Breast cancer is rare in men, but they fare worse
5 May 2012 20:32
Men rarely get breast cancer, but those who do often don't survive as long as women, largely because they don't even realize they can get it and are slow to recognize the warning signs, researchers say.
On average, women with breast cancer lived two years longer than men in the biggest study yet of the disease in males.
The study found that men's breast tumors were larger at diagnosis, more advanced and more likely to have spread to other parts of the body. Men were also diagnosed later in life; in the study, they were ۶۳ on average, versus ۵۹ for women.
Many men have no idea that they can get breast cancer, and some doctors are in the dark, too, dismissing symptoms that would be an automatic red flag in women, said study leader Dr. Jon Greif, a breast cancer surgeon in Oakland, Calif.
The American Cancer Society estimates ۱ in ۱,۰۰۰ men will get breast cancer, versus ۱ in ۸ women. By comparison, ۱ in ۶ men will get prostate cancer, the most common cancer in men.
"It's not really been on the radar screen to think about breast cancer in men," said Dr. David Winchester, a breast cancer surgeon in NorthShore University HealthSystem in suburban Chicago who was not involved in the study. Winchester treats only a few men with breast cancer each year, compared with at least ۱۰۰ women.
The researchers analyzed ۱۰ years of national data on breast cancer cases, from ۱۹۹۸ to ۲۰۰۷. A total of ۱۳,۴۵۷ male patients diagnosed during those years were included, versus ۱.۴ million women. The database contains about ۷۵ percent of all U.S. breast cancer cases.
The men who were studied lived an average of about eight years after being diagnosed, compared with more than ۱۰ years for women. The study doesn't indicate whether patients died of breast cancer or something else.
Greif prepared a summary of his study for presentation Friday at a meeting of American Society of Breast Surgeons in Phoenix.
Dr. Akkamma Ravi, a breast cancer specialist at Weill Cornell Medical College in New York, said the research bolsters results in smaller studies and may help raise awareness. Because the disease is so rare in men, research is pretty scant, and doctors are left to treat it the same way they manage the disease in women, she said.
Some doctors said one finding in the study suggests men's breast tumors might be biologically different from women's: Men with early-stage disease had worse survival rates than women with early-stage cancer. But men's older age at diagnosis also might explain that result, Greif said.
The causes of breast cancer in men are not well-studied, but some of the same things that increase women's chances for developing it also affect men, including older age, cancer-linked gene mutations, a family history of the disease, and heavy drinking.
There are no formal guidelines for detecting breast cancer in men. The American Cancer Society says routine, across-the-board screening of men is unlikely to be beneficial because the disease is so rare.
For men at high risk because of a strong family history or genetic mutations, mammograms and breast exams may be helpful, but men should discuss this with their doctors, the group says.
Men's breast cancer usually shows up as a lump under or near a nipple. Nipple discharge and breasts that are misshapen or don't match are also possible signs that should be checked out.
Tom More, ۶۷, was showering when he felt a pea-size lump last year near his right nipple. Because a golfing buddy had breast cancer, More didn't put off seeing his doctor. The doctor told More that he was his first male breast cancer patient.
Robert Kaitz, a computer business owner, thought the small growth under his left nipple was just a harmless cyst, like ones that had been removed from his back. By the time he had it checked out in ۲۰۰۶, almost two years later, the lump had started to hurt.
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