The most common cause of a palpable mass or asymmetry in male breast is gynecomastia; however, male breast cancer should not be overlooked as a cause, even though it is rare. It is important to know the anatomy and frequency of diseases that affect the male breast, and the differences compared to females, to make an accurate diagnosis and reduce unnecessary examinations and surgical procedures. This review aims to summarize the algorithm of breast exam in symptomatic men, gynecomastia, and breast cancer.