CHICAGO (AP) — Men rarely get breast
cancer, but those who do often don't
survive as long as women, largely
because they don't even realize they
can get it and are slow to recognize
the warning signs, researchers say. On average, women with breast
cancer lived two years longer than
men in the biggest study yet of the
disease in males. The study found that men's breast
tumors were larger at diagnosis, more
advanced and more likely to have
spread to other parts of the body.
Men were also diagnosed later in life;
in the study, they were 63 on average, versus 59 for women. Many men have no idea that they can
get breast cancer, and some doctors
are in the dark, too, dismissing
symptoms that would be an
automatic red flag in women, said
study leader Dr. Jon Greif, a breast cancer surgeon in Oakland, Calif. The American Cancer Society
estimates 1 in 1,000 men will get
breast cancer, versus 1 in 8 women.
By comparison, 1 in 6 men will get
prostate cancer, the most common
cancer in men. "It's not really been on the radar
screen to think about breast cancer in
men," said Dr. David Winchester, a
breast cancer surgeon in NorthShore
University HealthSystem in suburban
Chicago who was not involved in the study. Winchester treats only a few
men with breast cancer each year,
compared with at least 100 women. The researchers analyzed 10 years of
national data on breast cancer cases,
from 1998 to 2007. A total of 13,457
male patients diagnosed during those
years were included, versus 1.4
million women. The database contains about 75 percent of all U.S.
breast cancer cases. The men who were studied lived an
average of about eight years after
being diagnosed, compared with
more than 10 years for women. The
study doesn't indicate whether
patients died of breast cancer or something else. Greif prepared a summary of his study
for presentation Friday at a meeting of
American Society of Breast Surgeons
in Phoenix. Dr. Akkamma Ravi, a breast cancer
specialist at Weill Cornell Medical
College in New York, said the research
bolsters results in smaller studies and
may help raise awareness. Because
the disease is so rare in men, research is pretty scant, and doctors are left to
treat it the same way they manage the
disease in women, she said. Some doctors said one finding in the
study suggests men's breast tumors
might be biologically different from
women's: Men with early-stage
disease had worse survival rates than
women with early-stage cancer. But men's older age at diagnosis also
might explain that result, Greif said. The causes of breast cancer in men
are not well-studied, but some of the
same things that increase women's
chances for developing it also affect
men, including older age, cancer-
linked gene mutations, a family history of the disease, and heavy
drinking. There are no formal guidelines for
detecting breast cancer in men. The
American Cancer Society says routine,
across-the-board screening of men is
unlikely to be beneficial because the
disease is so rare. For men at high risk because of a
strong family history or genetic
mutations, mammograms and breast
exams may be helpful, but men
should discuss this with their doctors,
the group says. Men's breast cancer usually shows up
as a lump under or near a nipple.
Nipple discharge and breasts that are
misshapen or don't match are also
possible signs that should be checked
out. Tom More, 67, of Custer, Wash., was
showering when he felt a pea-size
lump last year near his right nipple.
Because a golfing buddy had breast
cancer, More didn't put off seeing his
doctor. The doctor told More that he was his first male breast cancer
patient. Robert Kaitz, a computer business
owner in Severna Park, Md., thought
the small growth under his left nipple
was just a harmless cyst, like ones
that had been removed from his back.
By the time he had it checked out in 2006, almost two years later, the
lump had started to hurt. The diagnosis was a shock. "I had no idea in the world that men
could even get breast cancer," Kaitz
said. He had a mastectomy, and 25
nearby lymph nodes were removed,
some with cancer. Chemotherapy and
radiation followed. Tests showed Kaitz, 52, had a BRCA
genetic mutation that has been linked
to breast and ovarian cancer in
women. He may have gotten the
mutation from his mother, who is also
a breast cancer survivor. It has also been linked to prostate cancer, which
Kaitz was treated for in 2009. A powerboater and motorcycle buff,
Kaitz jokes about being a man with a
woman's disease but said he is not
embarrassed and doesn't mind
showing his breast surgery scar. The one thing he couldn't tolerate
was tamoxifen, a hormone treatment
commonly used to help prevent
breast cancer from returning in
women. It can cause menopausal
symptoms, so he stopped taking it. "It killed me. I tell you what — night
sweats, hot flashes, mood swings,
depression. I'd be sitting in front of
the TV watching a drama and the
tears wouldn't stop pouring," he said. Doctors sometimes prescribe
antidepressants or other medication
to control those symptoms. Now Kaitz gets mammograms every
year. Men need to know that "we're
not immune," he said. "We have the
same plumbing."