Only between 0.5 and 1.2% of all breast cancers are found in men. Over the past 20 years 17 male breast cancers were treated in the University Clinic of Graz/Austria. Seven of these cases had localized disease and primary surgical treatment was performed; three out of the seven are still alive and show disease-free intervals of 2, 6 and 10 years, respectively. The metastatic cases were treated by various combinations of surgical treatment, radiotherapy, hormonal treatment and chemotherapy. Our results confirm the numerous communications in the literature that the therapeutic approach to male breast cancer is not essentially different to the management of female breast cancer at potentially curable stages. Primary orchidectomy still holds a dominant position in metastatic stages. Nevertheless, hormonal treatment with anti-oestrogens achieved an overall response rate of nearly 50%, which is comparable to the results with primary orchidectomy. Hence, this treatment is becoming of increasing importance as the primary form of treatment in hormone-sensitive metastatic male breast cancer.