Male breast cancer

The Conversation ran an article on Male Breast Cancer on 3rd May titled “Breast cancer campaigns might be pink, but men get it too“, as part of the series dealing with hidden or stigmatised health conditions in men.

In my experience as a medical oncologist, men tend to present later, perhaps because they aren’t aware that a lump growing on their chest should be investigated. Most will turn out to be harmless: a cyst or something similar. But for some men, the lump will be more serious.

In around 10% of cases, the cancer has occurred because of a mutation in either BRCA1 or BRCA2 but there are also other hereditary cancer syndromes associated with male breast cancer.

The Cancer Institute’s eviQ guidelines recommend a referral to a genetic oncologist or public familial cancer clinic (FCC) for “all male breast cancer at any age irrespective of other factors”.

Publicly funded BRCA testing is available to men who are diagnosed before age 60, regardless of family history. Women whose personal family history includes male breast cancer and other BRCA related cancers such as breast, ovarian, prostate and pancreatic cancer or where there is Jewish heritage would also be encouraged to seek advice. While FCC’s are based mainly in capital cities, they do provide outreach services. Sydney Cancer Genetics provides bulk billed TeleHealth consults for Australians living in rural and regional Australia.

Men who carry a BRCA mutation do not require mammograms or other screening. However, knowing about the increased risk may mean that men seek medical advice early rather than dismissing a small lump or skin change. This may allow the lump to be cured surgically, saving that man from the side-effects you mentioned that can be associated with treatments needed for more advanced disease such as chemotherapy, radiotherapy or Tamoxifen.

There are some excellent resources on male breast cancer and I would recommend them to patients and families. These include Not just a Woman’s Disease by Cancer Australia and Men get breast cancer too by Breast Cancer Network Australia.

It is important to highlight hidden or stigmatised health conditions: not talking about them doesn’t make them go away.

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