Men Get It Too

May 2006 Special Advertising Section

When Rick Wyatt first detected a pea-sized lump on his breast, he didn’t pay much attention. Even as a doctor, he figured it wasn’t cause for concern. “I didn’t even tell my wife about it,” he remembers. “I didn’t want to worry her, and I thought it probably wasn’t that big of a deal.” Over a period of six months, though, Wyatt’s lump became larger, and a biopsy revealed it was malignant.

Warning Signs
Because male breast cancer is so rare—making up just 1 percent of breast cancer cases—men tend to ignore the warning signs: a painless, firm lump below the areola of the nipple, a retraction of the nipple, or a fixed mass in the armpit. There are factors that can increase the risks of getting male breast cancer. In Wyatt’s case, it was a family history of the disease; his mother was diagnosed with breast cancer ten years before. Research shows about 20 percent of men with breast cancer have close female relatives who have had the disease. Conditions that increase male estrogen levels also put them at higher risk, such as Klinefelter’s syndrome, a genetic condition that occurs when a man is born with two or more female chromosomes.

Chronic liver diseases can also lead to male breast cancer. “Hormones are metabolized in the liver, and men with liver disease tend to have lower levels of androgens, or male hormones, and higher estrogen levels, which puts them at risk for gynecomastia,” says Ross McBride, MD, medical director of radiation oncology at St. Joseph’s Hospital in St. Paul.

Treatment of male breast cancer usually requires a radical mastectomy and lymph node evaluation. Since preservation of the breast isn’t an issue, it allows doctors to proceed directly to surgical treatments. If a patient exhibits high risk factors, hormone manipulation and chemotherapy may be given as follow-up. However, if the disease appears to be eliminated after surgery, chemotherapy and other follow-up treatments are generally not needed. “Women continue to need imaging, but we don’t image men or other mastectomy patients after they undergo surgery,” says Deborah Day, MD, medical director of the Piper Breast Center at Abbott Northwestern hospital and a physician with Consulting Radiology.

The Reality
For Wyatt, the news that he had breast cancer came as a complete shock. When he was diagnosed in 1987, he was only thirty-nine years old. Most men who develop breast cancer are in their late-sixties. “It was horrible. There were three to five days where I didn’t know what my future was going to be,” says Wyatt, an allergist at Park Nicollet Medical Center. “The hardest thing is telling your family and the people you work with.” Fortunately, Wyatt’s condition had not spread to his lymph nodes, which lessened its severity. Once it was diagnosed, he underwent a radical mastectomy within five days and had no follow-up treatments except recovery.

Today, a scar from his chest to his armpit is the only physical sign of Wyatt cancer, but the experience has made him an advocate for the cause. “One year I walked in the Race for the Cure,” he says. “I think I was the only guy there. But men need to be aware of this disease. It’s something that can happen to them, just like women. Not with frequency, but if they notice something, they need to deal with it.”  

Staying Vigilant
Self-awareness is the most crucial component to early detection of male breast cancer, McBride says. “Men need to be aware of the disease, but there is no definite role for breast exams or mammograms. Like with any cancer, however, early detection is important, which is aided by yearly physician visits,” he says. “Men tend to not talk about their diseases and are less likely to deal with their health issues.”

Wyatt agrees that having breast cancer has made him more aware of his health. “I’m definitely more vigilant about going to the doctor,” he says. “My advice to other men is that if you notice something, don’t ignore it. I sat on this for six months. I was one of the lucky ones.”