Father should consider mastectomy

Dear Dr. Roach: My 90-year-old father has been diagnosed with breast cancer. His doctor is recommending mastectomy, after which time they will determine a course of treatment. My father is fairly healthy for his age, although he does have high blood pressure, diabetes and spinal stenosis, for which he takes oral medications. He has a history of transient ischemic attack at age 75. I am concerned that the risks of surgery at this age may be greater than that posed by the cancer. There is not much information available on male breast cancer, and any information you could provide would be appreciated.

G.S.

Answer: I am sorry about your father. Breast cancer in men is less common than in women, but usually diagnosed later, as male breast cancer is not readily suspected by patients or many physicians.

Yours is a question I have seen frequently in medical practice.

The risk of cancer increases with age, and it is not uncommon to see a person who, like your dad, has been doing pretty well until a cancer is diagnosed at a late age. Some people choose to ignore it, but in your father’s case I would still be likely to agree with his doctor’s recommendation of surgery.

Although any surgery at age 90 should be taken seriously, mastectomy is not particularly dangerous.

The surgery not only will provide critical information about your father’s diagnostic options, it will also tell a lot about his prognosis. Perhaps most importantly of all, the surgery can reduce potential pain and suffering in many cases.

Untreated breast cancer, in both men and women, can have terrible physical effects.

These are much better prevented than treated.

Even with his medical issues, surgery is relatively low risk, and the benefits in understanding treatment options and their expected benefits, as well as reducing risk of complications from local tumor growth, makes this a strong recommendation. Of course, it’s your father’s decision, but I agree with his doctor’s recommendation.