Men at High Risk for Breast Cancer Need Better Screening Tools

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Scott Cunningham, 45 from Marion NC, is at a very high risk for developing Male Breast Cancer. Both of his parents had the disease in the 1990’s. Recently, he developed the same symptoms as his father, including a swollen chest with knots underneath the nipple and feelings of fatigue, but because he was uninsured, he put off receiving help. When he finally sought medical guidance, he was turned away – because he was a man.

“I didn’t know what to do at first,” Cunningham told ABC News. “I was stunned and confused. Breast cancer used to be just a woman’s cancer, but now it’s well known men are susceptible.”

In 2009, the American Cancer Society reported nearly 2,000 cases of male breast cancer in the United States. In men, the condition is usually more deadly – about 22% die each year. Although it is more common in older men between ages 60 and 70, it can strike at any age. As in Mr. Cunningham’s case, male breast cancer has a strong genetic link. One in six has the BRCA cancer mutation, the same gene that puts women at a higher risk.

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Other risk factors for male cancer include exposure to radiation, estrogen, or diseases that cause excess estrogen in the body, such as cirrhosis or Klinefelter syndrome, or a history of testicular cancer.
Just like in women, male breast cancer is best treated when caught early.

The free health clinic, which serves Rutherford, Polk, and McDowell counties in NC, is funded through a federal program by the Centers for Disease Control and Prevention. The program only serves low-income, uninsured and underserved women. Helen White, clinical nursing supervisor at the area health department, confirmed this, but has offered to help Cunningham find a referral for care.

It is possible for men to receive mammograms, although obviously it is a more difficult task, as the machines were designed for a woman’s breast. Peter Criss of the rock band Kiss, recently himself diagnosed and treated for male breast cancer, said, “Whoever invented (mammogram machines) had to do it in the medieval days," he said, but the screening is worthwhile.

The problem is that there are currently no screening guidelines for men, says Dr. Deborah Axelrod, director of the breast program at NYU’s Clinical Cancer Center. Men at high risk could, and probably should, be tested for the BRCA mutation, according to the American Cancer Society, but it is strongly recommended to talk first with a qualified health care provider to help explain both the benefits and the down-side of the tests.

Both Dr. Axelrod and a spokesperson for the American Cancer Society do not believe changes will come soon to the current recommendations for screening breast cancer in men. Self-exams for all men should be enough to detect lumps early because lumps are more easily felt on a man’s chest. What is needed is a greater awareness of the condition, a greater promotion of self-exams in men, and better resources for men who may be uninsured or underserved.

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