- By Ansa Hameed
BREAST CANCER IN MEN
Breaking Down Stigmas & Barriers
By Ansa Hameed
Breast cancer is often viewed as a “women’s disease”, leading many to overlook its occurrence in men. This misconception not only contributes to a lack of awareness but also creates significant barriers for men who may be experiencing symptoms or at risk.
In Pakistan, where cultural perceptions and stigmas are prevalent, it is crucial to address breast cancer in men, promoting understanding and encouraging timely medical intervention.
Medical experts confirm that breast cancer exhibits similar traits in both men and women, but there are important differences in biology and genetics.
Male breast cancer is significantly rarer than female breast cancer, accounting for just 1.3% of all cases in Pakistan. According to the Pakistan Cancer Registry, between 2018 and 2020, approximately 1,442 new cases of male breast cancer were diagnosed annually. Common risk factors for men include age, family history, genetic mutations, and conditions such as Klinefelter syndrome. Unlike women, men are less likely to have typical risk factors related to reproductive history, making awareness and understanding of the unique risks for male breast cancer particularly important.
BRCA1 and BRCA2 mutations, commonly associated with female breast cancer, also increase the risk in men, with BRCA2 mutations posing a higher risk. Additionally, mutations in other genes, such as PALB2 and CHEK2, can contribute to male breast cancer, though these are less studied than their effects in women.
Most male breast cancers are hormone receptor-positive, meaning they have estrogen and/or progesterone receptors, but the hormonal environment differs significantly between men and women, as men generally have lower estrogen levels. This hormonal difference influences how the tumors behave and respond to treatment. Additionally, male breast cancers often present as ductal carcinoma and may exhibit more aggressive histological features compared to some female breast cancers.
Men often exhibit noticeable lumps or changes in the nipple, which can be key indicators of breast cancer, while women typically undergo screening mammograms that lead to earlier detection of the disease. This difference in awareness and screening practices contributes to men being diagnosed at a later stage compared to women, highlighting the need for increased awareness and education regarding breast cancer in men.
In Pakistan, the most common type of male breast cancer is Invasive Ductal Carcinoma (IDC), which aligns with global trends. Other types observed include Ductal Carcinoma In Situ (DCIS), though it is less prevalent, and occasionally, Invasive Lobular Carcinoma may be diagnosed. Paget’s Disease of the Nipple, while rare, can also occur and is often associated with underlying breast cancer.
The Pakistan Cancer Registry indicates that the majority of male breast cancer cases, comprising 55.6%, are found in the 50-69 age range. Additionally, 21.1% of cases occur in the 40-49 age group, and 15.6% are diagnosed in individuals under 40.
In many cultures, including Pakistan, discussing health issues related to the breast can be taboo for men. Men with breast cancer face significant emotional and psychological challenges. The rarity of the disease often leads to feelings of isolation, compounded by societal stigma that associates breast cancer with women. Anxiety about treatment, prognosis, and personal impact is common, alongside concerns about body image and masculinity, particularly related to surgeries like mastectomy.
This stigma often discourages men from seeking help when they notice unusual changes or symptoms, such as lumps or discharge. The notion that breast cancer is a “female issue” can lead to feelings of embarrassment or shame, preventing open discussions about the disease.
To break down these stigmas, we need to normalize conversations about male breast cancer. Educational campaigns can play a pivotal role in raising awareness, emphasizing that all individuals, regardless of gender, should prioritize their health. Highlighting the stories of men who have faced breast cancer can also humanize the issue, showing that it is not a sign of weakness to seek help.
In Pakistan, various barriers hinder early diagnosis and treatment of male breast cancer. A significant issue is the lack of awareness, as many men are unaware that breast cancer can affect them. Increasing public knowledge through workshops, community health initiatives, and social media campaigns can empower men to recognize symptoms and seek medical advice.
Limited access to healthcare, particularly in rural areas, complicates the situation; mobile health clinics and outreach programs can help bridge this gap by providing education and screenings in underserved regions.
Cultural norms also play a role, as traditional beliefs around masculinity often discourage men from discussing health issues or seeking help for what may be perceived as “feminine” concerns. Engaging community leaders and influencers can help reshape these attitudes and promote health-seeking behaviors.
Additionally, many healthcare providers may lack training on male breast cancer, leading to missed diagnoses. Incorporating education about male breast cancer into medical training can ensure that healthcare professionals are better equipped to identify and manage this condition effectively.
Early detection is crucial for improving outcomes in breast cancer cases. Men should be encouraged to perform regular self-examinations and report any unusual changes to their healthcare provider. Community health campaigns can promote awareness of symptoms and the importance of early medical consultation.
Additionally, support groups specifically for men with breast cancer can provide a safe space for sharing experiences and challenges. These groups can help men feel less isolated and offer valuable emotional support during treatment.
Addressing breast cancer in men is an essential step in improving public health in Pakistan. By breaking down stigmas and addressing barriers to diagnosis, we can foster a more supportive environment that encourages open dialogue about this serious issue.
Education, awareness, and community engagement are vital in empowering men to prioritize their health and seek help when needed. Together, we can create a future where breast cancer is no longer shrouded in stigma, allowing all individuals—regardless of gender—to face the disease with knowledge, support, and confidence.
