Breast cancer is not just a woman’s disease.
While 99 percent of breast cancer cases stem from women, about 2,500 men in the United States contract breast cancer every year. And because awareness is scant, men often don’t go to a doctor promptly after discovering something suspicious — such as a lump in the chest area. Indeed, by the time men often seek medical attention, their cases are usually farther along.
“For men, most of these cases are invasive cancers,” said Dr. Robert DerHagopian, medical director of The Breast Center at Miami Cancer Institute, a part of Baptist Health South Florida. “For women, many of whom do annual mammograms, their cases tend to be pre-invasive.”
The American Cancer Society estimates that about 440 men will die from breast cancer in 2016.
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Alexander Sheppard, a 60-year-old grandfather from Richmond Heights in south Miami-Dade County, didn’t want to add to that statistic. In June, he felt something in his chest, which he initially thought was soreness from lifting boxes at his job. When he got home, he felt a knot on his left side. He talked it over with his wife, and saw a doctor the next day.
Sheppard got a mammogram. Cancer was not immediately detected, but the doctor referred Sheppard to a cancer surgeon.
After three pre-cancerous spots were discovered during a biopsy, Sheppard underwent a 90-minute surgery in July. Today, Sheppard — who said he felt no pain during or after the operation — is waiting for the six-month mark to get his next diagnosis.
“Men don’t like talking about [what is perceived to be] a feminine thing, but we need to be aware of this,” Sheppard said. “Cancer attacks the body. It’s nothing to be ashamed of, and you shouldn’t ignore the warning signs.’’
Sheppard’s enlightened approach can perhaps be explained by his family’s history with cancer.
Last year, his 38-year-old daughter, Erica, died from colon cancer. Six months ago, his 29-year-old daughter-in-law, Cassandra Sheppard, died of breast cancer.
Sheppard doesn’t see breast cancer as a female or a male thing. He sees it as survival.
“We all have chests,” he said. “If you feel a knot anywhere, then go straight to your doctor. Don’t play around.”
The rate of men contracting breast cancer hasn’t declined in 30 years, according to the American Cancer Society. The lifetime risk of men getting breast cancer is about 1 in 1,000, the Society reports.
Jewish men of European ancestry are more at risk of getting breast cancer because they have a greater chance of a mutation in the BRCA 2 gene, with a lifetime risk of about 6 in 100, according to the American Cancer Society. BRCA 1 mutations can also cause breast cancer in men, but the risk is lower, about 1 in 100, according to the Society.
Risk factors include a family history of ovarian and/or breast cancer. Radiation exposure can also increase the risk of breast cancer.
“Anything that lowers a man’s testosterone levels – such as obesity and old age – increases the risk of breast cancer,” DerHagopian said.
“Alcohol intake hurts the liver. Any liver problem may decrease the level of testosterone and increase estrogen.”
Dr. Aurelio Castrellon, a breast medical oncologist at Memorial Healthcare System in Broward County, cited a recent study that analyzed 13,000 males with breast cancer as well as 1.4 million women afflicted with the same disease.
“In that study, 82 percent of the women with stage two breast cancer survived after five years,” Castrellon said. “Only 74 percent of the men had survived stage two breast cancer at the five-year mark.”
Astonishingly, only 41 percent of males took the recommended medication after being diagnosed with breast cancer, Castrellon said.
“Men are not as compliant,” he said.
Raising awareness and seeking genetic testing if you have a family history of breast and/or ovarian cancer are two good places to start, experts say. Mammograms, which are are twice as effective for men as they are for women in detecting breast cancer, are especially useful to those who have a family history of the disease.
But even with added awareness and testing more must be done.
Castrellon said most of the available information on how to treat breast cancer comes from studies on women — not men.
“Most of the clinical trials exclude males from participation, and that’s a problem,” he said. “Certain medications are only approved for women.
“In addition, at the breast cancer treatment centers, the walls are often painted pink. There are places where physicians want their female patients surrounded only by women, and that’s an atmosphere that is not welcoming to men.”
Added Sheppard: “There are no pamphlets with photos of men. I think we should change that.”
▪ Dr. Robert DerHagopian, medical director of The Breast Center at Miami Cancer Institute, a part of Baptist Health South Florida. 786-662-4776.
▪ Dr. Aurelio Castrellon, director of breast cancer research at Memorial Healthcare System in Broward County, 954-265-4325.