There is a lot of awareness around breast cancer in women – and rightly so, as it is one of the top female cancers in SA 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. Many people simply do not realise that men can indeed get breast cancer. Although it is rare, only accounting for 1% breast cancers, it still happens.
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 SA.
The outdated National Cancer Registry reports that there were 194 cases in SA in 2017, while in the US there are around 2,800 cases per year.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.
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.
Kelly was declared cancer-free in May 2020. He is now on prophylactic hormone treatment and check-ups every three months. While he 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.
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.
Gap cover is a cost-effective way to safeguard financial well beingby covering many of the shortfalls around surgeons, anaesthetists, co-payments and more. Men need to be aware that breast cancer is something that is likely to happen to them, and they need to know what to look out for. The earlier that a cancer of any type is detected, the more successful treatment will be.
■ Singleton is the CEO of Turnberry Management Risk Solutions
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