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When men get breast cancer - (4/9/2019)

By Dr. Ron Gasbarro

Ben came into the pharmacy and said to the pharmacist, “Did you hear my brother, Ted, has breast cancer? Do men really have breasts?” The pharmacist explained that men have functioning nipples that can potentially produce milk but do not because males have a different hormone makeup. If artificial hormones are introduced or an imbalance occurs, then they can potentially produce milk or develop breast tissue. Hence, men can conceivably acquire malignancies of these structures.  

Compared to breast cancer in females, the male version is relatively rare, with 1% of all breast cancers occurring in males. The American Cancer Society predicts 2,670 new cases of breast cancer in men this year, causing about 480 deaths. Most cases of male breast cancer are detected between the ages of 60 and 70, although it can develop at any age. Obesity, alcohol use, and toxic environments have been linked to a greater risk of breast cancer in men, but more conclusive evidence is needed. Family history and genetics can also increase one’s risk of male breast cancer. Says Ben, “Both my mom and my sister have had brushes with breast cancer. But my brother, Ted? I’d never have guessed.” 

The symptoms of male breast cancer can be similar to those in women: nipple discharge in one breast; changes in the size and shape of the nipple or breast; a lump that feels like a hard knot or a thickening in the breast or under the arm. A biopsy, magnetic resonance imaging (MRI), and/or mammography can confirm or rule out a breast cancer diagnosis. Treatments include surgery, chemotherapy, and radiation.  

Aside from overcoming the medical challenges of male breast cancer, there are psychological issues to tackle. And Ben’s brother, Ted, may need professional help dealing with them. From the initial shock of being diagnosed with a disease perceived as “a woman’s thing” to the discomfort of being tested in medical facilities focused on treating women, or the permanent disfigurement visible whenever the chest is bared, male patients have a hard time escaping the stigma of breast cancer. In one study of men with carcinoma of the breast, participants reported feelings of anxiety, embarrassment, emasculation, and even depression regarding their condition. 

Education about male breast cancer is lacking. Even if the percentage of men diagnosed with male breast cancer is small, it is often more fatal for a larger percentage of the men diagnosed. Typically, men do not schedule regular mammograms and do not search for unusual chest lumps as women do. Since most men do not know to look for it, the disease is usually found after it has progressed to a more dangerous level. Because breast cancer, in general, can have a prevail in some families, getting regular checkups would identify this potentially life-threatening condition and get it “nipped in the bud.”

The pharmacist explained to Ben that referrals of men to breast assessment clinics are increasing as awareness heightens. While most will have benign disease, some will have a malignancy. Whichever pathology they have, men should be offered a service tailored to their needs, rather than being ‘shoehorned’ into a service designed for women. Male breast cancer is a serious issue that needs to be addressed more fully by the medical and public community. However, due to a lack of awareness and limited research on the topic, a general absence of knowledge exists concerning the psychological implications of this disease in men as well as a need for greater understanding of the medical diagnosis and treatment of male breast carcinoma. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com

 


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