Most people know someone with breast cancer, and I am no exception. My mother had breast cancer, and my aunt died of breast cancer. With one in eight women diagnosed with the disease during her lifetime, it is common knowledge that women are at risk for breast cancer as they age.
As an OB/GYN, I have been talking and thinking about breasts for most of my professional life. I have discussed breastfeeding, breast cancer screening, breast reduction, breast reconstruction, nipple soreness, mammograms, and ultrasounds, and new lumps that I have found during a routine breast exam.
When my husband told me he had a lump in his chest in 2017, I told him it was a benign, fatty lump — nothing to worry about. I had heard of male breast cancer in medical school but thought this was something that only happened to men with a strong family history of breast cancer. It couldn’t happen to my healthy 54-year-old husband, who exercised daily, ate leafy greens and didn’t have a single family member diagnosed with breast cancer. I was wrong.
Eventually, he got the lump checked out, and it was indeed cancer. Overnight, he became one of the 2,800 men in the U.S. to be diagnosed with male breast cancer every year. Like most of those men, it was not caught early. By the time he was diagnosed in 2020, the cancer had spread to more than 14 lymph nodes in his armpit and chest. Thankfully, through aggressive treatment, he is now cancer-free.
Surprised? I certainly was. My husband’s genetic testing was negative for gene mutations linked to breast cancer that might have magnified his risk by 50 to 100 times. But the truth is that no test is perfect. We will never know if he was simply unlucky or has a gene mutation that wasn’t included in the testing. However, there may be other reasons for his cancer.
Odd clusters of male breast cancer have popped up around the country in those exposed to toxins in drinking water, like the U.S. Marine Corps Base Camp Lejeune, or cancer-causing smoke at the World Trade Center ruins on 9/11. The link between chemical exposure and male breast cancer was formally recognized by the U.S. Department of Veterans Affairs. Firefighters and car mechanics, whose jobs involve exposure to smoke and chemicals, are also at higher risk.
A recent study found rising cancer rates in people under 50, including breast cancer. The reason for this increase isn’t known, but it has been speculated to be caused by rising rates of obesity and exposure to chemicals and cancer-causing agents. Being overweight is a known risk factor for male breast cancer. Men noticing growth of their breast tissue are encouraged to bring this up with their doctor and consider getting screened.
The American Cancer Society says that men at “high risk” for male breast cancer should speak to their doctors about whether and how they should be screened to detect an early cancer. Honestly, I am unsure who this recommendation will benefit. It would never have occurred to my husband or me, his physician wife, that he was at risk.
Do men with several female relatives diagnosed with breast cancer realize that they might be at risk and should be screened? What about men who have gained weight and noticed their breast tissue enlarging? Or men exposed to cancer-causing smoke, like firefighters? How many of these men are likely to take proactive action to discuss their risk of male breast cancer with their physician?
Not many, and that’s the problem. Men should watch out for a small mass that is often under the nipple. Any lump in a man’s breast should be checked by a doctor and followed up with an imaging test, such as a mammogram or ultrasound. If a man’s nipple has changed in appearance and become inverted, this is a warning sign. Finally, we need to encourage doctors to ask their male patients about their risk factors for breast cancer and examine their chests for small lumps, as they do in women.
I hope that male breast cancer never touches your family. Being proactive to catch this disease before it spreads may make the difference between life and death. Talk to your doctor about any risk factors you might have.
I am so thankful my husband is still alive. Let his story, and my dismissal of his lump, be a cautionary tale.
