Delayed presentation, diagnosis, and psychosocial aspects of male breast cancer

Abstract

IntroductionMale breast cancer is uncommon, delay in seeking medical attention often results in late presentation and poor prognosis.MethodsRetrospective review of a prospectively maintained database was performed. Patients who were still having regular follow‐up were contacted for telephone interview.ResultsIn this study, 56 male breast cancer patients were treated in our center from January 1998 to December 2018, accounting for 0.88% of all breast cancers treated during the same period of time. Median age of onset was 61 years old (Range: 33‐95). In this study, 6 (10.7%) patients presented with distant metastasis at the time of diagnosis and received palliative systemic treatment only. And, 50 patients were surgically treated and all had mastectomy. Axillary dissection was performed in 36 (72%) patients, while sentinel node biopsy was performed in 14 (28%) patients. Median tumor size was 23 mm (2‐100 mm). A Majority were diagnosed with invasive carcinoma (NOS), while 38 (67.8%) patients were node positive.Here 36 (64.3%) patients were alive at the time of the study, 31 (86.1%) patients responded to the telephone interview. More than 90% of our patients expressed various degrees of embarrassment at the time of breast symptom onset. Similarly, more than 90% of these patients experienced embarrassment while waiting in the breast center with predominant female patients. Most patients (N = 26) were not aware that breast cancer can occur in men prior to the diagnosis. Median duration from symptoms to the first medical consultation was 12.4 months (1‐120 months).ConclusionMale breast cancer is rare and patients usually present late, Lack of knowledge, public education, and embarrassment are the important related factors.

Men with breast cancer and their encounters with masculinity: An interpretative phenomenological analysis using photography.

“…Furthermore, increasing the visibility of men and reflecting greater patient diversity in breast cancer resources and campaigns would help to improve men's sense of identity and belongingness; reducing feelings of threat and negating the need to protect and assert their masculinities. Relatedly, recent research by Co et al (2020) also highlights the need for improvements in gender-specific information and to create breast cancer awareness materials that bridge the gap between men and breast cancer, to improve the male-patient experience and outcomes. Second, ensuring that men have a "voice," and are afforded greater choice over clinical care options.…”

Care of men with cancer-predisposingBRCAvariants

“…Men might be more likely to delay seeking care for a new breast lump, perhaps waiting until the lump becomes painful or changes the overlying skin. A study in Hong Kong of men with breast cancer found that median duration from symptoms to first medical consultation was 12.4 months, and 84% were not aware (before their diagnosis) that breast cancer could occur in men 27. Raising this issue may be challenging, particularly as resources promoting breast awareness are mainly aimed at women 28.…”

Genetic Landscape of Male Breast Cancer

“…At diagnosis, men with BC tend to present a more advanced stage of the disease when compared with women, usually with tumors >2.0 cm and positive axillary lymph nodes [ 26 , 27 ]. Many factors can explain the late diagnosis in men: absence of screening programs, lack of awareness about the condition by male population, embarrassment due to a stigmatization of the disease, and misjudgment by primary care physicians [ 20 , 46 , 47 , 48 ]. Bilateral disease at diagnosis is very rare [ 49 ].…”