En español | Mathew Knowles, a music executive whose daughters Beyoncé and Solange are among the most famous celebrities in that business, first noticed something was wrong back in July, when drops of blood started showing up on his shirts and bedsheets.
That’s when he decided to go to the doctor, he said last week during an interview on Good Morning America. What Knowles, 67, learned was something that more than 2,200 men hear every year in the U.S., according to the Centers for Disease Control and Prevention (CDC): He had breast cancer.
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“Of all the things I could get, why would I get this?” Knowles said about his initial reaction to the diagnosis.
Breast cancer in men is rare — less than 1 percent of all breast cancer cases develop in men, according to the National Breast Cancer Foundation. But it does happen.
“I think that people are often surprised that men also get breast cancer,” said Susan Brown, senior director of education and patient support at Susan G. Komen, a national breast cancer organization.
“So really, the risk of men not being aware or not being conscious of the fact that they could get breast cancer is that signs and symptoms that may be present will be unrecognized,” said Brown. “Or, if they are recognized and changes are noted, they don’t understand the potential implications of those changes, and so they delay seeking medical care.”
Unlike women, men are not routinely screened for breast cancer — and there’s a reason for that.
Jose Leone, an oncologist at Dana-Farber Cancer Institute in Boston, said that because the risk of breast cancer in men is less than 1 percent, the hazards of screening likely exceed the potential benefits.
“And it’s unclear if screening in these men would lead to reduced breast cancer mortality,” Leone said in an email.
That’s why it’s important for men to know the warning signs, which Leone said include a lump in the breast or armpit. Memorial Sloan Kettering Cancer Center in New York also lists nipple flattening, nipple inversion, nipple redness scaling and nipple discharge as signs and symptoms of breast cancer in men.
Because women 50 and older are routinely screened for breast cancer, tumors are usually small when caught. Men, however, often catch breast cancer when the tumor is larger, which can lead to prolonged treatment.
“This is one reason why it is important for men to seek care immediately if they feel a lump in the breast or armpit or notice changes to the breast or nipple,” Leone said.
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Although breast cancer can occur at any age, it is most commonly diagnosed in men in their 60s, according to the Mayo Clinic.
Family history is the biggest risk factor for breast cancer. About 1 in 5 men with breast cancer have a male or female parent, sibling or child with the disease, according to the experts at Sloan Kettering.
Robert Cohen, a breast cancer surgeon at Inova Breast Care Center in Fairfax, Virginia, said that just like women, men can have BRCA1 and BRCA2 gene mutations that increase cancer risk.
“And the thing that’s a little bit different in men is that all men with breast cancer are tested genetically, because the incidence of having a gene is higher in men who have breast cancer than women who have breast cancer, just because it’s so unusual in men,” Cohen said.
However, testing positive for a BRCA gene mutation does not lead to an automatic breast cancer diagnosis. Cohen said that carrying one of the gene mutations bumps a man’s lifetime risk of developing breast cancer to 6 or 7 percent. BRCA2 mutations in men are also associated with a higher risk for prostate cancer.
Other risk factors for male breast cancer include exposure to radiation and an excess of estrogen in the body, such as from estrogen-related drugs or liver disease. Dana-Farber’s Leone said obesity, heavy drinking, smoking and lack of physical activity can also contribute to cancer risk in men.
Black men are more likely to get breast cancer than white and Hispanic men; they’re also more likely to die from it, Susan G. Komen reports. A similar disparity is seen in women: Though white women have a slightly higher incidence of breast cancer than black women, the death rate from breast cancer is 40 percent higher in black women, according to a recent report from the American Cancer Society.
Leone recommends that men who are at high risk for breast cancer, or who have a personal history of breast cancer, discuss screening options with their doctor.
Treatments for men
Treatment is pretty much the same course of action for men and women with breast cancer. The biggest difference is that most men have all of their breast tissue removed during surgery (called a mastectomy), whereas a number of women opt to remove only the cancerous breast tissue (called a lumpectomy), Cohen said.
The lymph nodes in men and women are also treated the same, and because many men have tumors that are estrogen receptor-positive, they can take tamoxifen, a common breast cancer drug therapy, said Cohen.
Cohen said it’s important to keep in mind that as with breast cancer in women, cure rates for breast cancer in men are high. The CDC estimates 460 men in the U.S. die from breast cancer each year.
Knowles, who had a mastectomy this summer, told the New York Times that he plans to undergo a second mastectomy in January and intends to have mammograms every six months to further reduce his breast cancer risks.