When you think of breast cancer, what comes to mind? Many people picture women, sometimes wearing pink, or a pink ribbon. Although breast cancer very commonly seen in women, men can also develop breast cancer and it’s important to raise awareness and support men breast cancer thrivers or survivors as well.
The following are key facts about breast cancer in men:
- The ratio of male-to-female breast cancer diagnoses is 1 man to every 120 women.
- Male breast cancer rates are on the rise, which may be related to the hormonal effects of obesity.
- Men are often diagnosed with breast cancer at later stages than women (because routine screening is not recommended for men).
- Male breast cancer is usually estrogen receptor positive (ER+).
Specific risk factors for male breast cancer include the following:
- A family history of breast cancer, especially in other male relatives
- Certain genetic syndromes
- BRCA gene mutation and other genetic mutations.
- Klinefelter’s syndrome (sex chromosome combination of XXY), which carries a 50-fold increase in risk
How Is Breast Cancer in Men Diagnosed?
Usually, a man will discover the breast mass himself and seek medical attention. His physician will then take a careful history, perform a physical exam, and often order breast imaging, including mammography and breast ultrasound. If the imaging is suspicious, the patient will need a biopsy for a tissue sample.
How Is Breast Cancer in Men Treated?
Surgical treatment options for men diagnosed with breast cancer are the same as those for women. Male breast cancer can be successfully treated with lumpectomy and radiation therapy (also called breast conservation therapy). The current breast conservation rate for male breast cancer in the United States is 13%. This means that many men with breast cancer are being treated with mastectomy.
Chemotherapy and/or endocrine therapy treatment recommendations are similar for men and women, and are dependent on the stage and biology of the patient’s cancer. For estrogen receptor–positive breast cancers in men, tamoxifen is the drug of choice.
The risk of developing a new breast cancer in the opposite breast for a male breast cancer patient is about 1% to 2%. Due to this very small risk, preventive mastectomy, also called prophylactic mastectomy, for the opposite breast is not recommended.
Other Considerations for Men with Breast Cancer:
- Genetic testing—8% of all male breast cancer patients will carry a BRCA2 gene defect. This information is especially important for their female relatives. Genetic counseling for family members can be lifesaving.
- Risk of another type of cancer—12.5% of men with breast cancer will develop a second type of cancer. The most common associated cancers are prostate cancer, pancreatic cancer, stomach cancer and colon cancer. Appropriate cancer screening guidelines are recommended.
Are Survival Rates Different for Men and Women?
Breast cancer survival for men and women is the same when the stage and biology of the breast cancer is similar. As with women, the earlier a breast cancer is detected and treated in a man, the better the chances are of taking care of the breast cancer and improving long-term survival.
-Dr. Ann Chuang
Hernias are extremely common, affecting millions of Americans each year. However, only a portion of those suffering from hernias actually seek treatment. National Hernia Awareness Month aims to raise awareness about hernias and the effective treatment options that are available.
Dr. Desiree D’Angelo and Dr. Ann Chuang, answered some frequently asked questions about hernias and discuss their responses in the below video.
- What is a hernia?
- What are some common symptoms of a hernia?
- What are the common types of hernias?
- Can a hernia go away on its own?
- What kind of doctor treats hernias?
- What can happen if a hernia is left untreated?
- How is a hernia treated?
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What is recovery like?
Recovery after hernia surgery is usually about one week of being out of work and somewhat sore, followed by six weeks of no heaving lifting, nothing more than 5-10 pounds. A gallon of milk is about 10 pounds, so you won’t be able to lift anything more than that for 6 weeks following surgery. If your job requires you to do heavy lifting, sometimes your employer can offer you a light duty position or we would keep you out of work for those six weeks. After your surgery we would see you in the office and make sure everything is healing well, and once you’ve met that six weeks of no heavy lifting you can slowly resume your regular physical activity including lifting and exercising.
A hernia is known as “a hole in the wall.” It occurs when there is a defect in the hole in the strength layer of your abdominal wall, which is also known as the “fascia.” A hernia commonly occurs within the torso between the chest and hips. Common sites include the groin and belly button. Sometimes, underlying fat or an internal organ can protrude out through the hole and this results in a bulge.
Common symptoms of a hernia include a bulge or pain at the site. In some instances, hernias can cause intestinal obstructions, which becomes a surgical emergency.
Common types of hernias include umbilical and inguinal. Other types include incisional and femoral hernias.
Most hernias will not go away on their own. Most of them will require surgical intervention. This is because a hernia is a defect in the abdominal wall and the strength layer of the abdominal cavity. There are some exceptions to the rule (e.g. during pregnancy, some women will experience an umbilical hernia). Most times, these will resolve on their own after the delivery of the child. Most other hernias will require surgical intervention.
Different types of surgeons that repair hernias include general surgeons, some that are specialized in minimally invasive or robotic techniques, or plastic surgeons. Sometimes the plastic surgeon and the general surgeon will repair the hernia together.
If hernias are left untreated, they can sometimes become larger or symptomatic where they are painful, or parts of your small intestine or colon can fall into the hernia and make bowl movements or physical activity difficult. If the contents that are in the hernia start to get squeezed and lose their blood supply, it becomes an emergency where we must go to the operating room immediately to repair it, sometimes having to resect part of your intestine or colon. So, if you have a hernia that requires repair, you should definitely see your doctor sooner rather than later, so we don’t run into that emergency situation.
Hernias are treated with surgical repair, as long as you are able to undergo a surgical procedure. Hernias are usually closed with sutures in some fashion and reinforced with a mesh. The mesh is usually made of a polypropylene or sometimes an absorbable type of material, which are secured in place with either sutures or clips that are also sometimes absorbable. The hernia repair is usually done in an operating room under general anesthesia, sometimes laparoscopically or robotically, or through an open procedure which may be an incision overlying the palpable hernia.
To learn more about hernia repair click here or call our office at 844-973-0002.