When Herb Wagner, an analytical chemist based in Florida, was 61, he noticed one of his nipples was inverted. During his next physical, he mentioned it to his doctor, who then told him to forget about the change; it was nothing to worry about.
Months later, he went to another doctor to examine a cyst he had developed on his neck. As soon as he took off his shirt in the exam room, the doctor zeroed in on the nipple and scheduled a mammogram for Wagner the very next day.
It wasn't good news. Wagner had a biopsy and soon heard a startling revelation: The retracted nipple was a symptom of breast cancer.
"That was just an amazing shock," says Wagner, who is now 70.
Perhaps even more shocking is that Wagner's case isn’t an anomaly. Lost in the sea of pink ribbons that raise awareness for breast cancer is a sobering fact: Men can get breast cancer, too.
The facts about male breast cancer
While breast cancer is rare in men — it's about 100 times less common in men than in women — it does happen. Each year in the U.S., about 2,000 new cases of male breast cancer are diagnosed, resulting in about 400 deaths, according to the American Cancer Society.
Most male breast cancers are detected between the ages of 60 and 70 years old, and the likelihood of a man developing breast cancer increases with age.
"Men often come in with very advanced [stages of breast cancer],"says Christopher Pezzi, M.D., director of surgical oncology at Abington Memorial Hospital in Abington, Pa. This is because men often dismiss the symptoms.
“You would be amazed at how people can just ignore lumps,” Pezzi says.
Aside from lumps, the signs and symptoms of male breast cancer can also include:
- A nipple that suddenly turns inward;
- Nipple pain;
- Sores on the nipple and areola;
- Nipple discharge; and
- Changes to the skin covering the breast.
“Male breast cancers are almost always under the nipple and areola,” says Pezzi, adding that taking notice of an inverted nipple or lumps in that area can really pay off.
Gender differences in breast cancer
Though breast cancer does affect both males and females, there are some noticeable gender differences. Pezzi, who researches breast cancer in men and treats three to five male breast cancer patients a year, finds that most men tend to get diagnosed later in life than women.
In studying the differences in male and female breast cancer, he and his colleagues tracked more than 13,000 men and nearly 1.5 million women with breast cancer whose data was stored in the National Cancer Data Base from 1998 to 2007.
Here’s what they found:
- Men were diagnosed, on average, at age 63, while the average age of women when diagnosed was 59.
- Men had lower five-year survival rates — 74 percent compared to 83 percent for women.
- When determining treatment, men were more likely to have a full mastectomy, while women were more likely to choose a more conservative surgery, such as a lumpectomy.
Wagner opted for a mastectomy and can now call himself a male breast cancer survivor. He had a successful modified radical mastectomy and began taking an anti-cancer fighting drug known as an aromatase inhibitor. An aromatase inhibitor works by lowering estrogen levels in the body, taking away the fuel that many breast cancers need to grow.
These days, Wagner devotes his time to boosting awareness. Together with his daughters, he founded MaleBreastCancer.ca, a website in which other male breast cancer patients and their loved ones can learn more about the disease and share their stories. He’s also on a mission to make the third week of each October “male breast cancer awareness week.”
And it’s not a bad mission to be on. Increased awareness — by the general population, as well as doctors — could translate to men getting help more quickly.
“Early diagnosis has made a huge difference in female breast cancer in the last 30 years,” says Pezzi. “We'd like to see that same progress for men.”
Take the next steps
While breast cancer in men is rare, it’s important for you and your loved ones to be aware of the disease and take proper precautions. Here are some tips:
- Be aware of symptoms that are suspicious, such as a lump in the breast, an inverted nipple or bleeding from the nipple.
- Don't ignore the symptoms; seek help.
- If a doctor tells you it's nothing and it persists, get a second opinion.
- If you have many relatives with breast cancer, ask about genetic testing to see if you carry the gene mutations (BRCA 1 or 2) that boost cancer risk for both women and men.