As would be expected, the major presenting symptom of MBC is a lump, followed by nipple retraction ± discharge but advanced cases may also have ulceration or pain. Taking the history should include family history of FBC, infertility, prior occupation in the retired and current medications. Examination of the breasts, axillae and testes is mandatory. Using Royal College of Radiologists (RCR) guidelines, many men still have unnecessary imaging based on age and clinical score. As with females, if cancer is suspected on clinical and radiological grounds, core biopsy should be used to make the diagnosis with FNAC being reserved for confirmation that a mass is benign, or to sample suspicious axillary nodes. PET scan does not form part of routine triple assessment but can be of value in determination of distant spread of a cancer. MRI has a role in determining presence or absence of chest wall invasion. Elastography looks interesting but experience is limited. Extramammary breast tissue is a rare cause of MBC usually manifesting as an itchy rash. Synchronous bilateral MBC appears more likely to have risk factors for recurrence compared with metachronous disease. Occult MBC can present in younger men, sometimes with an alarmingly large axillary tumour burden but with apparently reasonable short-term outcome.