While breast cancer is common among women, close to 1% of breast cancer cases have been diagnosed in men.
Dr Lizanne Langenhoven, a breast cancer treatment specialist, noted men are prone to breast cancer, which often comes as a surprise.
However, men tend to present with more advanced disease, because they are not aware that they develop breast cancer in the first place.
While medical practitioners caution women to immediately seek medical assistance as soon as they spot a lump in their breast, Langenhoven explained a lump in men’s breasts is not always cancerous.
“About 50% of males develop small lumps in each of their breasts during puberty, usually behind the nipples which can be tender. This is called gynecomastia – colloquially a ‘stony’ and it’s perfectly normal. It usually goes away as they finish puberty.
“Breast cancer usually presents as a firm nodule in one breast that is not tender. There are some men who present with inflammatory breast cancer, where the breast is red, swollen and tender. This is, however, a rare but aggressive type of invasive breast cancer in which cancer cells block lymph vessels in the skin,” said Langenhoven.
Breast cancer can be genetic as women and men can inherit the harmful BReast CAncer gene 1 or 2 (BRCA1 or BRCA2) gene mutation that belong to a class of genes, known as tumour suppressors and have an increased risk of breast cancer.
Therefore, Langenhoven urged men to be assessed by a genetic counsellor if there is a history of any type of cancer in their family, women included.
“I have a patient in my practice who presented with a hard lump on his left breast. Because he was aware of his family’s history of breast cancer, he went to his GP for an examination. A mammogram and biopsy confirmed the diagnosis of breast cancer.
“In addition, should you have a family member diagnosed with male breast cancer, prostate cancer below the age of fifty or ovarian cancer (women), you should seek the opinion of a genetic counsellor to discuss the possible genetic risk and the option of genetic testing. Prevention is better than cure,” said Langenhoven.
Dr Salomine Theron, a radiologist at the SCP Radiology, said radiology played a pivotal role in the diagnosis and treatment of breast cancer.
However, due to gender disparity, there is a difference in terms of radiology’s initial role in screening for breast cancer.
“In women over 40, we recommend an annual mammography. In other words, looking for cancers which are asymptomatic. So even if there are no changes to your breast visibly or a lump, we still screen for anything that may develop into breast cancer or has already,” said Theron.
Theron said men had to undergo a different procedure when it comes to radiology.
“In men, that is not standard practice. Radiology is diagnostic and the referral is as a result of a lump in the breast, under the arm; there’s puckering or nipple pain,” said Theron.
She indicated a man’s mammogram differed from women.
“It is a single mammogram image of each breast so that a comparison can be made. In men, it will also include breast ultrasound and evaluation of the lymph nodes under the armpit.
“The imaging of a lump may also be incidental. For example, when we do any form of CT imaging on the chest in a male, even when creating images of the lungs, we always look at the soft tissue in the breast area. If we see an asymmetric nodule with an irregular shape (almost like a star) we alert the patient’s healthcare provider, even though that wasn’t the reason for the CT scan,” she said.
Both doctors concur regular check-ups heightens the chance of early detection.
“The first message is one of awareness that men can develop breast cancer. Even though only one in a hundred diagnosed cases of breast cancer is men, they should see their GP if they become aware of a lump in their breasts which feels firm and asymmetrical or if the breast becomes red, swollen and tender,” they said.
In the same light, health non-governmental organisation Right to Care urged men to be circumcised to help prevent cervical cancer for Cervical Cancer Awareness Month.
According to the organisation, cervical cancer is the most common cancer found in women, where 16 South African women die from the disease every day.
Right to Care further reported that male circumcision was medically proven to reduce the spread of HIV and sexually transmitted infections (STIs), like Human papillomavirus (HPV) by up to 60%. Persistent infection with HPV, the most common STI, causes cervical cancer.
HPV is also the cause of anal, penile, breast, and other reproductive organ cancers.
Head of the voluntary medical male circumcision programme at Right to Care, Dr Khumbulani Moyo, stated male circumcision would effectively counter the high rate of cervical cancer.
“As part of our national male circumcision programme, we ask men to consider circumcision as one of the single biggest ways to not only protect their health, but to protect the health of their female partners by preventing SA’s high rates of cervical cancer.
“While almost all sexually active people will be infected with HPV at some point, usually without symptoms. In most cases, the immune system clears HPV from the body. It is the persistent infection of the cervix with high-risk HPV, if left untreated, that causes 95% of cervical cancers,” he said.
Moyo encouraged men to circumcise, urging women to screen for cervical cancer with a pap smear or HPV test.
The Star