample is small, and the authors acknowledge this. But in a country where male breast cancer barely registers in public conversation, 15 cases documented with this level of detail carry weight.
The lump that a man notices and dismisses, the symptom that a doctor does not pursue, the six months that dissolve before anyone acts: these are not inevitable. They are the consequences of a gap in awareness that medicine and policy have the tools to close, and have not yet chosen to.
