Male Breast Cancer Proves Rare, Deadly : Health: Men are not likely to look for symptoms. A third who get the disease annually will die, compared to a fourth of women.

If you’re a man who assumes that breast cancer is only a woman’s disease, you’re wrong.

To be sure, the disease is rare in males. This year, an estimated 900 cases of breast cancer will be diagnosed in men, compared to 175,000 cases in women.

But even though the incidence of breast cancer in men is low, the death rate is not. Some 300 men--about a third of the men who develop the disease--are likely to die from it this year, compared to only one-fourth of the women.

The reason is that men are not trained to look for it, physicians say. “If a man finds a lump, he’s most likely to ignore it,” said Dr. Carl Mansfield, a cancer specialist at Thomas Jefferson University in Philadelphia. Men “think it’s a woman’s disease,” he said.

Breast cancer in women is a devastating national health problem, but thanks to extensive education programs, women are well aware of breast cancer. They know they are supposed to examine their breasts monthly, undergo regular mammograms and report suspicious lumps to their physicians.

Because the disease is so rare in males, however, men are far less likely to recognize the symptoms and take them seriously until it is too late.

Men also are at a disadvantage because they typically have less breast tissue than women. Once a tumor is found it has often already invaded the surrounding tissue--making it harder to treat.

“It’s such an unusual event in men, so they typically aren’t screened,” said Dr. Ruthann Giusti, special assistant for clinical science in the cancer treatment division of the National Cancer Institute.

“Men don’t seek medical advice for a lump,” Giusti said. “They are more likely to think of it as a benign thing. Usually, it is detected at a later stage in men, when the lymph nodes are involved.”

The symptoms in men are the same as in women: unusual changes in the appearance of the breast or nipple, discharge from the nipple, a lump or swelling in the breast or a lump under the armpit--which could mean the cancer has spread to the lymph nodes.

The treatments also are similar as well: surgery alone, or surgery followed by radiation, chemotherapy or hormonal therapy.

Studies of breast cancer in men have been limited, so no one really understands what causes it. In women, it is believed to have some relationship to hormones, although there are other factors as well.

Women are considered at increased risk for breast cancer if, among other things, they are overweight, have a family history of breast cancer, had their children after the age of 30, or never had children at all.

Risk factors for men are less clear-cut, although some medical experts have speculated that exposure to radiation and family history of breast cancer may play a similar role in men as they do in women.

“I don’t think we know enough to know what the risk factors are in men,” said Dr. John Laszlo of the American Cancer Society. But one is to be over 50. “The older you get, the more likely you are to get breast cancer,” he said. “The same is true for men and women.”

Because breast cancer in men is so often fatal, some medical experts recommend that men who have a family history of breast cancer regularly examine their breasts.

But physicians do not recommend that men undergo regular mammograms. The disease is so uncommon among men that the procedure is not considered cost-effective.

Still, experts caution that all men should seek prompt medical attention for any suspicious lump or swelling in the breast or armpit.

“Clearly, we don’t make the same educational initiatives with men as we do with women,” Laszlo said. “But the general message is the same: Be aware of your body, and follow up on a lump. Go see a doctor. More often than not, it will turn out to be nothing. But if it’s not, you give yourself an added life insurance policy--early detection is where the money is in terms of curability.”

BREAST CANCER IN MEN

The major warning signs of breast cancer is the same for males as for females. They include:

Unusual changes in the appearance of the breast or nipple

Discharge from the nipple

Lump or swelling in the breast

Lump under the armpit

If any of these appears, call your physician--immediately.

--Source: National Cancer Institute