Men’s awareness of breast cancer in men before their own diagnosis

Breast cancer in men is rare. There are about 390 men diagnosed each year in the UK. This compares to around 54,800 cases in women. (Cancer Research UK November 2016). Partly because campaigns to raise awareness of breast cancer in women have had such a ‘pink’ focus, many people are unaware that men can get breast cancer.

The majority of the men we interviewed did not know that men could get breast cancer and so their diagnosis came as a particular shock. One said he had “never dreamt about it”, another that he “didn’t have a clue”, and another described how he had only considered breast cancer to be a “woman’s disease”. One man couldn’t believe that he had breast cancer. (See Initial reactions to getting a breast cancer diagnosis).

Tom, whose wife had also had breast cancer, describes how he had no idea that men could get…

Age at interview 65

Gender Male

Age at diagnosis 60

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it’sfive year ago, I went to the doctor last week, got all cleared and the first time I got to know I thought it was a bruise. I walked into some timber, and it did swell, but not knowing I didn’t know at the time men could get cancer, breast cancer. So my wife noticed it and noticed the nipple going inwards and she told me to get in touch with the doctor, and when I got in touch with the doctor, like I said, I hadn’t seen the doctor in 36 years.

So they just stuck me straight in, cos it was that quick, you know, I got a bit worrwhat’s going on? That’s when it actually said, You’ve got breast cance and I can’t believe it. I said, I didn’t know men got i, butproved me wrong.

Yeah. Who was with you when you got your diagnosis?

My wife, my wife was with me.

And can you remember how you felt at the time?

Well, I feltI wouldn’t say embarrassed but I felt, you know, amazed, really, because I didn’t know men could get it. I only thought women could get it, you know what I mean? I didn’t believe it that men could get it till it happened, yeah.

Because when your wife was here earlier she said when you showed her the inverted nipple and she said, you said, Och, men don’t get breast cance and she said, Yes, they d, did you still not really believe her?

No. No, I never, no. I never believed them one bit till we went to see the doctor, and that’s why I was surprised. I didn’t know how it was done quick from Monday till coming on Friday, it was all done in a week. I was that surprised.

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Although most lumps are not cancer, the most common symptom of breast cancer in men is a painless lump under the nipple or areola. This can also change both the appearance and direction of the nipple. Some men also experience nipple discharge or ulceration. The earlier breast cancer is treated, the better, so it is important to get any symptoms checked out as soon as possible. Common symptoms include:

  • lump around the nipple or any other area of the breast
  • a nipple turning in (inversion/inverted nipple)
  • changes in the size or shape of the breast
  • a rash affecting the nipple
  • discharge or bleeding from the nipple
  • a swelling or lump in the armpit
  • an ulcer on the skin of the breast

Even when men had some of these symptoms, they rarely suspected that they could have breast cancer. One man only mentioned his itching nipple to his doctor whilst he was visiting him for something else, not for a moment suspecting that it might be a symptom of breast cancer.

Derek never thought, when he mentioned his itching nipple to his doctor whilst seeing him about…

Age at interview 69

Gender Male

Age at diagnosis 68

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I mean it was, it was so unusual in actual fact I mean I didn’t even have an inkling of anything and I was going to the doctors, cos I’ve got a breathing problem, and I’d gone to him for that, and whilst we were there I said to him, This is a bit embarrassing bu I said, my nipple itche. So, and I said, It doesn’t seem natura. So, I mean he immediately said, Well you realise men can get breast cancer So I said, Well, yes and n sort of thing.

What was, in general, what was people’s reaction? You said to me before we started the interview that, before you were diagnosed with breast cancer you hadn’t realised that men could get breast cancer?

Well I think the majority of people when I said it, were virtually of the same opinion as I was that they didn’t really realise that men had it, and of course when it was diagnosed and I got all the booklets and all the rest of it and I said, Wel, I said according to the booklet basically men getting cancer is something like 1% of, on an average, what is it 40,000 women, and 400 me. So I said you know, it’s not the sort of thing that the majority of people do know anything abou, it’s only if you actually encounter it. I mean now obviously people, my sort of friends and workmates and everything else I mean they’re obviously aware of it because of it having happened to me, and I think possibly you know, it works on that sort of basis, that, it’s if somebody gets it then it’s immediate family and sort of friends and that, that would get to know and it’s obviously spreading out like that you know. Because I mean, as I say, I mean nobody ever, ever said to me about, you know, a man could get cancer. And I mean, I didn’t even ask the doctor about it in the first context because I thought that it could be that, you know, because I, I hadn’t even given it a thought, that I mean, it wasn’t, well it was obviously a surprise, but I wouldn’t say that it was a shock, because I like to think that I accept life as it comes, so that it, you know it’s just one of those things. And, well I was getting on a little bit so it didn’t worry me that much (laugh).

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Another man who found a lump in his breast delayed seeing his GP for 6 months because he didn’t know that men could get breast cancer. His wife suggested that he see the doctor about it.

Tom H said his daughter persuaded him to visit his GP after reading on the internet that changes in the breast or nipple could also be a symptom of breast cancer in men.

One man suspected that the lump he had could be a cyst.

Some of the men who had no idea that men could get breast cancer before their own diagnosis were worried nonetheless when they found a lump or noticed another unusual symptom. This was the case for a few men with personal experience of cancer or who had worked in a medical environment.

Although Michael had never heard of breast cancer in men, he was immediately suspicious when he…

Age at interview 67

Gender Male

Age at diagnosis 57

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I discovered it [lump] in 2000. We were meeting together in a group and I just happened to put my hands across my chest and I noticed there was a lump in my left breast. Having worked in a hospital and alsoas a technician, not a nurse, and also a friend of ours had recently been through a very painful death from breast cancer, I was immediately suspicious of this lump so I went to the GP straight away, and within a week I’d seen the surgeon down at the hospital which was treating me, and he confirmed there was a lump. I had a biopsy and a mammogram and it provedactually, the worst thing of that was the first time I went to see the out-patients department, they weren’t sure of the diagnosis. The histology was a bit unclear, and they needed it to be seen on somebody sort of more senior presumably. So that was a very, very difficult week, between the two meetings but I had a very personal experience of God’s love for me.

I mean, we are Christians and have been for some years, and it reallyand that and the love of my family and my friends and the support, really in the end I felt yeah, okay nasty things happen to people. I’m no exception and you know, this is it.

And when you first had that lump, did you worry that you had breast cancer? Were you aware at that stage

Oh, I knewoh to be honest, I felt I have a lump there in my breast, it’s probably going to be breast cancer.

Right.

I’m not quite so sure why I was so sure.

Had you heard of any other men having breast cancer before, or

No, I haven’t. I’ve not really given it any thought in a personal sense, it was just we were very, very sad whenI mean, she was forty-eight which is young, she had everything to live for as they say and soI hadn’t no. To be quite honest, I’ve never really thought about cancer up until that happened when I was fifty-seven when I’ve discovered it. Apart from hurting my back while lifting things and having a hernia through lifting things, I’ve never really had anything more than flu so I’ve always felt fairly healthy, fairly active you know. I had a job that involved a certain amount of physical activity, standing up much of the time so I felt fairly fit. So itI’ve thought about it since you know you actually explained what would be happening, and I was trying to think how I felt about it and I think I was just accepting it.

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The men who were already aware of breast cancer in men had heard about it from various sources. One man remembered reading an article about it many years before.

Interview 32 had read an article in the Reader’s Digest which described breast cancer in men. His…

Age at interview 69

Gender Male

Age at diagnosis 66

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So when you first found out that you had breast cancer, was, and when you first went to see the doctor, had you known that it was a possibility that a man could get breast cancer?

Oh, yes, yes. I’d read about a year, I knew it a long time, I read it, think it’s in the Readers Digest years ago about it. I think that the first time I knew you could have it was a chap in America had it, y’know?

Right, so was that on your mind at all when you found, when you saw the, you know, the little lumps that you found, and then the nipple, was that what came to mind or

No, I thought well, it’s possible it could be, there’s no use worrying about it, if you’ve got it, you’ve got it, get on, well I think my daughter, her example made me, whereas I didn’t feel sorry for myself, I thought the idea was that I thought there’s a good possibility that you’ve got it, well you’ve got it, get on with it and whatever the doctors tell you to do, you do it, and whatever operations, whatever.

Sometimes you know, people have talked about stuff they’d seen on, you mentioned earlier that you’d first heard about male breast cancer from reading something in the Readers Digest?

Oh that was
Is that a good long time ago or?

Oh, goodness, I was over, I was well over fift,come near twenty years or more, it was a long, long time ago. I knew about it from that, then. Because I remember reading the article saying a chap that got it, but it said it was rare, but it wasn’t uncommon for men to have breast cancer, you know. I did know about it you know. But I didn’t think I was going to get it myself, no.

No, I’ll bet you didn’t. And have you seen much about it, you know, in the news and so on since then or

No not really, now and again.

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Other men who were aware of breast cancer usually had connections with a medical environment: John (Interview 25) had heard his wife, a phlebotomist, talking about a male patient being diagnosed with breast cancer; Tom (Interview 29) had a strong professional interest in understandings of risks; and others worked themselves within a hospital.

Only one man, Bill, had personally known a man who had breast cancer prior to his own diagnosis. He was immediately worried when he found his lump.

Bill warned his teenage sons before he went to hospital to a have his lump investigated that it…

Age at interview 54

Gender Male

Age at diagnosis 46

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Fifteen, thirteen and ten [son’s ages]. So, when I told them, I did tell them before I went to the hospital that I had found this lump in my chest and was kind of worrying about it, it might be bad news, and they were okay with finding out that it was a cancer. And I told them, because I knew of course men could get breast cancer, that was the other thing of course, many men don’t. Indeed many women don’t. But I had a friend who had died from breast cancer, years before, I always remembered that. And I was aware that men could get breast cancer.

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However, knowing about the possibility of breast cancer in men did not necessarily mean that men immediately suspected that they could have breast cancer themselves when they first noticed an unusual symptom.

Mike C had first-hand experience of breast cancer through his wife’s illness, and knew that men…

Age at interview 70

Gender Male

Age at diagnosis 66

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Up to that point had you been aware of the fact that, I mean obviously you’d been aware of breast cancer from your wife’s experience, but had you been aware that men could have breast cancer?

I had read they could yeah. I read they could yeah. it’s one in sixty or something is it?

I’m not sure the exact figures, I know there’s about three or four hundred men a year in the UK who are diagnosed so
Yeah, yeah.

Cos some of the men we’ve spoken to weren’t aware that they could have breast cancer.

Oh no I did know yeah.

When I was feeling it [lump] every morning when I was in the shower, it never occurred to me that I had cancer certainly, it was only when it hurt that I realised it might be something a bit more serious. But I still didn’t think it was cancer until I saw the GP, and he had me rushed to [name of] Hospital you know in about five or six days I’m thinking oh here we go. But, it didn’t occur to me, I wasn’t, I knew men could get breast cancer, it never occurred to me for one moment that I’d got it, until I was told I’d got it. Well until I went to the GP.

Yeah, why do you think that was? Do you think that’s how we all are in

Why do I think that was? – I don’t know, I don’t know, I, guess it never occurred to me that it could be cancer. I, I remember thinking – I’m going to see a doctor about this lump some time – but then I was going on holiday and I was working and left it another couple of weeks, and then when it hurt I then went pretty soon after I got back, but, it just never occurred to me that it would be cancer.

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