A lump, inverted nipple, or indentations in the skin of the breast. Men can also get breast cancer, but they often discover it too late. That is why on October 7, we will commemorate the fact that breast cancer is not just a women’s disease.
In 2021, according to figures from the Cancer Foundation, 133 men and 15,613 women were diagnosed with breast cancer. This means that 1 in 150 breast cancer patients is a man. This also applies to Richard Bos (58), who discovered the breast cancer by accident. ,,I had a painful spot on my chest and felt a kind of disc,” says Bos. “I thought it would go away, but I had it looked at anyway. The diagnosis in April hit like a sledgehammer. Because I also have a panic disorder, I had a panic attack on the spot. Turns out I’ve been carrying it around since February. I didn’t even know men can get breast cancer.”
Bos immediately tells his brother, friends and neighbors. “Not just to get rid of my egg,” he explains. “Also to make them aware that men can also get breast cancer.” Multiple scans show that the breast cancer has spread to his lymph nodes, but not to other organs or his bones. “My lymph nodes were surgically removed,” says Bos. “I also had chemotherapy for five months, which worked well. The tumors are as good as destroyed, but the last remnants are still surgically removed.”
Huge blow after surgery
Despite the successful operation, Bos not only receives a serious blow physically, but also mentally. “It has been a tough journey,” he says. “During chemotherapy, I had many conversations with the general practitioner, nurses and a psychologist. There is a small possibility that the breast cancer will return, but I try to put that off as much as possible.”
Other risk factors include previous chest radiation or increased estrogen exposure due to obesity or alcohol consumption
Breast cancer is caused by an error in the DNA of a breast cell. “As a result, the cell continues to divide uncontrollably,” explains Lemonitsa Mammatas, internist-oncologist at the Reinier de Graaf Gasthuis. ,, This creates a lump or resistance in the breast or sometimes only a change in the skin or nipple. These uncontrollably dividing cells (tumor cells) can later also spread further to, for example, the lymph nodes or other organs.”
Genetic predisposition
There is no single specific cause, but there are risk factors that can increase the risk of breast cancer. “For example, about 10 percent of men have a hereditary predisposition,” explains the internist-oncologist. “For example, with a so-called BRCA mutation, which means that men who are carriers also have an increased risk. Other risk factors include previous radiation therapy to the chest or increased estrogen exposure due to being overweight or drinking alcohol. Some cancer cells grow under the influence of hormones such as estrogen.”
According to Mammatas, there are many similarities between breast cancers in men and women, so treatment in men has largely been copied from that of women. The internist-oncologist doubts that this is entirely justified. “The scientific research is almost exclusively based on female patients,” she says. “Therefore, more research is needed to collect the results of men with breast cancer.”
Although in many cases men today can also participate in research into new treatments, they remain underrepresented. “Hopefully with such research, the treatment and counseling of men with breast cancer can become even better.”
There are also differences
In addition to similarities, there are also a number of differences between breast cancers in men and women. For example, men develop breast cancer at a later age on average, namely 68 years, for women this is 61 years. “Men are more likely to have a genetic predisposition to breast cancer (10 percent) compared to women (5 percent),” Mammatas says. Men are also more likely to have a hormone-sensitive form of breast cancer. In men, breast cancer is generally discovered later than in women, so that the tumor is often larger and may have already spread further, for example to the lymph nodes, and the prognosis is therefore less good on average than in women.”
In men, breast cancer is generally detected later than in women, so the tumor is often larger and may have already spread further
Depending on the stage of the cancer, treatment usually consists of a combination of surgery, radiotherapy, chemotherapy and/or anti-hormonal therapy. “The surgery is the cornerstone of treatment when a cure is possible,” Mammatas says. “When the tumor is large or has already spread to the lymph nodes, it may be advised to start chemotherapy before surgery. The aim of this is to reduce the size of the tumor, which increases the chance of a cure.”
Also in a muscular chest
“After surgery, radiation is necessary for some of the patients to reduce the chance that breast cancer cells will grow locally again. Also, in hormone-sensitive breast cancer, anti-hormonal therapy can be given for five to ten years after surgery that is aimed at blocking estrogen and further increasing the chance of a cure.”
Mammatas wants to emphasize that men should not be ashamed when the diagnosis is made. “Breast cancer can also sometimes develop in a muscular chest,” says the internist-oncologist. “It is especially important to raise awareness about breast cancer in men. So that if they feel such a lump, they also consult their GP and the diagnosis can be made in time, because then the prognosis will be better.”
The right care
Both men and women with breast cancer can get care from their health insurer, says Bas Knopperts, health insurance expert at Independer. “Almost all care you need is covered by the basic insurance. Please note that this does apply at your own risk.” You can also claim care via your supplementary insurance. According to Knopperts, you don’t have to be afraid of medical selection. “In the case of supplementary insurance, insurers do not look at diseases such as cancer. With the diagnosis of breast cancer, it is therefore possible to switch health insurance.”
For men with breast cancer there is a special website with information: www.mannenmetborstkanker.nl. There is also the possibility of contact with fellow sufferers via the Facebook page @mannenmetborstkanker.
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