In an interview set to air onΒ Good Morning AmericaΒ this week, Beyonce Knowles-Carter’s 67-year-old father, Mathew Knowles, reveals to the world that he is currently battling breast cancer. In the interview, the music executive reveals how his motherβs sister,Β his motherβs sisterβs two daughters died as well as sister-in-law had each all passed away from breast cancer. Additionally, his mother-in-law as well as his wife’s mother, each battled with the disease as well.Β breast cancer, too.
While breast cancer has surrounded him his whole life, the father of four never believed that he would later develop the disease, until he began to experience some troubling symptoms,
“The first day I was like, ‘Oh, OK, no big deal … maybe itβs something that just got on my T-shirt.’ The second day I looked and did the same thing and I was like, ‘Eh … interesting.” He shared in the interview: “Then on the third day I was like, ‘What is this? I wonder what this is.’…A couple of days passed, and I didnβt have any type of discharge. Then on the fifth day, another, just a tiny drop of blood. I told my wife, I said, “Look at this,” And she says, ‘You know when I cleaned the sheets the other day I saw a drop of blood on it, and I didnβt pay any attention to it — but this was kind of weird.’ I immediately went to my doctor.”
He also adds that while his mind was racing, he never for one second thought that he had breast cancer. Which begs the question as to why do men believe they are immune to the disease?
The truth about male breast cancer
For every 100 women that we see with breast cancer, we see one man. Therefore the risk is low, particularly in comparison to cancers such as lung, prostate or colon. The National Cancer Registry states that the lifetime risk of suffering from breast cancer in malesΒ is between 1 in 500 and 1 in 1000, depending on race.Β Men of any age may develop breast cancer, but it is usually detected in men between 60 and 80 years of age (compared to women, usually detected from the age of 40).Β
Do men get the same types of breast cancer as women?
The following types of breast cancer are found in men:Β
- Infiltrating ductal carcinoma: Cancer that has spread beyond the cells lining ducts in the breast. Most men with breast cancer have this type of cancer.
- Ductal carcinoma in situ: Abnormal cells that are found in the lining of a duct; also called intraductal carcinoma.
- Inflammatory breast cancer: A type of cancer in which the breast looks red and swollen and feels warm.
- Paget disease of the nipple: A tumor that has grown from ducts beneath the nipple onto the surface of the nipple.
- Lobular carcinoma in situ (abnormal cells found in one of the lobes or sections of the breast).
What are the possible causes in men and does this include a family history?
- Family history and known carriers of the breast cancer gene mutation BRCA-1 and 2 have a higher chance of breast cancer.Β Other genes linked to breast cancer include P53, P65, ATM en CHECK2. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some genes related to breast cancer are more common in certain ethnic groups.
Other risk factors include:
- Being exposed to radiation.
- Having a disease related to high levels of estrogen in the body, such as cirrhosis (liver disease) or Klinefelter syndrome (a genetic disorder).
How would breast cancer be detected in a man?
Men with breast cancer usually have lumps that can be felt.Β
As menβs breasts are usually not as big as womenβs and a mass is, therefore, more easily palpated by men. On the other hand, in contrast to women health care seeking behavior in men is not well developed and most cases that we see are fairly advanced.Β
The following tests and procedures may be used:
- Biopsy: The removal of cells or tissues soΒ they can be viewed under a microscope by a pathologist to check for signs of cancer. The following are different types of biopsies:
- Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
- Core biopsy: The removal of tissue using a wide needle.
- Excisional biopsy: The removal of an entire lump of tissue.
- Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
- Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. Test results show whether hormone therapy may stop cancer from growing.
- HER2 test: A test to measure the amount of HER2 in cancer tissue. HER2 is a growth factor protein that sends growth signals to cells. When cancer forms, the cells may make too much of the protein, causing more cancer cells to grow. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out if there is too much HER2 in the cells. The test results show whether monoclonal antibody therapy may stop cancer from growing.
What is the normal treatment?
Treatments for breast cancer in men and women are generally the same. Many men benefit from a combination of different treatments. Here’s an overview of the various approaches:
Surgery
Β The typical treatment for men is a mastectomy, in which the entire breast is removed. Breast-conserving surgery — in which just a tumor is taken out — isn’t usually possible for an obvious reason. Men don’t have much breast tissue to begin with. The surgeon will also take out one or more of the lymph nodes to see if cancer has spread.
Radiation Therapy
Radiation is used commonly after surgery for breast cancer in men, as these tumors are often advanced and without radiotherapy, there is a high chance of recurrence.
Chemotherapy
Β It is a treatment used with drugs — either taken by mouth or by injection — that attacks cancer cells. Chemotherapy is often used after surgery to lower the risk of cancer coming back. For men with advanced cancer or cancer that has spread to other parts of the body (metastatic cancer), chemotherapy may be the primary treatment.
Hormonal Therapy
Some kinds of breast cancer need certain hormones to grow. Hormonal therapy blocks the effects of these hormones, choking the cancer. Your doctor might use tamoxifen or other drugs. The effects of new aromatase inhibitors like Arimidex and Femara — as well as the drug Aromasin, known as an aromatase inactivator — haven’t been studied much in men. Sometimes, removal of the testes is used to reduce the amount of certain male hormones in the system. Men with breast cancer should never take testosterone.
Hormonal therapy is often used after surgery to lower the risk of cancer coming back. For men with locally advanced or metastatic cancer, this may be the primary treatment.
Biological Therapy
Β This is a new approach. Some men have an excess of a protein that makes cancer spread quickly. Herceptin is a drug that’s been approved to treat metastatic breast cancer. It stops this protein from making the cancer cells grow. It may also boost your immune system, giving it more strength to fight the cancer itself.
More questions about male breast cancer
What role do male hormones and/or estrogen play?
Evidently hormones play an important role, but because the incidence of the disease in men is so rare, there is no intensive research available and the precise role of hormones is unknown.
Men that are treated with estrogen blockers β does this have an effect?Β
Men have very limited side effects of estrogen blockers. Β We previously did orchiectomy as part of the hormonal treatment, however, we found this to not be acceptable to the patients.
Are the chances of survival higher for men?
No β the chances for survival are lower than for women for a variety of reasons. The most important being that men are less likely to go to a doctor and therefore present themselves with advanced cancers. Due to the anatomy of the male torso with very little breast tissue, small tumors infiltrate into the surrounding tissue which can then easily spread. Β
Do daughters face an increased risk of developing cancer?Β
Yes. Each man that is diagnosed with breast cancer should go for genetic testing. The chances are high that he is a carrier of breast cancer gene mutations and therefore this would be inherited by his children.Β
Who Is The Author?
Dr. Justus Apffelstaedt, a specialist surgeon with an interest in breast, thyroid and parathyroid health as well as soft tissue surgical oncology.Β He has dedicated his professional life to breast, thyroid and parathyroid health management, and soft tissue tumors. His main interest in his field of expertise is to bring academic excellence in breast, as well as thyroid and parathyroid health matters within reach of everyone. Dr. Justus Apffelstaedt is registered as a specialist with the Health Professions Council of South Africa (HPCSA).
