As Timothy Mlenje knows to his cost, Breast Cancer Awareness Month concerns men as well as women.
Mlenje (57), of Berea in Johannesburg, had no idea that breast cancer could affect men, but today the scars on the left-hand side of his chest bear testimony to the existence of male breast cancer.
The incidence of male breast cancer in Africa, particularly sub-Saharan Africa, is between 3% and 10% of all breast cancers, according to Dr Carol-Anne Benn, a breast cancer surgeon in Johannesburg. The rate is not as high in South Africa, though, where male breast cancer cases range from 2% to 3%. Yet Benn sees about 54 male patients a year at breast cancer clinics at Chris Hani Bara-gwanath hospital, Soweto, and Johannesburg hospital in Parktown.
Five years ago Mlenje discovered that ”there was something growing underneath my breast — it was oval and painless”, he told the Mail & Guardian. Mlenje had a lump. He said the fact that the lump itched just for a few seconds at a time caused him not to worry much about it.
But then, within the last two years, the itching became unbearable as the lump grew bigger and became more irritating. His female employer reacted with shock to seeing it. ”She never thought that it could be cancer, because I’m a man,” said Mlenje. But she sent him to hospital anyway.
Part of his breast was removed because the tumour was starting to spread to the armpit, and skin was grafted from his back.
Mlenje said his friends and male family members still find it difficult, even after his ordeal, to believe that men do get breast cancer. Have they changed their minds yet? ”Not at all,” he said. ”They said it can’t be.”
But Mlenje is not giving up. He is going public to get men to realise that breast cancer can strike anyone. ”Men should know that the disease is not only for women, it’s for men also,” he said. He is relieved that he was able to talk to his employer about it, leading to his getting medical help. ”I’d like to advise men to go for regular [medical] check-ups, preferably every six months.”
Mlenje said it helps to check your body regularly, so that a disease is detected before it grows into something big and difficult to control. ”Anything that’s surprising, they [men] should see a doctor, especially if they don’t feel comfortable about it,” he said. ”No matter how small the lump is, one should have it checked.”
Benn said that ”breast cancer is more of a stigma to men. Men do not consider themselves to have breast tissue.”
She said treatment for male breast cancer includes chemotherapy and radiation therapy. ”The usual treatment is a modified radical mastectomy with a lymph node dissection followed by radiation treatment to the chest wall,” said Benn.
Other than smoking, alcohol has also been implicated in breast cancer, she said. The third suspect is radiation.
Dr Sebastian Mundawarara, who runs a breast clinic at Ga-Rankuwa hospital, north of Pretoria, said the real cause of male breast cancer is not very clear, but ”it is partly hereditary”. Mundawarara said men who have gynaecomastia, a chromosomal disorder that leads to men developing larger breasts, are at greater risk of getting breast cancer. He said radiation has been mentioned as a possible cause, but was very rare.
”The peak incidence of male breast cancer is five to 10 years later than it is in women,” according to Ayesha Sasman, information officer for the Cancer Association of South Africa. If women get breast cancer it is usually in their 50s or 60s.