Rick Yaffe of Owings Mills, Maryland, got lucky. During a routine physical in October 2018, his doctor noticed a lump in his breast area that didn’t feel right. After a mammogram and biopsy, Yaffe was diagnosed with breast cancer. He had his breast and some lymph nodes removed surgically, and since the cancer was caught early, Yaffe didn’t need chemotherapy or radiation.
“It was fortunate my doctor caught it,” the 64-year-old says. “If I had done nothing it could have been a lot worse.” He now takes tamoxifen, and there haven’t been any signs that the cancer has recurred.
Michael J. Schultz, MD, a breast surgeon and medical director of The Breast Center at University of Maryland St. Joseph Medical Center in Towson, MD, was the surgeon who treated Yaffe. He and his colleagues treat about 46 men with breast cancer every year. He points out that the risk of breast cancer in men is small, but it exists — men have a 1 in 833 lifetime risk of a breast cancer diagnosis.
Approximately 1% of breast cancers occur in men — last year, about 2,700 men were diagnosed with breast cancer. “Statistically, this number is too small for any significant randomized clinical trials, or studies that allow us to develop specific diagnostic, treatment, and prevention strategies for diseases,” Schultz says.
Here are seven key facts to know about the disease.
1. Breast cancer in men is treatable
“If you feel something, say something,” Schultz says. “Men don’t go to the doctor as often as women in general, and if they feel a lump they think, ‘Eh, it’s nothing.’”
As a paramedic, Yaffe has noticed that men think nothing can ever go wrong. “They think they are indestructible, but that’s not how diseases work,” he says. “They need to get over that.”
2. Finding a lump doesn’t mean it’s breast cancer, but it should still be checked
“Men frequently have benign lumps that can mimic breast cancers,” Schultz says. Lumps could be feminization of the breast, fatty tumors, or skin lesions. Ultrasound, mammogram, and biopsy can determine whether the lump is cancerous.
Joshua Mansour, MD, a hematologist/oncologist at City of Hope in Los Angeles, says that along with lumps, men should watch for changes in the skin such as thickening of the skin or breast tissue, redness, dimpling, or changes to the nipple such as discharge, redness, or inversion.
3. Breast cancer in men is the same disease as it is in women
“It’s exactly the same disease right down the line,” Schultz says. “We use the same medications and treatments.” One small difference — mastectomy is more common in men. That’s because since men don’t have as much breast tissue, removing a lump can mean removing the entire breast.
4. Breast cancer in men is usually found at a later stage than in women
In women, mammograms often pick up breast cancers that are too small to feel. Men don’t get routine mammograms, so they generally don’t spot breast cancer until a lump is detected by them or their doctor.
“For men, it’s a good idea in the shower, every once in a while, to run a hand over the neck (checking for nodes), the breasts, and under the arms, to see if you feel anything unusual,” Schultz says.
5. Breast cancer survival rates are worse in men
Breast cancer is detected later in men. But that’s not the whole story. “When men do develop breast cancer, the survival and outcomes are worse, even when adjusted for stage of the disease at diagnosis, age, and other factors,” Schultz says.
6. Men with breast cancer should see a genetic counselor
“Approximately 30% of male breast cancer patients have a family history,” Schultz says. It’s important for them to be tested — if they carry a genetic risk their parents, children, and siblings are also at higher risk for breast cancer and related cancers. (Yaffe and his family are fortunate — he was tested, and his cancer doesn’t have a known genetic link.)
7. Some factors can increase the risk of breast cancer in men
Older men are at higher risk — men are diagnosed in their 60s on average, Mansour says. A family history of the BRCA2 gene puts men at higher risk for both breast and prostate cancer.
Exposure to estrogen-related drugs and hormone therapy, and a genetic condition called Klinefelter syndrome, can also increase risk. And men who have had radiation therapy to the chest for Hodgkin’s disease are at a higher risk, usually 20 years or so after treatments, Schultz says.