The article reviews the role of gender in breast cancer (BC) genetics, highlighting the emerging differences in the impact and magnitude of genetic risk factors between male and female patients. Despite being commonly perceived as a female-only disease, BC also occurs in men, although rarely. The genetic architecture of BC susceptibility is similar in both sexes, with high-, moderate-, and low-penetrance risk variants. However, sex-specific features have begun to emerge, particularly in the context of inherited high-penetrance pathogenic variants (PVs) in *BRCA1* and *BRCA2* genes. *BRCA1* and *BRCA2* PVs are more commonly associated with increased risk of female and male BC, respectively, and *BRCA*-associated BCs exhibit sex-specific pathologic features. Next-generation sequencing technologies have provided insights into moderate-penetrance BC risk variants in genes like *PALB2*, *CHEK2*, and *ATM*. International collaborative genome-wide association studies have contributed evidence on common low-penetrance BC risk variants and their combined effects in polygenic models. Overall, while the genetic basis of male BC is similar to that of female BC, it may differ in specific aspects, such as molecular features and clinical behavior. Addressing these differences is crucial for improving personalized risk assessment and therapeutic choices in both sexes, ultimately leading to gender equality in BC care. The review also discusses the implications, challenges, and open issues surrounding the establishment of a gender-oriented clinical management for BC.The article reviews the role of gender in breast cancer (BC) genetics, highlighting the emerging differences in the impact and magnitude of genetic risk factors between male and female patients. Despite being commonly perceived as a female-only disease, BC also occurs in men, although rarely. The genetic architecture of BC susceptibility is similar in both sexes, with high-, moderate-, and low-penetrance risk variants. However, sex-specific features have begun to emerge, particularly in the context of inherited high-penetrance pathogenic variants (PVs) in *BRCA1* and *BRCA2* genes. *BRCA1* and *BRCA2* PVs are more commonly associated with increased risk of female and male BC, respectively, and *BRCA*-associated BCs exhibit sex-specific pathologic features. Next-generation sequencing technologies have provided insights into moderate-penetrance BC risk variants in genes like *PALB2*, *CHEK2*, and *ATM*. International collaborative genome-wide association studies have contributed evidence on common low-penetrance BC risk variants and their combined effects in polygenic models. Overall, while the genetic basis of male BC is similar to that of female BC, it may differ in specific aspects, such as molecular features and clinical behavior. Addressing these differences is crucial for improving personalized risk assessment and therapeutic choices in both sexes, ultimately leading to gender equality in BC care. The review also discusses the implications, challenges, and open issues surrounding the establishment of a gender-oriented clinical management for BC.