Breast cancer is often mistaken as solely female and the majority of information, awareness campaigns and research on this disease tends to focus on females. The month of October is dedicated to breast cancer awareness, and yet, most activities are focused on women. This has led to one of the most common breast cancer myths: that it only affects women. Accordingly, most males fail to recognize and look for signs and symptoms of breast cancer, and those who do struggle with feeling ashamed of being associated with a disease perceived as feminine.
In a study by Eileen Thomas from the University of Colorado, Denver in 2010, the researcher highlighted that 80 percent of surveyed males were not aware that they could even develop breast cancer, and the majority could not identify any symptoms of MBC other than a lump in the breast. The study also reported that 43 percent of participating men in the study said they would question their masculinity if they were dia nosed with breast cancer.
Although rarer, male breast cancer (MBC) carries a higher mortality rate than females resulting from breast cancer, primarily due to a lack of awareness, leading to delay in seeking treatment. This is reflected on the size of tumors diagnosed in males, as they tend to be larger and the cancer is more likely to spread to other organs as a result of late diagnoses.
The truth is, breast cancer is a sexless disease. Males also have breast tissues containing ducts and cells in these ducts that can develop to breast cancer, just like females. In both sexes, if the breast cells grow uncontrollably and don’t die off as they normally would, the result would be breast cancer. The cancerous cells can enter the lymphatic vessels of the breast and grow in the lymph nodes situated above and below the collarbone, under the breast bone. Once in the lymph nodes, it is likely the cancer cells enter the bloodstream and spread to other areas of the body.
The most common diagnosed MBC type is Ductal Carcinoma, where cells around the breast ducts begin to invade the surrounding tissue, according to the National Breast Cancer Foundation (INC). Cases of lobular carcinoma and the Paget disease of the nipple are more rare, accounting for around 2 percent of all MBCs.
But the lack of awareness alsogather enough participants to comprehensively and effectively study MBC. This hampers the development of malespecific breast cancer treatments and hinders developing management guidelines for the disease.
MBC in numbers
The MBC incidence rate is less than 1 percent of that of females globally. However, males should check themselves periodically by doing a breast self exam while in the shower and reporting any changes to doctors.
The low percentage of breast cancer occurrence among males is explained by the fact that males have less breast tissue and lower Estrogen hormone levels, the main contributors to the development of breast cancer. However, the low percentage might also reflect under diagnoses of MBC and lack of reporting of the disease.
The Chinese German Journal of Clinical Oncology reported that the incidence of MBC has increased significantly from 0.86 to 1.08 per 100,000 populations over the past 26 years in the United States. Also, the American Cancer Society estimates that 460 males in the United States will die from breast cancer in 2017.
The same journal published a study carried out by the National Cancer Institute (NCI), Cairo University, Egypt which indicated that MBC constitutes 1.5 percent of all breast carcinomas. The NCI study targeted a total of 123 male patients with a median age of 58 years. The sample included patients diagnosed with breast carcinoma over the period from January 1999 to December 2009. The NCI study revealed that there are some gender differences in relation to breast cancer, including stage, hormone profile and tumor subtypes among the patients.
In 2012, the Mansoura University Hospital carried out a study to report clinic athological characteristics, treatment patterns and out comes of MBC in Egypt. The study focused on 37 patients diagnosed with MBC during 2000-2009 with a median age of 57.7 years. The conclusion of this study was that MBC is a rare disease often diagnosed at a locally advanced stage and that further research for better understanding of the disease is needed to improve the management and prognosis of MBC patients.
In Egypt, each year the Breast Cancer Foundation of Egypt (BCFE) launches campaigns on breast cancer to mark the international breast cancer awareness month of October. As part of this campaign, the foundation targets males, not only as partners and family members of females affected by the disease, but also as victims of MBC. In October 2015, the foundation launched a campaign on social media outlets with the theme “the blue ribbon for males” to highlight that men can be affected by breast cancer. The BCFE reports on its official Facebook page that 65 percent of males are not aware of MBC while the remaining 35 percent do not take preventive action.
Males diagnosed with MBC and their supporters, especially in the US and the UK, advocate for allocating the third week of October as a week to raise awareness on MBC, raising a blue ribbon. In addition, male support groups and programs are becoming more common to help patients and their loved ones understand the disease and to manage their lives through the process.
While the precise reasons behind breast cancer are not known, risk factors include smoking, obesity, liver and testicle diseases, exposure to radiation, high alcohol consumption and abnormally high levels of the estrogen hormone, which stimulates cell growth and multiplication. Baby boys born with higher levels of estrogen than normal are 20 times more likely to develop MBC than other boys.
MBC is most common in older males, although it can occur at any age. It is also more common among males with family history of breast cancer, as one in every five males diagnosed with MBC has a first degree male relative who also has a history of breast cancer.