October is Breast Cancer Awareness Month, which comes with some now-familiar trappings: pink ribbons everywhere, survivor stories, requests for donations. For the obvious reason that it is extremely rare, male breast cancer is not at the top of the discussion points. But the risk exists, and many men don’t know they can develop the disease. Here is what men should know.
Alexandra Heerdt, a surgeon at Memorial Sloan Kettering Cancer Center, says that men and women share some of the same risk factors for breast cancer, notably age and genetic mutations. According to the National Cancer Institute, breast cancer usually affects males between 60 and 70, and a family history of the disease also heightens the risk.
Heerdt says the signs are the same for both genders, with an unusual mass, nipple discharge and changes in the skin being common warnings. In many cases, the disease goes undetected early and has already spread to the lymph nodes or other areas by the time of diagnosis.
Associated Press writer Andrew Dalton detailed his own scare with cancer after first experiencing pain in his lymph nodes. Because his mother and sister had both been diagnosed with the disease, Dalton’s doctor sent him in for a mammogram, where he noted the lack of men at the facility. While Dalton did not have cancer, his story highlights how men can often feel like an outsider when dealing with a disease that so rarely affects the gender.
Kathryn Ruddy, a breast medical oncologist at the Mayo Clinic, says many of her male patients feel isolated following a diagnosis. “Breast cancer is so associated with women in the press, and in our culture because breast cancer is so much more common in women, it can be difficult psychologically and psychosocially,” she says.
Currently, early-screening measures for men are non-existent. For women, the U.S. Preventive Services Task Force recommends that women undergo mammography screening every two years between 50 and 74.
“The reason that the mammograms are not used is that it is not cost-effective to screen a huge population for a rare cancer yearly,” Heerdt explains. Also, men tend to detect lumps early more easily than women do because they have minimal breast tissue.
But that early detection doesn’t happen enough. Ruddy says that among the estimated 2,000 men who are affected each year, the prognosis is usually poor. In many cases, the cancer has already spread by the time it is diagnosed. As Ruddy explains, male breast cancer is understudied, and solid guidelines to instruct men about when to do a breast self-exam are lacking. Although self-exams are no longer a recommended screening tool, Ruddy believes they may be the best course of action for men who are at increased risk.
“For men, we don’t have any routine imaging for screening,” she says. “Personally, I don’t think it’s unreasonable for men to know their breast tissue.”
The best thing at-risk men can do is be aware that breast cancer isn’t a disease only affecting women. “I would encourage men who notice a change in their breast tissue or nipple to alert their doctors,” Ruddy says. “Men should be aware that they can also get breast cancer, so these types of changes shouldn’t be ignored.”