Learning breast cancer has no boundaries
It is a familiar story. A breast lump is discovered while showering, and it was assumed to be just another harmless fatty cyst – others had been found in the past. But given a family history of cancer, this lump was biopsied and turned out to be cancerous.
This same scenario – or close variations of it - is played out every year for tens of thousands of women in the U.S., but there was something different here. It was a man who found the lump and had a bi-lateral mastectomy – surgical removal of both breasts.
Craig McMillan, a 59-year old independent insurance agent from Quincy, Florida, hesitated when he felt the lump, and decided to mention it to his family physician because cancer runs deep in his family: his sister had breast cancer, his grandmother died from the disease, and both his parents had lung cancer. Another sister had preventative breast surgery.
But when he learned the results of his biopsy – that he had invasive breast cancer - McMillan was simply stunned.
“Like most men, I thought it was primarily a women’s disease, so I was in denial and didn’t think it could happen to me,” he says.
His wife, Jane, was also surprised. “I was shocked when my husband’s breast cancer diagnosis was made since I never heard of men having this disease, “ she says. “After the diagnosis, we found out that we know three other men who have survived breast cancer. I guess this is an issue that men just don’t like to talk about.”
McMillan realizes that his decision to mention his family history to his family doctor may have saved his life.
According to the National Cancer Institute, any man can develop breast cancer even though women are about 100 times more likely to be diagnosed with the disease. Another way to understand the risk is that 1 man in 1,000 will be at risk for developing the cancer and that rate has not changed for decades. The American Cancer Society estimates that in 2008 about 1,990 new cases of invasive breast cancer will be diagnosed among men in the United States, and about 450 men will die from the disease.
Male breast cancer is most common between the ages of 60 and 70, and treatment in men is identical to that of women with the same stage of breast cancer. Both sexes have a fairly similar outlook for survival.
When told he had cancer, McMillan’s Tallahassee surgeon said he could operate on him, but McMillan requested a referral when he found out that the doctor had never treated a male breast cancer patient before. He was referred to Dr. Alvaro Moreno-Aspitia, an oncologist at Mayo Clinic in Jacksonville, Florida, who has treated a number of men with breast cancer. McMillan had both breasts removed in early 2005, and then was given chemotherapy and radiotherapy for several months.
“Mr. McMillan’s cancer type was infiltrating ductal adenocarcinoma, the most common type found in men. Like many male breast cancer patients, he comes from a family who share an abnormal gene (BCRA 1 or BRCA2) that predisposes them to have breast, ovarian, colon or prostate cancer,” said Dr. Moreno-Aspitia. “Despite his family history of cancer, he tested negative for this mutation – yet we cannot completely exclude that he has a yet-to-be-identified genetic mutation that predisposed him and several of his family members to have been diagnosed with cancer.”
National Cancer Institute statistics show that hereditary breast cancer accounts for about five to ten percent of all cases of breast cancer – both in men and women
Today, Craig McMillan is cancer-free but takes a daily dose of Tamoxifen as a preventative measure, and he sees Dr. Moreno-Aspitia every six months for follow-up checkups to make sure everything is ok. He has resumed his normal life as an insurance agent, which also includes such hobbies as woodworking, golf and occasionally hunting and fishing.
What does he say to men who find a lump in their breast?
“The main thing I can say is to get it checked out sooner than later, before it spreads and becomes harder to treat,” he says. “And if you are diagnosed, you can help get past the initial fear and uncertainty by adopting an ‘I can get through this’ attitude that, with the help of a supportive family, will make all the difference in the world in your recovery.”
