Do men know they can get breast cancer?

(Results of the INVI-Reproclinic Male Breast Cancer Awareness Survey)

A few weeks ago we communicated the collaboration agreement between the INVI Association and Reproclinic to give visibility and raise awareness in society of the existence of male breast cancer.

Marius Soler, a good friend, founder and director of the INVI Association, made us understand that the andrologist must be one of the first links in the chain to diagnose breast cancer in men.

We decided that our first collaboration should focus on measuring the knowledge that men have about this disease and to do so, we set up a 6-question survey, which we carried out with 175 of our male patients between 18 and 56 years old.

Facts about the mammary gland and male breast cancer:

Men have mammary glands, although they are not naturally programmed to produce milk, unless there are certain circumstances that modify their functionality (pituitary tumors, estrogen treatment, hormonal imbalances linked to ageing, or stimulation of the gland by suction or aspiration, as this action produces an increase in prolactin secretion).

About 2 % of breast cancer cases diagnosed worldwide are male. Most cases are ductal carcinomas. This means that the disease starts in the ducts that connect the different alveoli and are usually invasive, since, originating inside the duct, they are more easily distributed throughout the gland and, if it crosses the wall of the duct, it develops in the surrounding breast tissue.

When a man is diagnosed with breast cancer, it is usually at an advanced stage. This is mainly due to social ignorance about the existence of male mammary glands and, therefore, also to the possibility of developing cancer.

What men think about male breast cancer:

• 65.7% of male surveyed considered that men have only pectorals and no mammary glands.
• 54.3% thought that breast cancer is an exclusively female disease.
• 82.8% considered to be false the fact that between 1 and 2% of breast cancers diagnosed were male, and 82.3% were surprised by the explanations offered by the andrologist and commented that they were unaware of this and had only just found out.
• When told that survival during the first 5 years after diagnosis was significantly worse in men compared to breast cancer in women, 41.6% related this to lack of knowledge, lack of education and lack of self-examination and 33.3% considered that the reason was that when it was diagnosed in men, the cancer was already at a more advanced stage. Some 12% considered that the genetic make-up of the tumor was different in men and that this made it more aggressive compared to female breast cancer and, surprisingly, 13% considered that the reason for the worse survival rate in men was due to the fact that the therapeutic protocols established for breast cancer in women were not indicated for men.
• 88.6% of surveyed acknowledged that they did not know how to self-examine their mammary glands.

Society needs to open its eyes to male breast cancer

We have an obligation to make society aware that male breast cancer exists. As with all cancers, early diagnosis can save many lives. We must make our fellow doctors aware of the need to train their patients in self-examination, especially our fellow urologists and andrologists. The andrologist is the man's gynaecologist; the specialist doctor caring for male sexual and reproductive health and, therefore, also for endocrine problems arising from sex hormones. Our obligation is to take advantage of the andrology consultation to carry out an examination of the mammary glands and teach breast self-examination to men who come to Reproclinic. In this way, we prevent and diagnose the pathology early.

Thanks to Marius Soler and the INVI Association, we are aware of our role in the diagnosis of breast cancer in men and how we can improve the mechanisms of early detection and conscious prevention and, above all, that male breast cancer is a different pathological entity to that of women and therefore deserves its own nosological classification.