Like women, men have susceptible breast tissue that can develop cancer. About 2,550 men will be diagnosed with invasive breast cancer and about 480 will die of it this year, according to the American Cancer Society.
Unlike women, who are advised to get regular mammograms, men usually discover they have breast cancer when they feel a lump or experience symptoms such as discharge from a nipple.
“Men don’t think they have breasts—they have chests,” says Bret Miller, who started the Male Breast Cancer Coalition after his own diagnosis. “Men need to realize they do have breast tissue and they can get breast cancer. They should do self-exams like women do.”
At age 17, Miller felt a lump in his breast, but doctors told him it was probably calcium buildup. Seven years later, after he got health insurance through his job, he had a mammogram, the lump was removed and it was found to be cancerous.
Miller, now 32, is unusual: Most men with breast cancer are age 60 or older. Those with BRCA gene mutations or a family history of breast cancer are at higher risk.
Men with breast cancer often don’t receive optimal treatment, according to a recent study. Fatima Cardoso, MD, and colleagues with the International Male Breast Cancer Program analyzed nearly 1,500 men diagnosed with breast cancer. They found that although half had small tumors, most underwent mastectomy rather than breast-conserving procedures, such as lumpectomy.
Male breast cancer is usually estrogen- and androgen-receptor positive (see "Targeting Tumors" in our feature profile). But men are less likely than women to have HER2-positive tumors and fewer than 1 percent have triple-negative breast cancer. Although more than 90 percent of the men in this study had estrogen-receptor-positive tumors, just 75 percent received hormone therapy to prevent cancer recurrence.
In 2010, Miller underwent a mastectomy and removal of nearby lymph nodes. He was treated with the estrogen blocker tamoxifen but stopped after six weeks because of side effects such as hot flashes. He now takes anastrozole, a drug that stops estrogen production.
Most clinical trials of breast cancer drugs don’t include men, and little is known about how well new types of targeted therapy might work for them. Men may also feel left out by breast cancer treatment facilities and support programs geared toward women.
“Sometimes it can feel emasculating because it’s a disease associated with women,” Miller says. His message: “It’s not something to be embarrassed about. You are not alone—there are other men out there who are facing the same fight.”
Click here to read about how Latonya Wilson advocates for better understanding of metastatic breast cancer and more outreach to African Americans.