Men account for about 1% or less of all breast cancer diagnoses in the U.S., yet male breast cancer patients have a 19% higher mortality rate than their diagnosed female counterparts, according to a recent study in JAMA Oncology.
Scientists from Vanderbilt University looked at data on mortality rates from over 1.8 million female patients and 16,025 male patients who were diagnosed with breast cancer. The stark contrast between the number of men surveyed compared to the number of women underscores the deep lack of male representation in breast cancer studies.
“Breast cancer isn’t just a disease for females,” said Dr. Xiao-ou Shu, a professor of epidemiology at Vanderbilt and senior author of the study. “Men diagnosed with breast cancer have a worse survival rate, and we don’t understand the exact reason for the disparity. We need to take a closer look at the biology and the treatment.”
Shu explained that even though there isn’t enough research to give an exact reason for the disparity, there are still some clear contributing factors that help explain why. She pointed out that “there’s a combination of clinical factors like the disease stage, the age of diagnosis, cancer treatment, etc.,” she said.
According to Shu, the results from the study enforced the need for more research into the biological features and tailored treatments in men with breast cancer.
“The article serves to remind healthcare professionals of male breast cancer which is sometimes overlooked,” said Dr. Denise Monahan, a surgeon from the Breast Care Program at Northwestern Medicine Lake Forest Hospital. “It also emphasizes the need to make sure male breast cancer is treated in a multi-specialty fashion including surgery, medical oncology and radiation oncology for the best outcomes.”
Monahan also suggested that disparities in the treatment that men and women with breast cancer receive could explain the disparity in mortality rates. Men don’t always get the same attention and treatment options that women get, she said.
“It seems that in studies, men are undertreated, and maybe not offered radiation when it’s appropriate, or counseled on chemotherapy, or the importance of other therapies,” Monahan said.
While Shu’s research does not pinpoint specific ways to improve male mortality rates, two advocacy groups are pushing to improve awareness, increase education, and reduce the stigma surrounding diagnosis.
Bret Miller, a breast cancer survivor himself, founded the Male Breast Cancer Coalition with his mother Peggy Miller, who is the organization’s director, to bring together men who have been diagnosed and to encourage others to get checked. Their website offers instructional videos on how men can administer their own breast exams and other educational programs.
“If you’re going in for your yearly physical and your doctor isn’t checking you for breast cancer, ask — because they should,” Bret told STAT.
Harvey I. Singer, breast cancer survivor and co-founder of HIS Breast Cancer Awareness, another male breast cancer advocacy group, is working to help others overcome the assumption that breast cancer affects only women.
“Most guys think, ‘It’s not going to be me.’ I did. Even when my sister told me I could be carrying the mutation I thought ‘Oh, well it’s not gonna be breast cancer.’ Then three years later, I was diagnosed,” he said.
Unlike Singer, most men who get diagnosed don’t have a family member with a preexisting marker, according to Monahan, the Northwestern Medical Group physician. “But if there is, it significantly increases their lifetime risk of getting breast cancer,” Monahan said.
She, like Singer, the Millers, and Shu, emphasized that everyone should be aware of the common signs of breast cancer and be tested.
“There’s really no disadvantage to getting checked,” she said.
Correction: An earlier version of this story misstated the name of HIS Breast Cancer Awareness.
As a stage IV male breast cancer patient, I am getting good care from people experienced with it. But I did not get good advice from surgeons and internists who looked at my breasts and their lumps and said “no problem, get more exercise.” And I was skinny, so I didn’t need more exercise. They simply dismissed my concerns until it was too late. It is not always the patient’s fault.
My husband is a breast cancer survivor – he also is at high risk genetically for colon, and prostate cancer due to his genetic status-BRCA-1 +. He did not know this prior to my noticing a lump in his breast (1997) which turned out to be cancer and because I’m an RN who learned about genetic testing a year later , we learned of his BRCA status – positive! This gene controls breast, colon, ovarian and prostate cancer. His brother died of colon cancer, his son is doing well after surgery for prostate cancer and his daughter had an oophorectomy to be safe from ovarian cancer. My point is that it’s important that we are treated in a wholistic manner that starts with our genes and family history. My husband is hale and hardy as he approaches his 92nd year.
Genetics is very important as is the fact that men have breasts and that statistically male breast cancer is low. This makes it more deadly, because once it is discovered, it often is in a late stage.
My husband, an Ashkenazi Jew, is a breast cancer survivor and is BRCA1 genetic mutation. This last, puts him at greater than average risk for breast, colon, and prostate cancer. I found a lump in his breast when I casually placed my arm over his chest in a drowsing state early one morning and felt a suspicious lump with the back of my arm. That started us on a roller coaster ride that landed him in the OR.
He had a total mastectomy with lymph node excision followed by chemo, and then, after we learned of the genetic mutation, he had a simple mastectomy of the remaining breast. That was 21 years ago, and as my grandmother would say: “knock wood,” he’s been fine since! The lesson to be learned from this story is to be informed and take action!
It is remarkable that the reason men don’t to as well with breast cancer as women is “hiding in plain view” – It is mammography screening. It was not mentioned in this article and was not analyzed in the paper. There has been so much misinformation that has been published in journals with poor peer review and passed on to the public that is it not too surprising that the obvious reason was overlooked. Women have access to screening, but since breast cancer is so rare in men it is not practical to screen us breast cancer and our cancers are found later than among women.
The death rate from breast cancer in women was unchanged from 1940-1990. Mammography screening began in the 1980’s and in 1990 death rate for women began to fall. Deaths have continued to fall for women as more and more have participated in screening, and as we have improved our ability to detect breast cancers earlier. At the same time, in 1990, the death rate for men actually increased. It then returned to 1990 levels where it has remained while deaths continued to fall for women. The obvious difference is that women participate in screening and many have their cancers detected early enough so that they can be cured by therapy. Since breast cancer is so rare in men, we are not screened and do not do as well.
Therapy has improved, but breast cancers are only cured when they are treated early. This latest analysis is one more example supporting screening and the importance of early detection for breast cancer.
A major reason that men with breast cancer die more often than women with breast cancer is because insurance companies act as if men can’t have breast cancer; men, therefore, get inferior treatment. According to the insurance industry, men are disposable.
Maybe the lack of breast physical exam?
A related issue is man prostate cancer lack of funding when it is affecting men in the same proportion as breast cancer affects women.
Do we need a masculinism movement?
19% is not “soaring”. And even if it were, the headline makes it sound like the mortality rate for men is soaring over women’s overall, not among those diagnosed.
I know it’s your job to write articles even when you don’t have anything interesting to say, but at least have some dignity and don’t write clickbait headlines. People will respect you for it in the long run.
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