Despite what most of us take for granted, women aren’t the only ones who should worry about breast cancer. It strikes men as well.
Catching it early is critical, but most men don’t even consider they could have it, let alone watch for it.
Paul Dombroski pushed his body to the limit to reach the top. Not only did he make it to the NFL, the former Buccaneer was a two-time Player of the Year for the Patriots. Then breast cancer lined up against him.
“I was yawning, and I lifted my arm up and I ran my hand across my chest and I felt a lump, and immediately I knew it was breast cancer,” Dombroski explains.
He was shocked, but right.
The tumor was detected and removed early, but Dombroski still worries about other men.
“We can call it your chest, you can call it your pecs. They’re breasts,” he says.
Nicole Figueredo says men’s breasts are built much the same way women’s are. In 2018, more than 2,000 men will be diagnosed with invasive breast cancer.
“Unfortunately, a lot of men with breast masses fail to go to the physician. That leads to breast cancer in men being diagnosed at later stages,” Figueredo says.
Here’s what to watch for: a firm lump behind the nipple, an itchy and scaly rash, any change in shape or size, or an inward pulling of the nipple. Thanks to his vigilance and preparation, Dombroski can list professional football player and breast cancer survivor on his resume.
Figueredo says breast cancer in men could be confused with benign breast development due to hormone change.
Treatment in men is similar to women.
Dombroski is working with Figueredo to create a more unisex environment to avoid female stigmas that surround breast cancer.
MALE BREAST CANCER: REALLY?
BACKGROUND: All people, whether male or female, are born with some breast cells and tissue. Even though males do not develop milk-producing breasts, a man’s breast cells and tissue can still develop cancer. Even so, male breast cancer is very rare. Less than one percent of all breast cancer cases develop in men, and only one in a thousand men will ever be diagnosed with breast cancer. Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment. Of the men who develop breast cancer, the vast majority of those cases are Infiltrating Ductal Carcinoma (IDC), which means cells in or around the ducts begin to invade surrounding tissue. Very rarely, a man might be diagnosed with inflammatory breast cancer, or Paget disease, of the nipple.
GENETIC TESTING: Although treatment outcomes are very similar to women at the same stage of detection, a man diagnosed with breast cancer should also consider seeing a genetics counselor for a consultation. If a man tests positive for a defective gene (most commonly either BRCA1 or BRCA2) that can lead to a future diagnosis of breast cancer, then his children have a 50 percent chance of carrying the gene. In addition, a male child of a man with breast cancer who inherits the defective BRCA2 gene has approximately 6 percent chance of eventually developing breast cancer and just over 1 percent with BRCA1. A female child of a man with breast cancer who inherits the defective gene has a risk between 40 percent and 80 percent of eventually developing breast cancer. Men with a genetic predisposition to breast cancer are also at higher risk of getting prostate cancer at a younger age than usually diagnosed.
ADVANCEMENTS IN MALE BREAST CANCER: The rarity and lack of surveillance of male breast cancer makes it a difficult disease to study. However, Breast Cancer Research Foundation (BCRF) investigators are tackling this challenge with the International Male Breast Cancer Study (IMBCS). Led by BCRF investigators, Dr. Fatima Cardoso and Dr. Sharon Giordano, the IMBCS is the largest international study in male breast cancer ever conducted. Investigators reported that as in female breast cancer, most breast cancers in men require the hormone estrogen to grow. These cancers are called estrogen receptor (ER)-positive. Conversely, the HER2-positive type of breast cancer, which makes up about 25 percent of female breast cancers, occurs rarely in men. Triple negative breast cancer, a rare aggressive disease accounting for about 15 percent of female breast cancer, makes up less than one percent of male breast cancers. Despite most male breast cancers being driven by estrogen, the IMBCS researchers found that few male breast cancer patients receive the appropriate treatment for this form of the disease. Dr. Ben Park, BCRF investigator, explained that to precisely treat the disease, it is important to know the mutations driving its growth and survival. They are already seeing the success of this approach in female breast cancers with targeted therapies against tumor promoting pathways, such as HER2 and CDK4/6. Similarly, Dr. Park envisions a future where all cancers are matched for the mutations in the tumor, making it less important whether that cancer is in the breast, the lung or colon, or whether the patient is male or female.