Each October, I usually share a little blurb in my newsletter to remind readers about National Breast Cancer Awareness Month and the importance of screening and early detection. I was content to leave it at that until two recent events prompted the desire to share more information: the announcement from Beyoncé’s father, Mathew Knowles, that he had been diagnosed with breast cancer and the news that a dear family member is experiencing a recurrence of her breast cancer after being in remission for about 10 years.
Men and Breast Cancer
According to the CDC, about 2,200 cases of breast cancer in men are diagnosed in the US each year – compared to about 245,000 cases in women. So, although breast cancer occurs mainly in women, men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer.
Men have much less breast tissue compared to women and thus, are not routinely screened for breast cancer. Breast cancer screening is only recommended for some men at higher than average risk due to:
- an inherited gene mutation (either they have the BRCA2 or BRCA1 gene mutation themselves or an immediate family member has the mutation), or
- a strong family history of breast cancer, such as a mother and/or sister diagnosed at age 40 or younger
For these men, screening may increase the chances that breast cancer is found early, when the chances for survival are highest. The National Comprehensive Cancer Network (NCCN) recommends men at higher risk for breast cancer, starting at age 35:
- have a clinical breast exam every year
- learn how to do breast self-exam
Men at higher risk for breast cancer should also be aware of the warning signs of breast cancer, including:
- a lump, hard knot or thickening in the breast, chest or underarm area (usually painless, but may be tender)
- any change in the size or shape of the breast
- dimpling, puckering or redness of the skin of the breast
- itchy, scaly sore or rash on the nipple
- pulling in of the nipple (inverted nipple) or other parts of the breast
- nipple discharge (rare)
Any man noticing these signs or other changes in his breasts or nipples should see a health care provider right away. Mathew Knowles said he noticed a recurring dot of blood on his shirts and his wife saw the same on their bed sheets. Fortunately, he contacted his doctor, was diagnosed quickly and underwent treatment immediately. He emphasized the importance of early detection to increase the chances of survival.
Click here to learn more about male breast cancer – and ladies, please share this information with the men in your life.
Women and Breast Cancer
Unfortunately, despite all of the advances of modern medicine, there is no sure way to prevent breast cancer – or its recurrence. Therefore, emphasis is still placed on understanding the risk factors and promoting screening and early detection.
There are some risk factors that are out of your control, such as being female and getting older (it’s more common in women 55 years and older). You are also more at risk if there is a family history of breast cancer or if you have an inherited mutation in the BRCA1 or BRCA2 gene. However, there are other lifestyle-related risk factors which you can modify to help lower the risk of developing breast cancer. I thought it would be helpful to highlight some of the ways you can do so, including:
- Maintain a healthy weight – being overweight or obese after menopause increases breast cancer risk. Having more fat tissue after menopause can raise estrogen levels and increase your chance of getting breast cancer. Also, women who are overweight tend to have higher blood insulin levels, which have been linked to some cancers, including breast cancer.
- Exercise regularly – evidence is growing that regular physical activity reduces breast cancer risk, especially in post-menopausal women. The current recommendation is that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity (or a combination of these) each week, preferably spread throughout the week.
- If you drink, limit alcohol to no more than one drink per day – drinking alcohol has been linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Alcohol is also linked to an increased risk of other types of cancer.
Understanding and modifying your behavior-based risk factors is important, but at the end of the day, finding breast cancer early and seeking treatment immediately are the most important strategies to prevent deaths from breast cancer. Getting regular screening tests is the most reliable way to find breast cancer early. For women of average risk for breast cancer, the gold standard for screening is the mammogram, which is a low-dose x-ray of the breast. A mammogram can often find breast changes that could be cancer years before physical symptoms develop. Women at high risk for breast cancer are often urged to undergo a breast MRI as well as a mammogram. An MRI uses magnets and radio waves to take pictures of the breast.
At this time, there are some differences in the breast cancer screening guidelines recommended by some of the leading organizations, such as the American Cancer Society and the US Preventive Services Task Force. Therefore, it is best to talk to your health care provider about the most appropriate screening options for you.
Finally, I think its important to end with a note about breast exams. For years, women were urged to perform monthly breast self-exams. Recent studies have not shown a clear benefit of regular physical breast exams done by either a health professional (clinical breast exams) or by women themselves. Unfortunately, there is very little evidence that these tests help find breast cancer early when women also get screening mammograms. However, women are still encouraged to be familiar with how their breasts normally look and feel and to report any changes to a health care provider right away. All of the women I know who were diagnosed with breast cancer felt something in their breast that prompted them to seek further testing. That’s enough to make me continue with regular self-breast exams.