Men can get breast cancer too

There’s a lot of awareness around breast cancer in women – and rightly so, as it is one of the top female cancers in South Africa and carries a lifetime risk of one in 25.

However, there is a distinct lack of awareness of the fact that men can also get breast cancer.

While the risk is significantly lower and incidences are rare, it is in fact becoming more common.

The issue is that it is often diagnosed late, because men simply do not think that they could have breast cancer, which increases the mortality rate and has implications on treatment.

Men need to be aware of the signs and symptoms of breast cancer and ensure that they have the right medical and gap cover in place to protect them from financial hardship. Although it is rare, only accounting for 1% breast cancers, it still happens and the diagnosis is arguably even more devastating for men.

Anatomically, the male breast is very similar to the female breast and although it lacks the mammary glands and milk ducts, it still contains breast tissue that has the potential to become malignant.

Incidence of male breast cancer is increasing, although upto-date statistics are difficult to obtain for South Africa.

The outdated National Cancer Registry reports that there were 194 cases in South Africa in 2017, while in the United States there are around 2 800 cases per year.

Risk factors include age and family history of breast cancer, as well as lifestyle factors such as obesity and oestrogen-related drugs that are used for gender reassignment and in the treatment of prostate cancer.

South African Steve Kelly is a breast cancer survivor. He was diagnosed with high-risk stage 3 grade 3 breast cancer in December 2018, after his partner felt a lump behind his right nipple.

The nipple also appeared slightly inverted, but otherwise Kelly had no symptoms or feelings of illness.

The lump, a ductal carcinoma about the size of a marble, was surgically removed along with several lymph nodes, and after surgery he had six months of chemotherapy followed by six weeks of radiation.

“Nothing can prepare you for the shock of a cancer diagnosis. It is a reality check and it forces you to relook at your life,” he said.

“I found myself to be ignorant on the basics of breast cancer awareness. How could I not know that men get breast cancer?”

Kelly was declared cancer-free in May 2020. He is now on prophylactic hormone treatment and check-ups every three months.

While he is one of the lucky ones, the reality is that many men who receive a diagnosis of breast cancer are not.

The late stage of diagnosis increases the mortality rate and also means treatment has to be more aggressive.

Lack of awareness is the number one challenge when it comes to male breast cancer. Men need to be aware breast cancer could happen to them and they need to know what to look out for.

Seek medical help if:

• There are lumps in the breast;
• The nipples appear inverted;
• The skin is dimpled, puckered or resembles an orange peel;
• The skin is red or scale;
• There is fluid or bloody discharge from the nipple; or
• There is any change in size or shape or a thickening under the areola or the armpit.

The earlier any cancer is detected, the more successful the treatment. The treatment for male breast cancer is the same as for women, and includes a mastectomy, radiation, chemotherapy and ongoing hormone therapy.

Although male breast cancer may be covered as a prescribed minimum benefits (PMB) condition, this is not always the case, and even if it is, there are certain limits and things like biological cancer drugs will not be covered.

For non-PMB conditions, medical aids typically offer either an overall annual limit, or a specified rand value for treatment, after which expenses will need to be paid for out of pocket.

• Singleton is chief executive officer of Turnberry Risk Management Solutions, a provider of gap cover for medical expenses