Mammograms for Men?

Most men don't think they can get breast cancer. Yet each year, an
estimated 1,300 males will be diagnosed with it and some 400 will
die.

The diagnosis usually comes as a shock. "Breast cancer is the last
thing they are thinking about," says Sharon Giordano, M.D., an
epidemiologist at The University of Texas M.D. Anderson Cancer Center in
Houston. She has conducted the largest study of breast cancer in
men. Even physicians and nurses who treat breast cancer expect the
patient to be a woman. "They're always called Mrs. Jones when they're
sitting in the waiting room," says Giordano.

Male breast cancer is rare, accounting for only about 1 percent of
cases each year. But men tend to have larger tumors and more serious
cases than women even though male cancer is more easily detected.
Researchers don't know if that's because male breast cancer is more
aggressive or because men simply go to the doctor later than
women.

There's reason to believe that risks related to male breast cancer
differ significantly from those associated with the disease in women. For
females, major factors include family history, lifetime exposure to
hormones, and age at various biological milestones such as first
menstrual period, childbirth and menopause.

Although many tumors in men are "hormonally driven" (and can be
treated after surgery with hormone blockers like tamoxifen, a drug widely
used in women), male breast cancer largely afflicts men older than 65 and
is very rare in young men. It is associated with breast and testicular
abnormalities, infertility and Klinefelter's syndrome, a genetic
abnormality in which men have one or more extra X chromosomes.
Klinefelter's syndrome is often marked by gynecomastia, an enlargement of
the breast tissue, which Giordano says may also turn out to be a risk
factor.

Does this mean men should get mammograms? Considering the low risk
for males in general, a self-exam is probably enough, says Giordano,
because lumps are more easily felt on a man's chest. Men can also get
genetic tests to screen for risks such as the BRAC2 gene, a known risk
factor for men and women. Giordano offers the testing to all her
patients, male or female. According to her, "Men who have children,
especially daughters, are more likely to want to be tested" in hopes of
giving their kids a head start detecting the disease.

Men tend to have larger tumors even though male breast cancer is
more easily detected.

Cancer cases in men:

1. Prostate - 220,900

2. Lung - 91,800

3. Colon - 72,800

4. Bladder - 42,200

5. Melanoma of skin - 29,900

38. Breast - 1,300