Awareness and Treatment of Male Breast Cancer Lacking, Say Experts

2012-05-06 12:02

According to a study comparing more than 13,000 male and 1,440,000 female breast cancer cases from 1998 to 2007 presented at the American Society of Breast Surgeons Annual Meeting, researchers have determined that there is a disparity in breast cancer survival between men and women that is due to a lack of awareness, a lack of early screening and a lack of research on how to best treat male breast cancer.

Part of the lack of awareness is that the incidence of male breast cancer is much lower than that of female breast cancer. Men on average account for 1% of all breast cancer cases with an expected 2,000 per year in the U.S.

Another cause for lack of awareness is that breast cancer is normally viewed as “a female disease” due to sex-health stereotyping and current breast awareness marketing. Last year’s Breast Cancer Awareness month festivities was so overly saturated with pink ribbons, pink runs, pink walks, and pink t-shirts with clever breast-related slogans, that breast cancer awareness appears to be more of all-girl club in celebration of women. Which is fine—but it does so in a way at the expense of the health of some men and their affected families. Where was the representation of the guys during all this pink mania?

This disproportionate representation is especially poignant by the fact that the study shows that men present with significantly larger tumors that were more likely to have spread to lymph nodes and were more likely to have distant metastases in comparison to women.

"This may be attributed to the fact that awareness of breast cancer is so much greater among women than men,” comments lead researcher Jon Greif, D.O., FACS, of the Bay Area Breast Surgeons. “Guidelines call for regular screening, both clinical and mammographic, in women, leading to earlier detection.” In addition he adds that, “…male breast cancer is nearly always found as a lump, while many female breast cancers are detected before a lump is felt, through screening. This might also explain many of the findings of our study, including the more advanced stage at presentation and the lower overall survival of men with breast cancer."

Which begs the question, how prevalent does male breast cancer have to be in order to qualify for guidelines? Currently, regular mammographic screening for men does not exist and possibly only rarely for those who may have certain genetic predispositions, family breast cancer histories, or significant occupational exposure to radiation in the chest area.

To be fair, a lack of guidelines has to do with a lack of research on male breast cancer. Without scientific knowledge regarding the most efficacious ways to screen and detect male breast cancer, guidelines may be useless and/or a waste of resources.

A final point about male breast cancer is that there is a lack of research dedicated to treating male breast cancer. Is male breast cancer the same as female breast cancer? The answer is simple: yes, no and maybe--depending on who you ask.

According to the study’s findings, men were more likely than women to have estrogen-positive tumors (88.3% vs. 78.2%), but only 41% of males in the study were treated with anti-estrogen medications.

“If estrogen blocking medications were used more liberally for men with breast cancer, outcomes may improve,” comments Dr. Greif.

Furthermore, treatment for male breast cancer typically follows the guidelines set for female breast cancer; however, according to the study, care between the two sexes can differ. Men are more likely to have a full mastectomy, whereas women were more likely to have a lumpectomy. And, men are also less likely than women to be treated with radiation.

Clearly, physicians have their reasons for why treatments can vary between the sexes, but are these reasons backed by a sufficient amount of male breast cancer research? And, if so, why are we not as familiar with modalities of breast cancer treatment for men as we are for women?

The authors of the study conclude that males do suffer breast cancer and frequently enough to warrant concern, especially with advancing age.

“Examination of a man's nipple and areolar area, where invariably male breast cancer is first apparent, might result in detection of male breast cancer at a smaller and less advanced stage,” Dr. Greif concludes. “Men and their healthcare providers should take note.”

To learn how to screen for a possible breast cancer tumor, follow this link to an article that describes a 60-second male breast self-exam procedure that can be done at home.

Image Source: Courtesy of MorgueFile

Reference: The American Society of Breast Surgeons press release

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