Male Breast Cancer is Real: Pass It On
A woman’s chance of developing breast cancer during her lifetime is about 1 in 8. In men, the chance is 1 in 1,000. That’s a big difference, so big, in fact, that many people don’t even realize that men can have breast cancer and that they can die from it just like women can.
Even though less than 1 percent of all breast cancers occur in males and only about 2,550 men will be diagnosed with the disease in 2018, that’s a huge blow to those 2,550 men and their family and friends. One problem, however, is there isn’t as much research into the causes, prevention, and treatment of the disease as there is for breast cancer in women. In addition, since male breast cancer is largely swept under the rug, there isn’t much support for these men and their loved ones.
Recently there has been some activity in both of these areas. In fact, a newly published study in the Journal of Clinical Oncology has announced there are some distinct biological factors for breast cancer in males compared with those in females. This finding has opened a door for use of genomic testing to help healthcare providers and their patients make treatment decisions once a diagnosis has been made. Genomics is the study of the activity and interaction of specific genes and what role they play in the development of certain diseases.
Study of male and female breast cancer
More specifically, the authors of the study analyzed data from 3,806 men and 571,115 women who had hormone receptor-positive breast cancer. The participants were evaluated using the 21-gene Breast Recurrence Score (RS) results. The 21-gene test (assay), also known as the Oncotype DX breast cancer assay, helps doctors and their patients make better treatment decisions by predicting how aggressive the tumor is, the chances that chemotherapy will be beneficial, and the risk of recurrence over multiple years. In this case, the authors looked at the 5-year breast cancer-specific survival and overall survival chances.
Generally, the authors found some significant differences between men and women in terms of gene expression and receptor levels for estrogen and progesterone. For example:
• Men tended to have higher scores for gene expression for estrogen receptors, proliferation, and invasion than did women
• RS scores were low (less than 18) in both men and women, but high scores (31 or greater) and very low scores (less than 11) were more frequent in men than in women
• Breast cancer specific survival (BCSS) was similar between men and women when the RS was less than 18 and between 18 and 30.
• Five-year BCSS and overall survival were lower for men with an RS of 31 or greater when compared with women.
Stated another way, high-risk breast cancer is more common in males than in females
Overall, the findings of this study reveal there are “some distinctive biologic features of breast cancer in men and an important prognostic role for RS testing in both men and women.” The findings also suggest that breast cancer in men and women is not the same and therefore they need to be treated differently.
These are important findings that all men and their loved ones should be aware of, because it will help them better understand their options if male breast cancer should become a part of their lives. One man who experienced male breast cancer first hand and decided that the lack of information and support were unacceptable is Bret Miller from Kansas City.
Bret Miller and the Male Breast Cancer Coalition
Bret Miller is a 32-year-old man who was diagnosed with stage 1 breast cancer in 2010 at the age of 24. Yet 2010 was not the first time Bret had an inkling something might be wrong. Seven years earlier, he had detected a lump behind his right nipple. However, visits to his doctor did not result in any red flags until that decade mark, when he asked his doctor to investigate the lump. That’s when the cancer was discovered.
Bret’s initial reaction was shock. “I didn’t think that men could get breast cancer,” he said. “I also felt loneliness going through my diagnosis and treatment. This was a woman’s disease, and doctors really did not know enough about how to treat male breast cancer. I was told I would be treated as a woman!”
After these initial reactions, Bret underwent a mastectomy followed by four rounds of chemotherapy. He also had genomic testing, which revealed that he was at high risk for recurrence.
This series of events, plus his introduction to a woman named Cheri whose close friend’s husband was diagnosed with breast cancer, led Bret and Cheri to found the Male Breast Cancer Coalition in 2014, a not-for-profit patient advocacy organization. Their goals are simple yet challenging: “to spread the word to EVERYONE that men can get breast cancer TOO!” explained Bret. “Not only men but women need to start checking themselves at a younger age because it is becoming more and more common in younger people. Early detection is the key to survival!”
When asked what are the most surprising things he has learned from having breast cancer, forming the coalition, and talking with men and women about the topic, Bret noted that “It’s incredible to me that the knowledge after 8 years is still not out there and we have lots more work to get this out globally. Doctors still treat men for breast cancer like women with breast cancer.”
Bret pointed out that although things are changing, more needs to be done if we want to save lives. “More percentage of men die every year than women for the mere fact that men do not know to even check,” he said. “If you ask most men when they go for their yearly physical if their doctor checks their breast, a majority will say no! This must change,” he emphasized.
If you want to be part of that change, for yourself or a loved one, and to get more information about male breast cancer and self-examinations, visit the Male Breast Cancer Coalition at http://malebreastcancercoalition.org/ and learn how to examine your breasts at