San Antonio resident speaks out on breast cancer in men

Rare demographic can feel isolated as field focuses mostly on women

SAN ANTONIO — When Henry Ross discovered the marble-sized lump on his chest, he was alarmed. But his eventual diagnosis still came as a shock.

“I just never did think that I, a male, would get breast cancer,” said Ross, 65.

His 2017 diagnosis of invasive ductile carcinoma was triggered by a mutation of his BRCA2 gene, which can raise the risk of developing breast, prostate and ovarian cancers. Women with this genetic mutation have a 40 to 60 percent lifelong risk of getting breast cancer.

For men, it’s 6 percent. Ross was unlucky enough to be counted among that group.

Breast cancer is understandably treated as a women’s disease — men make up only 1 percent of all diagnoses. Last year, about 2,500 men in the U.S. learned that they have the disease, and the number of cases seems to be growing slightly over time, said Dr. Maryam Elmi, a breast surgical oncologist with the Mays Cancer Center at UT Health San Antonio.

“Men have breast and glandular tissue as well. Although it’s rare, they are at risk for breast cancer,” she said.

With such small numbers, the men who do get diagnosed can feel isolated, out of place. Everything in the field is oriented around women, from clinical trials to guidelines for preventive screenings.

“Most of the support groups are led by women. The majority of the survivors, 99 percent, are women,” Elmi said. “It’s hard for men to relate.”

That was true for Ross, whose experience with breast cancer was in some ways the same and in others completely different from that of women.

The treatment itself was standard: chemotherapy and a mastectomy, followed by radiation. Ross, who was at the time commuting from his home in San Antonio to his job in Austin with the Texas Department of Licensing and Regulation, felt the same overwhelmed emo

tions that come with any cancer diagnosis, the same physical toll from chemo and surgery.

The social aspects were another story. When he went in for his appointments, the waiting room was filled with women. He had few peers to lean on, as opposed to the numerous groups for women with breast cancer and survivors. Telling other people about his diagnosis felt embarrassing, Ross said, because “we still look at this as a women’s issue.”

After initially refusing treatment — as a diabetic, Ross was also dealing with dialysis and the prospect of a kidney transplant at the time — he came to grips with the situation. Ross, whose mother and aunt both had breast cancer, told his extended family members, which led to three cousins learning that they also had BRCA2 mutations. He did his research,

learning that he was about 30 percent more likely to also develop prostate cancer.

Sure enough, in September he was diagnosed with prostate cancer. He planned to undergo treatment for it in December and into 2020.

Ross’ surgical oncologist, Dr. Morton Kahlenberg, said men like Ross who have family members with a history of breast and ovarian cancers should be aware of the risks, even if they’re small. He encouraged men to conduct self-examinations and consider undergoing genetic testing, which can provide more information about a person’s risk of getting breast cancer.

Kahlenberg, who serves as medical director of San Antonio’s Baptist Cancer Center and Baptist Breast Network, added that some negative stigma around men’s ability to develop breast cancer, including the incorrect perception that it makes them more feminine, leaves men more reluctant

to pursue medical care.

As a result, they are often diagnosed at a later stage, limiting treatment options. For example, Kahlenberg said, most men end up getting mastectomies, where the entire breast is removed, as opposed to lumpectomies, where just the abnormal tissue is excised.

Some doctors may even have their own blind spots when it comes to treating male breast cancer patients, Elmi said. While reconstruction is a normal part of treatment for women, she said it’s important that physicians broach that conversation early on with men, too.

Ross said he is more comfortable now talking about his experience with breast cancer so that other men can be aware of the risks without feeling ashamed.

“It’s not just a disease that your mother or your aunt gets,” he said.

Kin Man Hui / Staff photographer Breast cancer is often thought of as a woman’s disease, but in rare cases men can develop it, too. That was the case for 65-year-old Henry Ross, who noticed a lump in 2017.