Yes, men do get breast cancer
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By Tony Singleton
There is a lot of awareness around breast cancer in women – and rightly so, as it is one of the top female cancers in South Africa and carries a lifetime risk of one in 25.
However, there is a distinct lack of awareness of the fact that men can also get breast cancer. While the risk is significantly lower and incidences are rare, it is in fact becoming more common.
The issue is that it is often diagnosed late, because men simply do not think that they could have breast cancer, which increases the mortality rate and has implications on treatment.
Men need to be aware of the signs and symptoms of breast cancer, and ensure that they have the right medical and gap cover in place to protect them from financial hardship.
Rare, but it happens
Many people simply do not realise that men can indeed get breast cancer. Although it is rare, only accounting for one percent breast cancers, it still happens and the diagnosis is arguably even more devastating for men.
Anatomically, the male breast is very similar to the female breast, and although it lacks the mammary glands and milk ducts, it still contains breast tissue that has the potential to become malignant.
Incidence of male breast cancer is increasing, although up-to-date statistics are difficult to obtain for South Africa.
The outdated National Cancer Registry reports that there were 194 cases in South Africa in 2017, while in the US there are around 2800 cases per year. Risk factors include age and family history of breast cancer, as well as lifestyle factors such as obesity, and oestrogen-related drugs that are used for gender reassignment and in the treatment of prostate cancer.
A case in point
South African Steve Kelly is a breast cancer survivor. He was diagnosed with high-risk Stage 3 Grade 3 breast cancer in December 2018, after his partner felt a lump behind his right nipple.
The nipple also appeared slightly inverted, but otherwise Kelly had no symptoms or feelings of illness.
The lump, a ductal carcinoma about the size of a marble, was surgically removed along with several lymph nodes, and following surgery, he had six months of chemotherapy followed by six weeks of radiation.
“Nothing can prepare you for the shock of a cancer diagnosis. It is a reality check, and it forces you to relook at your life. I found myself to be ignorant on the basics of breast cancer awareness. How could I not know that men get breast cancer?” he says.
He was declared cancer-free in May 2020. He is now on prophylactic hormone treatment and check-ups every three months. While Kelly is one of the lucky ones, the reality is that many men who receive a diagnosis of breast cancer are not. The late stage of diagnosis increases the mortality rate and also means that treatment has to be more aggressive.
WATCH: How to check for the signs of male breast cancer
Financial wellbeing is critical too
The treatment for male breast cancer is the same as for women, and includes a mastectomy, radiation, chemotherapy and ongoing hormone therapy same as a woman. Although male breast cancer may be covered as a Prescribed Minimum Benefits (PMB) condition, this is not always the case, and even if it is, there are certain limits involved and things like biological cancer drugs will not be covered.
For non-PMB conditions, medical aids typically offer either an overall annual limit for cancer treatment, or a specified Rand value for treatment, after which expenses will need to be paid for out of pocket. There is generally a co-payment of around 20 percent that the patient will need to cover themselves, and cancer treatments quickly become costly.
Gap cover is a cost effective way to safeguard financial wellbeing by covering many of the shortfalls around surgeons, anaesthetists, co-payments and more.
In addition, some gap covers offer cover for trauma care and counselling to help men who have received a diagnosis of cancer to get professional mental health support to help them process the diagnosis and come to terms with it.
Certain gap covers also offer a special cancer benefit that gives policy holders a once-off payment for the first diagnosis of cancer.
Know the signs
Lack of awareness is the number one challenge when it comes to male breast cancer. Men need to be aware that breast cancer is something that could happen to them, and they need to know what to look out for.
If there are lumps in the breast, the nipples appear inverted, the skin is dimpled, puckered or resembles an orange peel, if the skin is red or scale, or there is fluid or bloody discharge from the nipple, or there is any change in size or shape or a thickening under the areola or the armpit, SEEK MEDICAL ATTENTION. The earlier that a cancer of any type is detected, the more successful treatment will be.
* Tony Singleton is CEO at Turnberry Risk Management
** The views expressed here may not be that of IOL