By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
It’s October again, which means we’re awash in a sea of pink—the annual symbol of breast cancer awareness.
Each year, more than 250,000 women are diagnosed with this terrible disease. Another 40,000 will succumb to it.
Campaign participants have done a fantastic job of educating women about the importance of self-exams, mammograms, and early diagnosis in combatting breast cancer. But there’s one fact about the disease that consistently seems to get lost: yes, men can get breast cancer too.
Breast Cancer in Men: The Other One Percent
Don’t get me wrong—I’m not saying breast cancer awareness should become a “men’s thing.” More than 99 percent of cases occur in women, and awareness messages for women should continue to be a primary focus.
But a nod toward men now and then is something I’d like to see, and something I think could save lives.
Here’s why. For the one percent of breast cancers that occur in men, outcomes tend to be less favorable than in women—often because it never occurs to men, or their doctors, that cancer may be a possibility. By the time men seek help for their symptoms, their malignancies are usually more advanced and more lethal.
Male breast cancer is also an issue that has affected my family—and I’ve seen firsthand how awareness makes a difference.
Quick Action Leads to Remission
My wife Jan’s son, Greg, was diagnosed six years ago.
One day while Greg was working, he noticed a stain on his shirt, near his nipple. Thinking he must have spilled some coffee on himself, he wrote it off.
But a few days later, the mystery spot was back.
This time, Greg realized it was blood—and it was coming from his nipple. A day later, he was at his doctor’s office undergoing tests. Initially, his results showed nothing wrong. Then his doctor ordered a mammogram, hoping that would shed some light on the problem.
Greg’s images revealed some calcification and a blocked duct in his breast tissue. The news turned his thoughts to his sister, who, herself, was recently treated for breast cancer. After discussing this family history with his doctor, Greg had a biopsy.
It came back positive.
From that point forward, Greg’s journey was similar to that of many breast cancer survivors.
Statistics and Signs of Breast Cancer in Men
My takeaway from Greg’s experience was the importance of his quick and decisive action in seeking treatment. Because of that, his cancer is in remission today and he’s able to be a healthy, active father to three of our wonderful grandchildren.
Unfortunately, this isn’t true of many other men—and when you look at the numbers, it’s easy to understand why men may ignore symptoms that would send a woman to the doctor in a heartbeat. Male breast cancer is flat out rare. According to the American Cancer Society—
- A man has a 1 in 1,000 lifetime chance of being diagnosed with invasive breast cancer
- About 2,600 new cases of invasive breast cancer will be diagnosed in 2016
- About 440 men will die this year of breast cancer
- Breast cancer is 100 times less common in men than in women
In fact, many people assume that men can’t get breast cancer because they don’t have breasts. While that may be true, men do have a small amount of breast tissue.
Both genders are born with the same type of breast tissue. At puberty, estrogen causes it to further develop in women. Men with normal estrogen levels see no change. Still, the tissue is there and it can develop abnormalities.
In addition to bleeding from the nipple, as Greg experienced, other signs of breast cancer in men can include a lump in breast tissue, nipple pain, nipple inversion, clear discharge from the nipple, and enlarged lymph nodes under the arm.
Risk Factors for Breast Cancer in Men
If awareness is the first step in combatting male breast cancer, the second is understanding risk factors. There are a handful of things that can raise the risk for breast cancer in men (not surprisingly, several are the same as for women)—
Older men are more likely to develop breast cancer than younger men. The average age of onset, according to breastcancer.org, is 68.
Studies have shown that up to 20 percent of male breast cancer cases occur in men with a female relative who has also been diagnosed with the disease. When the cancer occurs in a first-degree relative, risk can increase by two or three times. This was certainly true in Greg’s case, as his sister was undergoing treatment at the time of his diagnosis.
Male breast cancer may be up to 20 times more common in men who have this rare genetic condition. Characteristics of Klinefelter syndrome include low testosterone levels and reduced muscle mass and body hair.
High Estrogen Levels
All men have estrogen circulating in their bodies, but men whose levels are higher than average may be at higher risk of developing breast cancer. Estrogen levels can be driven by many factors. Some men naturally produce more estrogen than others. Estrogen levels are also related to obesity, some medications (therapy for prostate cancer often includes estrogen), heavy drinking, liver impairment, and exposure to chemicals and foods—such as unfermented soy—that mimic estrogen in the body.
The gene most commonly associated with male breast cancer is BRCA2, but others have been associated with the disease as well.
Experts agree that men with a history of chest radiation – X-rays for example – may be at greater risk of breast cancer, but I believe the radiation threat is much more pervasive, and not just limited to ionizing radiation (like that in X-rays which are known to be carcinogenic). Think wifi, cell phones, tablets, Bluetooth, and the dozens of other wireless devices that litter our homes, schools, and offices.
Because these technologies are still relatively new and there isn’t enough longitudinal data to draw definitive conclusions, experts vary widely—and rabidly—in their opinions about the electromagnetic fields (EMF) they generate. I believe that science will eventually prove me right. Just because we can’t see EMF doesn’t mean it doesn’t exist, or that it’s not toxic to some people, or that it can’t trigger the abnormal division of cells.
Remember, at one time, we couldn’t conceive of bacteria and viruses, either—but acceptance of them revolutionized medicine!
We already know that some forms of nonionizing radiation can be dangerous. One study found that the risk of breast cancer was higher in men whose jobs required consistent exposure to EMF, with risk highest among electricians, telephone linemen, and electric power workers. Another study, which followed Belgian military personnel for 37 years, found that twice as many men in radar battalions died due to neoplasm (abnormal growth) than did men in non-radar battalions.
Winning the Fight Against Male Breast Cancer
For men who are diagnosed with breast cancer, the classification and treatment of their disease follow the same protocols as for women—and they can expect similar prognoses depending on their disease stage.
Again, I can’t say often enough that there’s no doubt in my mind that Greg’s story ended happily because he took action as soon as he felt something could be wrong, and because he was aware that breast cancer could affect him—even though he was a man. Jan and I are tremendously grateful he acted so quickly with an open mind, and remain inspired by his strength and outlook. We thank him for letting us share his story and hope it brings life-saving awareness to other men who might also one day be “that one-percent.”
- American Cancer Society. What Are the Key Statistics About Breast Cancer in Men? Accessed September 14, 2016.
- Breastcancer.org. U.S. Breast Cancer Statistics. Accessed September 22, 2016.
- Breastcancer.org. The Risk Factors for Male Breast Cancer. Accessed September 14, 2016.
- Breastcancer.org. Symptoms of Male Breast Cancer. Accessed September 30, 2016.
- Degrave E et al. Causes of death among Belgian professional military radar operators: a 37-year retrospective cohort study. Int J Cancer. 2009 Feb 15;124(4):945–51.
- National Breast Cancer Foundation, Inc. Male Breast Cancer. Accessed September 14, 2016.
- Niewoehner CB and Schorer AE. Gynaecomastia and breast cancer in men. BMJ. 2008 Mar 29; 336(7646):709–713.
- Richter E et al. Cancer in radar technicians exposed to radiofrequency/microwave radiation: sentinel episodes. Int J Occup Environ Health. 2000 Jul-Sep;6(3):187–93.
- Weiss JR, Moysich KB, and Swede H. Epidemiology of Male Breast Cancer. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):20–6. Accessed September 20, 2016.
- Yale Cancer Center. Greg: Breast Cancer Survivor. Accessed September 14, 2016.
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