When you hear the words "breast cancer," what's your first impression (besides dread)? Do you picture your mother, sister, or girlfriend? Film footage of legions of pink-ribbon bedecked women striding through the streets of a major city, television coverage of one of the big breast cancer fund-raising walks? Do you ever see a man in this picture? No?
We often speak about the sisterhood of breast cancer. Well, move over ladies-men get breast cancer, too. Not nearly as often as women, admittedly; while about 200,000 American women are diagnosed with breast cancer each year, the figure for men is about 1,300, a little over half of one percent of the total. But for those 1,300 men, the diagnosis is just as searing; the treatment as painful, the illness just as life-threatening. In fact, statistics show breast cancer diagnosis in a man is actually more life-threatening, due to the fact it was probably made later, and the cancer is usually more advanced.
The vast majority (93.7%) of men with breast cancer have invasive ductal carcinoma: cancer of the milk ducts. Yes, surprise: men have milk ducts, too, they're just not highly developed. Usually these cancers are found directly behind the nipple, as that's where the majority of men's breast tissue lies. Since men aren't routinely performing self-examinations on their breasts, how does the diagnosis happen? As the result of an enlarged breast, a lump, or an inverted nipple (sound familiar?)
An American Society of Clinical Oncology study in 2004 revealed that many of the men in the study had fairly advanced cancer by the time it was diagnosed, due to the fact that men simply aren't on the lookout for breast cancer, as women are. Thus, while men's survival rates are similar to women's if you compare them stage I through stage IV, overall men have a poorer outcome simply because they're more likely to be diagnosed at a more advanced stage.
So, should men have routine mammograms? Not every year, surely, but maybe every 5 years, like the colonoscopy many of us have regularly as we get older? No, says a study by the Mayo Clinic, reported Dec. 16 at the San Antonio Breast Cancer Symposium, America's primary annual gathering of breast cancer researchers and oncologists. "Mammography is being performed with increasing frequency in men with breast symptoms, but we found that breast cancer in men can be felt as a firm, discrete mass on a physical exam, or seen as changes in the skin or nipple," reported Stephanie Hines, M.D., the study's lead author. "The bottom line is that most men don't need a mammogram, and that is good news for them," concluded Dr. Hines.
So, breathe a sigh of relief, ladies. You don't have to badger your dad, brother, or significant other to go get an annual mammogram. On the other hand, let's not forget that men DO get breast cancer. Imagine what that feels like, getting a "woman's disease," seeing the entire bright spotlight focused on women, when YOUR life is just as threatened, your future just as compromised. It's like being Oprah's second makeup assistant, or the guy sweeping the stands at Fenway Park after the Red Sox won the World Series: officially part of the action, but in reality ignored. From now on, when I think of breast cancer, I'm going to add one male face to that comforting mental picture of women I always have. Welcome to the club, guys-the club no one wants to belong to. We're all in this together.