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Men's Breast Cancer

Photo: Jose Ferreira
Written by: Dr. Fátima Cardoso Breast Cancer Unit Director,
Champalimaud Medical Center Head of the International Program for Men’s Breast Cancer 

Breast cancer is a well known health issue, frequently discussed in the media. It is the most frequent type of cancer affecting women and is responsible for over half a million deaths every year around the world. What many don’t know is that this disease can also affect men. Unlike women’s, men’s breast cancer is rare: it represents only 1% of every cancer that may occur in men and only 1% of the total breast cancer cases. Portugal registers around 5500 new breast cancer cases in women and 350 in men every year; its mortality rate is around 1500 women and 30 men per year. But rarity isn’t the only culprit regarding the lack of knowledge about men’s breast cancer. The fact that this is a disease typically associated to the female gender and to a human organ traditionally more important in women substantially contributes to some taboos, feelings of discredit and shame, which inevitably lead to late diagnoses. When early diagnosed, men’s breast cancer has a high recovery rate (around 70%), as in women. But the prognosis becomes a lot worse if the diagnosis is done in a more advanced stage, which is unfortunately the case in male patients. The rarity of this clinical condition also results in almost inexistent clinical trials, which are one of the most important tools to gain scientific knowledge. Thus, the way men’s breast cancer is treated today is simply extrapolated from the knowledge we have of the disease in women, which certainly is not the best way. It is urgent to change the reality of these patients and to offer them the medical care and support they need and deserve. On a scientific level, the International Program for Men’s Breast Cancer was created, aiming to obtain a deeper knowledge of the disease’s biology, its particulars and differences from women’s breast cancer. The project involves investigators from several countries, mostly from Europe and the USA, coordinated by EORTC (European Organization for Research and Treatment of Cancer). The first results, presented in 2014, on 1800 men with breast cancer, revealed important biological differences, namely regarding a protein called androgen receptor, which seems to have a relevant part in the disease. This discovery was the starting point for clinical trials of a new treatment, beginning in 2016, which represents a new hope for these men. This study has also demonstrated that, globally, the quality of treatments for male patients is worse than for most women with breast cancer. For instance, men are almost always treated with a mastectomy (complete removal of the breast) and have no access to plastic surgery or any major aesthetical concerns. This decision is based on the wrong notion that the procedure will have a small impact in men and no major physical or psychological consequences. However, many patients isolate themselves after a mastectomy, stop playing sports or going to the beach, for fear of exposing themselves, even among friends. The emotional and psychological consequences of the disease and its treatment are as relevant in men as in women. Concerns regarding the loss of manhood, communication difficulties with the spouse and secondary effects of hormone therapy (the main treatment for these tumors) are very frequent and complex problems. Besides scientific advancements, it is urgent to give voice to these men, to help them break taboos and understand their needs, without prejudice or preconceptions. This is the main goal of this project. Stories told in first person, followed by the powerful message expressed by photography. We are confident that the courage these men had, revealing their disease as well as their physical and emotional consequences, will allow others in this situation to feel less alone and marginalized. We wish to convey a message of hope – that this affliction and specially these patients will not be forgotten.