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  health > cancer > story page AIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

Men and breast cancer: Not just a woman's disease

September 30, 1999
Web posted at: 3:09 PM EDT (1909 GMT)

By Melissa Kaman

(WebMD) -- When Adam's mother noticed that one of her teenage son's breasts was growing, she called their family doctor. He assured her that her son's condition was due to what he believed to be a harmless condition called gynecomastia, an enlargement of the male breast not uncommon during puberty, and that it would go away with time.

Months passed and Adam's breast continued to grow, but the doctor insisted it was the result of pubescent hormones. Two years passed, and Adam was wearing two t-shirts to school to try to hide his condition. To spare himself further embarrassment, Adam wanted the mass removed. The doctor agreed, removed the growth successfully, and sent it in for routine testing.

Astoundingly, the biopsy came back positive for something no one had dreamed of: breast cancer.

Why men fare worse than women

Although extremely rare, breast cancer will kill hundreds of men by the end of this year. The Susan G. Komen Breast Cancer Foundation explains that men and women, when compared at similar stages of the disease, actually have the same survival rate. However, because men are reluctant to report changes and problems in their breasts, their condition is diagnosed later, often after the cancer has spread, increasing the risk of fatality.

The foundation reports that this year, 1,300 men will be diagnosed with breast cancer and 31 percent of them will die, compared with 175,000 cases of female breast cancer and a 25 percent mortality rate.

Who gets male breast cancer?

Fred Dirbas, M.D., assistant professor of breast cancer surgery at Stanford University, says that male breast cancer is generally a random occurrence. Certain groups of men, however, are regarded to be at higher risk, according to the American Cancer Society. They include:

  • Men with increased estrogen. Several conditions serve as markers for increased estrogen, the most common being liver disease. (For this reason, alcoholics are believed to be more susceptible.) In addition, certain countries in the Middle East and Africa, where malnutrition and infection affect the liver, have a much higher incidence of male breast cancer than the United States.

  • Men with Klinefelter's syndrome, a genetic disorder that produces an extra sex chromosome. Men with this disease have low production of testosterone and higher-than-normal production of estrogen.

  • Men with gynecomastia, enlargement of the male breasts. Gynecomastia is also more common in men with Klinefelter's syndrome.

  • Men with a family history of breast cancer. About 20 percent of men with breast cancer have close male or female relatives with the disease.

Some evidence suggests that men with breast cancer also have mutations in the BRCA-2 gene, as do women with breast cancer. The majority of men in these risk groups will never develop breast cancer, however. "Any connection that can be made remains somewhat loose," Dirbas says. The number of men affected is still extremely low; in his entire career, Dirbas has seen only six cases.

How treatment differs for men

Once diagnosed, treatment is usually simpler for men than it is for women. Because the breast mass is much smaller and there is no psychological connection to it, the majority of male breast cancer is treated by full mastectomy, or removal of the breast.

Despite this, men diagnosed with breast cancer still experience a high level of psychological trauma. Their condition is often misdiagnosed and, once revealed, presents somewhat of an enigma by which even doctors are puzzled. Adam's mother complained that there were no support groups or even informational flyers to help her son and believes this added to his feelings of alienation and shame.

The need for awareness and acceptance

Adam's mother spoke on the condition of absolute anonymity. "He has been extremely traumatized by all this and does not want to relive it. I just want it to get out there to people that this happens. Had even our doctors known about this, he would have been diagnosed immediately and spared a lot of embarrassment and confusion," she said.

According to the American Cancer Society, the survival rate for a breast cancer patient diagnosed within five years of disease development is 97 percent. Men who notice lumps, dimpling, discharge or changes in the size of their breasts should bring it to the attention of their doctor. The majority of symptoms will be attributed to other causes, but an increased awareness on the part of doctor and patient is essential to survival.

Copyright 1999 WebMD, Inc. All rights reserved.



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