A Rarity of a Tragedy Hits Home

Breast cancer only affects an estimated 2,500 men annually in the U.S., meaning late diagnosis can have lethal and tragic consequences.

EDITOR’S NOTE: Sharon Easterling will report on cancer screening relative to the 2023 Medicare Physician Fee Schedule, published last week by the Centers for Medicare & Medicaid Services, today at 10 a.m. EST on Talk Ten Tuesdays.

I just lost a male friend to breast cancer.

He was a tall, athletic, black male, in the prime of his life. He lived in a small town with a small-town lifestyle. He was silently attacked from within. He often patiently waited to hear findings from his wife’s mammogram, only to find that he was the one in need. He just found out much too late.

I was aware of breast cancer in males before this but was immediately taken aback by this news. My mind went into analysis mode. Unfortunately, men are typically diagnosed with breast cancer at later stages than women. The diagnosis is so far from the mind of the average man and his female friends, family members, and partners. I wonder how we could draw more awareness to this issue, and more widely share that there is coverage for this diagnosis in males.

Breast cancer affects about 2,500 men every year in the U.S., but studies have shown the incidence rate is 52 percent higher in Black men, as compared with whites. The reasons for the elevated risk are not fully understood, but risks for male breast cancer, as stated by the American Cancer Society, include:

• A family history of breast or ovarian cancers;
• Mutations in the BRCA2 gene;
• Radiation exposure;
• Conditions that change the balance of hormones, such as Klinefelter syndrome and gynecomastia; and
• Certain lifestyle risk factors, such as heavy drinking and obesity.

The signs and symptoms are the following:

• A lump or swelling, which is often (but not always) painless;
• Skin dimpling or puckering;
• Nipple retraction (turning inward);
• Redness or scaling of the nipple or breast skin; and
• Discharge from the nipple.

The cancer can spread to lymph nodes under the arm or around the collarbone and cause a lump or swelling at either site.

Most payors will cover screening and diagnostic mammography in males with risk factors and/or signs and symptoms. If you have a precedent of breast cancer in females within your family history, you should discuss this with your physician and take the appropriate steps for evaluation.

It can be very difficult for males to follow through with their health, but more so for Black males. As I discussed in a prior article, provider trust is a detrimental issue in the Black community, but Black males also deal with socioeconomic status, masculinity, racism, lack of awareness of the need for primary care, religious beliefs, and peer influences. There is some commonality here among races, but also some differences.

Health fairs are a common activity within the healthcare community. We should ensure that we make some of these activities male-oriented, and focus on those communities that may be apprehensive to participate. Find leaders and influencers in your community to bring others along in the journey to engage our males to positively impact health.

I believe if we would have had a fair with entertainment, speakers, screening, and education, I could be writing a different article today.