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Men At Higher Risk of Breast Cancer Misdiagnosis

April 16, 2013

Nearly everyone is aware of the ongoing fight against breast cancer. Nearly everyone is also likely to know someone affected by the disease. But while most people associate breast cancer with women, the disease can also affect men, with results that are even more devastating.

Male breast cancer is relatively rare in the United States. The American Cancer Society states that men are diagnosed with about 2,240 cases of breast cancer each year in the U.S. In contrast, women account for about 232,000 diagnosed cases of invasive cancer. But because most men (and their doctors) don't expect breast cancer to affect them, they often ignore symptoms like breast lumps or discharge, or other changes in the breast or nipple. It's usually not until a significant lump appears that men consult a doctor, and by that point the odds are good that the tumor will be a later-stage cancer. As a result, male breast cancer patients are at higher risk of misdiagnosis than female patients.

Because men produce very little estrogen, their risk for breast cancer is low. While it's not clear if a relationship exists between estrogen and testosterone, researchers do note that breast cancer most often develops in older men, whose testosterone production is slowing down. Other risk factors associated with estrogen include obesity, because fat cells can convert testosterone into estrogen, and cirrhosis of the liver, due to the liver's ability to metabolize estrogen. Family history of the disease and the presence of the BRCA2 gene mutation are indicators of an increased risk for breast cancer as well.

While women are encouraged to have annual mammograms after age 40 to screen for breast cancer, there is no similar recommendation for men. Women often learn about a breast cancer diagnosis after a mammogram, which can catch cancer at an early stage and lead to a better prognosis for survival. The outlook isn't as good for men, with male breast cancer most often diagnosed at an advanced stage requiring more intense treatment. To combat those negative outcomes, doctors recommend that men with a family history of breast cancer undergo genetic testing to see if the gene mutations that put women in higher-risk categories, BRCA1 and BRCA2, are present.

The rarity of male breast cancer can give men a false sense of security about their ability to contract the disease. Nearly 400 men die of breast cancer in the U.S. each year, compared with 40,000 women, often because of a delay in seeing a doctor about a troubling lump or discharge, or because a doctor doesn't consider male breast cancer when diagnosing a problem. While a misdiagnosis does not necessarily equate to medical negligence, a failure to properly investigate a patient's symptoms could lead to incorrect or delayed treatment, sometimes with devastating results.


Washington Post, Because Male Breast Cancer is Rare, Many Cases Aren't Caught Till Later Stages, 2-25-13

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