Published on November 16, 2020
Why is Male Breast Cancer Often Diagnosed at a Late-Stage?
Approximately one-half of males with breast cancer receive a diagnosis after it has already spread, according to a recent study by researchers at the Centers for Disease Control and Prevention (CDC).
Because breast cancer in men is rare — less than one percent of all cases are diagnosed in men — and the risk rises with age, men often receive diagnoses later in life and at a later stage of disease compared to women, the authors reported.
Nearly one in every 10 cases of male breast cancer — 8.7 percent — was diagnosed at a late stage.
Overall, five-year survival with male breast cancer diagnosed early was nearly 99 percent. However, it dropped to about 26 percent for men whose tumors had already spread to "distant" sites upon diagnosis.
“The five-year overall survival among males with breast cancer was worse for those who did not receive any treatment or who received primary radiation therapy than it was for those who received any type of mastectomy,” the authors wrote.
Racial Disparities in Diagnosing Male Breast Cancer
The research team used U.S. health data to track outcomes for nearly 15,000 men diagnosed with breast cancer between 2007 and 2016. Approximately one-third of the cases were diagnosed in men before age 60, one-third in men ages 60-69 years, and one-third in men 70 and older.
While survival estimates were similar by race, a larger proportion of Black males were diagnosed at a distant stage (12.2 percent) than in other racial/ethnic groups: 7.1 percent of Hispanic males and 8.1 percent of white males. One-year survival was lower among Black males than Hispanic and white males. Men who have had breast cancer have a higher risk for developing cancer in the opposite breast, melanoma, pancreatic cancer, and prostate cancer.
It is critical that men self-check for any breast masses and related symptoms and seek immediate medical attention, the authors said. Symptoms of male breast cancer are similar to those of women: a painless lump or thickening in breast tissue; skin dimpling, puckering, thickening, redness, or scaling; and nipple discharge, ulceration, or retraction.
Risk factors include aging, family history, radiation exposure to the chest, estrogen treatment, obesity, liver disease, and testicle disease or surgery, according to the American Cancer Society. Men with BRCA1 and BRCA2 mutations are more likely to develop breast cancer — like women.
The authors suggest healthcare providers routinely discuss family history with their patients to identify men who could be at increased risk and should undergo counseling and testing for genetic mutations.
Men, however, are often reluctant to consult a doctor, which means many do not seek help until the disease has progressed. Furthermore, there is a stigma associated with male breast cancer. Men report being mistakenly called by female prefixes in doctor waiting rooms because the staff is accustomed to seeing female patients (not to mention they may be the only male patient in the room). This can lead to feelings of isolation, shame, and emasculation.
The Importance of Male Breast Cancer Awareness
The awareness of male breast cancer has grown in recent years thanks to well-known celebrities disclosing their diagnoses, such as former KISS drummer Peter Criss, “Shaft” actor Richard Roundtree, and Mathew Knowles, famous musician Beyonce’s father.
“It can happen to you, and when it does, if you don’t deal with it right away, with your ‘dude’ and your metal and your tattoos, you’ll go in the box and we’ll see you,” Criss told Reuters in 2009. Criss was diagnosed with breast cancer in December 2007. He underwent a lumpectomy in February 2008 and a mastectomy the following month.
Knowles was diagnosed with Stage 1A breast cancer last July at age 67 after noticing dots of blood on his white T-shirts. An inconclusive blood test led to him to get a mammogram. A biopsy confirmed he had breast cancer, the same disease that claimed the lives of his mother, aunt, and great-aunt.
He had a mastectomy and three lymph nodes removed, which tested negative for cancer. While conducting tests for his surgery, doctors discovered he had the BRCA2 gene mutation.
"I need men to speak out if they’ve had breast cancer,” Knowles said in a “Good Morning America” interview last year. “I need them to let people know they have the disease, so we can get correct numbers and better research. The occurrence in men is one in 1,000 only because we have no research.”
He added: “Men want to keep it hidden because we feel embarrassed — and there’s no reason for that.”
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- Male Breast Cancer: A Rare, Increasing Trend
- Former KISS drummer: men get breast cancer too
- Mathew Knowles reveals he is battling breast cancer: 'We need men to speak out'
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