Male Breast Cancer
I read all the comments readers make to my blogs - thank you - and one reader was in particular upset that I had not discussed male breast cancer. Mea culpa. I'll try to correct the infraction.
Male breast cancer is rare - about 2000 new cases a year in the US or 1% as many cases as female breast cancer. As such, it does not get much coverage in the media. There are no spokesmen for male breast cancer.
In the past year I have seen two men with breast cancer (both in remission, fortunately). Men who suffer from breast cancer have two burdens to carry - that of having a cancer diagnosis, and that of having a cancer diagnosis that most people can't understand. Many people do not believe that males can get breast cancer, and this can create embarrassment for patients. For example, every time one of my male breast cancer patients went to get mammography he was given a bit of a hard time.
Treatment is similar for male breast cancer to female with the exception that (1) lumpectomy is not possible - only mastectomy, and (2) aromatase inhibitors may not be so effective; tamoxifen is used for estrogen receptor positive disease.
The risk of breast cancer in males is elevated if they have BRCA1 or BRCA2 mutations - the lifetime risk of developing a male breast cancer is 1.2% for men with BRCA1 mutations and 6.8% for those with a BRCA2 mutation according to a study by Dr Sining Chen at Johns Hopkins. BRCA2 is associated with breast cancer, ovarian cancer, colo cancer, and also pancreatic cancer, prostate cancer and possibly melanoma. Thus, I usually ask my male breast cancer patients to undergo genetic counseling and possibly testing.
The psychological aspects of the diagnosis of course vary from man to man. Most of the men I've seen have come to terms with their diagnosis; but some can feel embarrassment, shame, or a sense of isolation. Because of the small number of patients there are no support groups (unless there is an online one I don't know about!).