Understanding Male Breast Cancer
- Ronald Norman, a 76-year-old retired professor, hopes that by sharing his male breast cancer story he will inspire other men to check their breasts/chests and take action when needed.
- Norman’s discovered he had stage 2 to stage 3 breast cancer after a pickleball injury led him to notice a bruise and lump behind his right breast nipple.
- The lifetime risk of getting breast cancer is about 1 in 833 for men. In addition, the American Cancer Society estimates that about 2,800 new cases of invasive breast cancer will be diagnosed in men in the United States in 2023.
- There are several risk factors that can increase a man’s chance of developing the disease, just like in the case of female breast cancer. If you’re a man with any, all or some of the following risk factors, vigilance is key.
In a recent op-ed for the San Diego Union-Tribune, Norman detailed the moment he was struck by a pickleball in his right breast nipple back in June 2022, and how just weeks later, he noticed a bruise/lump behind his nipple never went away.
The mammogram Norman underwent revealed the lump behind his nipple was male breast cancer, a discovery which prompted his doctor to also have him undergo an echo cardiogram to check his lymph nodes in his right armpit.
Expert Mastectomy & Male Breast Cancer Resources
Norman explained further, “The oncologist doctor did an exam and decided to insert a titanium marker into the most swollen lymph node for use later on if needed to locate the most swollen lymph node more easily. After this, a PET scan was ordered and it ‘lit up’ not only the breast cancer lump but also at least three of my lymph nodes.
“The diagnosis was stage 2 to 3 breast cancer since it had spread to my armpit lymph nodes. If only I had reacted sooner, I might have caught the cancer before it metastasized into my lymph nodes. But playing the ‘if only’ or ‘why me?’ game was not helpful. Staying positive and willing to seek corrective action was the best strategy.
Following conversations with his family, a Scripps MD Anderson Cancer Center surgeon, a radiation doctor, and an oncologist, Norman decided to take part in a “four-month-long alternative program,” which began to minimize the size of the tumor, along with “infusions of small amounts of chemotherapy.” However, the tumor never went away.
It was then he chose to return to Scripps MD Anderson Cancer Center and get the recommended treatment, which Norman said to be a mastectomy of his right breast, an extraction of the cancerous lymph nodes in his armpit, followed by eight rounds of chemotherapy for 16 weeks, and then six weeks (five days a week) of radiation.
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Norman noted, “After that, a five-year period of taking an estrogen-blocking medication. Seems my body has been generating a higher-than-normal amount of estrogen for many years which could be the genesis of my breast cancer.”
Now, more than one year after his diagnosis, he has finished up his chemo treatments and will begin radiation before the year’s end.
Pointing out how he’s experienced some “chemo side effects,” including numbness and loss of energy, Norman said, “To me, these are short-term sacrifices for the potential of long-term future health. And what made the difference for me was an incredible support group of family and friends throughout my journey.”
Now he’s hoping his story inspires other men to “manually” check their breasts/chests often throughout the year when taking a shower.
“If you feel something lumpy, then for sure get it checked out by your primary care physician; It might be nothing, a cyst, or it could be ‘the big C,’ and if it’s ‘the big C,’ you want to catch it as early as possible,” he concluded.
“Statistically, only one in 1,000 men get breast cancer. I am very special! I am one in 1,000! You might be special too!”
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Understanding Male Breast Cancer
The lifetime risk of getting breast cancer is about 1 in 833 for men. In addition, the American Cancer Society estimates that about 2,800 new cases of invasive breast cancer will be diagnosed in men in the United States in 2023.
There are several risk factors that can increase a man’s chance of developing the disease, just like in the case of female breast cancer. If you’re a man with any, all or some of the following risk factors, vigilance is key.
Possible Risk Factors for Male Breast Cancer:
- Age. Breast cancer risk increases with age, and most cancers are found in patients over 50. The average age of a man diagnosed with breast cancer is 72.
- Family history. Men with close blood relatives who have had breast cancer are at higher risk for the disease.
- Genetic mutations. Patients may inherit gene defects that make them more susceptible to breast cancer. Men with a mutation in the BRCA2 gene have a 6 percent lifetime risk of developing breast cancer, and men with a mutation in the BRCA1 gene have a 1 percent lifetime risk. These gene mutations are most commonly found in families with strong histories of breast or ovarian cancer, but they have also been found in male breast cancer patients without a family history.
- Klinefelter syndrome. Men with Klinefelter syndrome are born with at least one extra X chromosome which may increase a man’s breast cancer risk by producing high levels of estrogen (a hormone responsible for female sex characteristics) and low levels of androgens (hormones responsible for male sex characteristics). This condition affects about 1 in 1,000 men, and can raise the risk of breast cancer by 20 to 60 times that of the general population.
- Hormone therapy. Men who have been treated with drugs containing estrogen are at a greater breast cancer risk. These drugs were once used to treat prostate cancer, and they are still used in sex reassignment processes.
- Conditions affecting the testicles. Testicle injuries, swelling or removal surgery can increase a man’s risk for the disease by disrupting normal hormone levels.
- Liver disease. Diseases that impede the liver (like cirrhosis) may raise men’s estrogen production and lower their androgen levels, therefore, increasing breast cancer risk.
- Alcohol. Heavy drinking is known to raise the risk of breast cancer (which may be related to alcohol’s effect on the liver).
- Radiation therapy. Men who have received radiation therapy to their chests (for conditions like lymphoma) have a higher risk of developing breast cancer.
- Obesity. Fat cells can transform androgens into estrogens, boosting the possibility of an overweight man developing breast cancer.
If any of the above risk factors applies to you, consult your doctor and feel free to ask questions. While it’s true that men can work to lower their breast cancer risk by exercising and maintaining a healthy bodyweight, the most important element of effective cancer treatment is an early diagnosis.
Symptoms of Male Breast Cancer Can Include:
- A lump developed in the breast (usually painless), or a thickening in the breast tissue
- Nipple pain
- An inverted nipple
- Discharge from the nipple, which may be clear or bloody
- Changes to the color or texture of the nipple and areola
- Changes to the color or texture of skin on the chest
- Enlarged lymph nodes under the arm
If You Feel Something, Say Something: Men Ignore Symptoms Too Often
Treatment for male breast cancer is largely the same as female breast cancer. A person’s options depend greatly on a variety of factors, including the size of the tumor and how far the cancer cells have spread, but possibilities include surgery, chemotherapy, hormone therapy, radiation therapy and targeted therapy.
Treating Breast Cancer
Doctors treating breast cancer look for markers on your particular cancer to help decide what course of treatment is best for you. That’s because cancer cells may have what are called receptors that help identify the unique features of the cancer.
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The three main receptors are the estrogen receptor, the progesterone receptor, and the HER2 receptor. The estrogen and progesterone receptors go together because they are fueled by hormones. Think of the cancer cell as having little hands on the outside of the cell which grab hold of proteins that help it grow. These proteins are sometimes called “ligands.”
An example of a type of ligand that can stimulate a cancer cell is the hormone estrogen. An estrogen receptor-positive breast cancer will be stimulated by estrogen to grow. In this instance, your doctor may offer you treatment to specifically target the estrogen receptor.
Another important receptor to test for is the HER2 receptor. For HER2 positive breast cancers, therapies that uniquely target the HER2 receptor are essential to treating the disease.
There Is Nothing To Be Ashamed Of With Male Breast Cancer
Marc Futterweit is a two-time breast cancer survivor and he knows first-hand that the shame that comes with a diagnosis of male breast cancer can be quite debilitating. The urge to just ignore the symptoms may sway you from getting screened. But Futterweit has become an advocate for the disease, and is now dedicated to halting that way of thinking.
“Men are basically standing in the shadows,” Futterweit previously told SurvivorNet. “They’re ashamed or embarrassed this is a woman’s disease. [But] why can’t men get breast cancer?”
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Many people assume men can’t even get breast cancer because they don’t have breasts, but that’s not the case. It’s much less common in men than it is in women, but surveillance and screening is still important.
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That’s why Futterweit’s philosophy is, “if you feel something, say something.” He detected his own cancer when he felt an odd lump on his chest during a shower. He admits, he was baffled when his doctor suggested he get a mammogram, but in reality, it probably saved his life.
“The problem with men is that they wait, and they think things are going to go away,” Futterweit said. “Once they’re diagnosed, sometimes it’s too late.”
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Contributing: SurvivorNet Staff
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