Men can get breast cancer too!

Today I had 2 cases in the OR and then an afternoon of surgical oncology clinic. We had a rare case of male breast cancer and performed a mastectomy today to remove the cancer. This patient is a 30 year old hispanic male who noticed a lump in his right nipple about 2 months ago. He went to his primary care doctor and was told it was most likely nothing given his gender and young age. He noticed that the lump was growing and made an appointment with  a different doctor 1 month later. The 2nd doctor refereed him to the surgical oncology team for evaluation. He had a core needle biopsy and it was sent to pathology to get a diagnosis. The pathology came back as ductal carcinoma. 

How rare is male breast cancer? Men are a 100 times less likely to get breast cancer than females or you could say females are 100 times more likely to get breast cancer than men. However once a man gets breast cancer, the prognosis and outcomes are identical to women. Unfortunately men usually present much later than women and the cancer is further progressed than the average women presenting with breast cancer. Often men will die from their breast cancer due to delayed treatment and metastasis. The average age of a man diagnosed with breast cancer is 65. Men have a higher risk if their mother had breast cancer. 

Today's patient was fortunate that his cancer was diagnoses relatively early. We removed all of the breast tissue and made sure that there was not cancer in the chest wall. We also removed the sentinel axillary lymph node which is the first node that a breast cancer spreads to. His lymph node was negative, if the node was positive then we would have had to take more nodes. He will have a 6 week course of radiation and then regular follow up exams. It looked like we got all the cancer and there was no evidence of metastasis. His mother had breast cancer and I believe his grandmother did as well.

Following the surgery I had the responsibility of talking with his girlfriend and family. As you could imagine they had tons of questions about the cancer. They were still in shock and had trouble believing that he had breast cancer. I reassured them that the surgery went well and that it looked like we got all the cancer. I also explained how the remainder of his treatment would proceed. The treatment protocols are the same for men and women except that you always do a mastectomy in men rather than breast sparing lumpectomy because they do not have enough breast tissue and like women with small breast it makes more sense to do the mastectomy. Obviously a man does not have the social stigma with a missing breast that a woman would have. 

This was an interesting case and fairly rare, so I was glad that I was able to help with the surgery.