Men get breast cancer too

I have been meaning to write this post for some time now, but finally I am getting around to it.  I am aware that I refer to women and breast cancer frequently, but of course men get breast cancer too. Male breast cancer is uncommon, men account for approximately 1% of all breast cancer cases. Incidence in Western populations is under 1 case per 100,000 men, though rates reported in some African countries are much higher. The majority of male breast cancers are of the infiltrating ductal type, this is where the cancer has spread beyond the cells lining ducts in the breast. In many respects male breast cancer is similar to that found in women, though in general men tend to be older than women at diagnosis. Treatment tends to be the same as that for women with breast cancer of the same type and stage.

In today’s  Baltimore Sun, you can read an interview with Mike Nelsen, a 49-year-old high-level sales executive, who  quite understandably never saw himself at risk of breast cancer. “I guess I don’t get shocked by a lot but I didn’t even think men could have breast cancer. I’d never heard of it before.

The diagnosis put Nelson into an overlooked and understudied group. While decades of research into breast cancer in women has led to more effective treatments and improved outcomes for patients, comparatively little attention has been paid to the disease as it strikes men.

The common lack of awareness about male breast cancer can be lethal. Diagnosed at the same stage of cancer, men and women of the same age do equally well. But the disease tends to be caught later in men, giving it time to grow and spread and wreak havoc in the body.

“Men are different than women. They think it’s not really a lump. It’ll go away. I’ll ignore it,” said Dr. Michael J. Schultz, Nelsen’s oncologist at the Breast Center at St. Joseph Medical Center in Towson. “Women are conditioned: If it’s a lump, I’ve got to take care of it.”

Men “just can’t believe it – I’m not a woman [they say]. How can I have this? It’s sort of a challenge to their masculinity but any cell type in the body can develop a mutation and develop into a cancer cell. It’s all around us.”

Schultz said that while male breast cancer is something to be aware of – men do have breast tissue – it certainly should not be added to the list as yet another thing to worry about. The diagnosis is a rare one.

Mike Nelsen, a healthy, vigorous guy, felt the lump underneath his right nipple last fall as he lay on his stomach in bed. “It felt tender,” he recalled. “I thought, ‘That doesn’t seem right.’ ”

Nelsen procrastinated a bit about going to the doctor. He didn’t have one. Within a month, though, he had an appointment. It was a good choice, he figured, when, a few days before his scheduled visit, he took off his T-shirt and found a wisp of blood on it.

His doctor sent him to Schultz, who ordered a mammogram and diagnosed the cancer. On Dec. 17, Mike Nelsen had a mastectomy. Schultz removed the breast tissue on Nelsen’s right side and 14 of his lymph nodes.

Now, he is taking tamoxifen, a drug that interferes with the estrogen that fed his breast tumor. Tamoxifen is used to shrink existing tumors and to prevent them from coming back. He will be on the drug for the next five years. It does have side effects.

“How I got a women’s disease from the start I don’t know,” Nelsen said. But because of the tamoxifen, “I get flushed from time to time. As my female friends say, ‘Now you know what it’s like to have hot flashes.’ ”

Nelsen doesn’t know for sure if he inherited his disease. But knows his mother had breast cancer while in her 40s, melanoma in her 50s and died of ovarian cancer at 63. And that an aunt had ovarian cancer, too. His daughter, 23-year-old Megan, plans to start getting routine mammograms when she is 25, much earlier than the average for women.

It is not Nelsen’s way to fret about his health.”I try to take everything in stride. You run into issues your whole life. Instead of feeling sorry for yourself, you just have to go on. I don’t know how else to do it,” he said.

This post adapted from the Baltimore Sun. Read the article in full here