A UK study of incidence, prevalence and survival of MBC has revealed a 2.5-fold increase in prevalence with time. For FBC there was a >5% improvement in 5-years but no change in MBC survival. To achieve an early diagnosis it is important that gynaecomastia is appropriately investigated to exclude underlying MBC. If health advice to avoid obesity is heeded this will significantly reduce a spectrum of morbidity, including MBC. This is the most promising approach to prevention of MBC since in absolute numbers there are too few cases to form a meaningful target group for more specific interventions. There is a pressing need for randomised trials of adjuvant treatment for MBC looking not only at survival but also compliance with treatment in men. Use of cyclin-dependent kinase 4/6 inhibitors in combination with endocrine therapy for MBC at high risk of recurrence looks to be a promising improvement in adjuvant therapy. Endocrine neoadjuvant offers an opportunity to reduce the extent of surgery for many with MBC in a relatively non-toxic and inexpensive manner. The psychological morbidity associated with the diagnosis and treatment of MBC requires the establishment of self-help groups with input from MBC survivors to counter the sense of isolation, guilt and emasculation. The great rarity of male breast sarcomas and lack of consensus regarding management should act as a spur to set up national/international registries to enable evidence-based treatment.