Twice Healed : It Was One in a Million When He Got Breast Cancer . . . Then His Wife Did, but Both Have Survived

When Mary Arndt learned she had breast cancer, she knew what to expect. After all, her husband, Allen, had undergone a mastectomy just two years earlier.

The Arndts are a medical phenomenon. Not only did Mary and Allen Arndt both develop breast cancer, but both are considered cured after five years without recurrence.

“My doctor said I was one in a million,” Allen Arndt, 70, said matter-of-factly. “I guess it’s pretty rare.”

About 1,000 cases of male breast cancer will be diagnosed in the United States this year, up 11% from 1991, according to the American Cancer Society. Nearly one-third of those with the disease die from it.

By comparison, an estimated 180,000 American women will learn they have breast cancer this year. More than one-fourth of them will die.

With those figures, the Arndts consider themselves lucky. So does their doctor, who has treated just two cases of male breast cancer--and no other cases involving both a husband and a wife--in the nine years he has practiced medicine.

“It’s extremely rare,” said Dr. Cary Kaufman, a surgeon at Long Beach Memorial Medical Center. “I’ve never heard of another couple developing and being cured of breast cancer. And I doubt if I’d find another case in medical literature.”

The Arndts’ case began in November, 1983, when Allen Arndt, a retired dairy worker, noticed a dime-size lump on his left nipple. Not wanting to alarm his wife, who was planning a trip out of state, he kept his discovery a secret.

Though little had been written about male breast cancer, Arndt was suspicious.

“I knew what (the lump) was,” he said.

When his wife returned home two weeks later, Arndt broke the news to her.

“I was shocked when he showed it to me,” said Mary Arndt, 72, a retired nurse. “It was good-sized.”

At his wife’s insistence, Arndt called Dr. Kaufman, who insisted on examining him the same day.

“He did a biopsy that day,” Allen Arndt said. “He called that night and said it was cancer.”

Just six days after the biopsy, Arndt underwent a modified radical mastectomy at Long Beach Memorial Medical Center. During the procedure, his left breast, including the nipple and the lymph nodes under his arm, were removed. He remained in the hospital five days.

Minor infections followed, but the worst was over. Neither radiation nor chemotherapy was required.

Because it’s so rare, breast cancer in men has been difficult to study. What is known, however, is that the disease, which was first recognized during the 14th Century, usually appears in the form of a painless lump located near the nipple, where breast tissue is concentrated. The average age of men who develop breast cancer is 65.

Because the male breast is comparatively small, cancer can spread to adjoining tissues much more readily than in the female breast. It often spreads to nearby tissue before it is diagnosed because men usually wait longer than women before consulting a physician--either hoping the lump will disappear or denying the possibility that they may have breast cancer, according to the National Institutes of Health.

It is not known what causes the disease but it has been linked to advancing age, heredity, excessive weight and prior serious injury to the breast. As with breast cancer in women, prompt diagnosis and treatment of male breast cancer are essential.

Studies have shown that men who develop the disease often display abnormal hormonal activity. Some researchers believe that use of the female hormone estrogen to treat prostate cancer may be linked to the development of breast cancer in some patients.

“I look at breast cancer as one big disease, not a male or female disease,” said Rosemarie Hanisch, a nurse epidemiologist for the USC Department of Preventive Medicine. “It is clear that in females it is hormone-related. It may be hormone related in men too.”

In 1988, Hanisch and five other investigators published the results of a comprehensive study on male breast cancer. Arndt’s case was one of 75 examined.

Excessive weight in early adulthood was the only statistically significant risk factor identified. Increased weight may translate to increased levels of estrogen and a greater threat of breast cancer, the researchers suggested.

But Hanisch said anyone is susceptible to breast cancer: “With men, we don’t have much to go by. But it seems reasonable that it develops similarly in women and men.”

After his mastectomy, Arndt was examined by doctors every three months for five years. After five years without recurrence, Arndt was considered cured. He continues to be examined twice a year and undergoes mammography every two years.

When asked whether he experienced any embarrassment over having suffered from a predominantly female disease or over having mammograms, Allen Arndt shook his head.

“It never bothered me,” he said.

His wife smiled.

“Every time he has a mammogram I ask him how they do it,” she said. “But he won’t tell me.”

In December, 1985, the disease revisited the couple. This time Mary Arndt discovered a lump on her left breast.

“It was a large lump, and I knew what it was,” she said.

As he did with Allen Arndt two years earlier, Kaufman wasted no time in treating Mary. He did a segmented mastectomy, removing just the tumor and lymph nodes, and prescribed radiation therapy. Doctors have considered her cured since 1990.

“I couldn’t believe it at first,” Kaufman said of discovering that Mary Arndt also had breast cancer. “I thought, ‘Is it something in the food, in the water, or what?’ ”

He said the Arndts acted typically in selecting their treatment plans. Some women feel that breasts are important to their self-esteem, and Mary Arndt elected to keep hers. Her husband opted for removal of his breast, including the affected nipple.

Today, the Arndts remain free of cancer. They are confident they have beaten a dreaded killer and have maintained their sense of dignity--and humor--throughout the ordeal.

“We dared each other to ever get it again,” Mary Arndt said.