Male Breast Cancer Has Limited Effect on Survivor’s Perceptions of Their Own Masculinity: A Record Review and Telephone Survey of Patients in Johannesburg, South Africa
Rayne S, Schnippel K, Thomson J, Reid J, Benn C
Am J Mens Health. 2016 Feb 10. pii: 1557988316631512.
Breast cancer is of course strongly associated with women, thanks in part to the enormous success of the pink movement. Readers of the blog know that a small group, around 1% of breast cancer patients are men. Rayne et al have explored whether the diagnosis with breast cancer affects men’s perception of their own masculinity.
Using a record review and telephone survey, the authors spoke to 18 male breast cancer patients, and found that for those who had no awareness of the possibility that men could get the disease had a higher likelihood to express the fact that they felt their masculinity was affected by it. These were still a minority of the men interviewed – around 20%. The authors state that given the racial and economic history of South Africa, a correlation was observed between a lack of upfront awareness and being Black and being treated in a government as opposed to a private hospital.
First and foremost I commend the authors for looking at this issue. It shows once again that the lack of awareness of male breast cancer has far reaching consequences. It is reasonably well accepted that these include later presentation, but now we also learn that quite possibly the psychological impact of being diagnosed with breast cancer is higher for a man who was not aware of the possibility. This is more rationale to invest in male breast cancer awareness alongside the strong campaigns that exist for women already.
Of course the study is relatively small – only a handful of people were able to participate in the study – often the case with a rare disease. Further studies would be well worth it, perhaps in larger catchment areas.
Lastly, the study used general questions about the impact of “having breast cancer”. As a survivor myself, and a man with the typical presentation of ER/PR+ cancer, I can attest that what has affected my self image much more than the diagnosis or acute treatments, including mastectomy, is the hormone therapy. The many years of Tamoxifen also affect the brain and the mind… This might we worth including in a future study, and/or alongside a much overdo study of hormone-therapy non-compliance in men with breast cancer. If half the anecdotal stories I hear from my male breast cancer friends who have stopped hormone therapy because of what it has done to their lives are true, then there is an interesting finding waiting to be made.