Men and breast cancer: breaking the silence

When breast cancer is mentioned, the conversation often centers on women. However, clinical oncologist Dr. Nazreen Bhim emphasizes that breast cancer can affect anyone with breast tissue—including men. Globally, male breast cancer accounts for less than one percent of all cases, but its impact is equally profound. In Trinidad and Tobago (TT), the numbers are similarly small, yet the challenges are significant. Dr. Bhim, who practices at Medical Associates Hospital, highlights that breast cancer is the leading cancer in TT, with male cases forming a minimal fraction of the total. Between 2015 and 2020, the national breast cancer incidence was around 75 per 100,000, with male cases making up less than one percent by international standards. Despite the low prevalence, male breast cancer presents unique challenges, including delayed diagnoses and societal stigma, making awareness crucial. Dr. Bhim, trained at the University of Cape Town and MD Anderson Cancer Center, specializes in advanced radiation therapies and palliative care. She explains that male breast cancer typically affects older men, with a median diagnosis age of 69. Symptoms often include a painless lump near the nipple, nipple retraction, or discharge. Genetic factors, particularly BRCA2 mutations, significantly increase the risk. Unlike women, male breast cancers are more often hormone-receptor positive and less likely to be triple-negative, a more aggressive form. Diagnosis involves mammography, ultrasound, and biopsy, with treatments mirroring those for women, including surgery, systemic therapy, and radiation. Dr. Bhim advocates for increased awareness, genetic testing for high-risk individuals, and rapid-access clinics to reduce diagnostic delays. She also stresses the importance of strengthening data collection to improve outcomes. While TT’s healthcare system has the core capabilities to manage male breast cancer, challenges like wait times and drug access persist. Early detection remains key, as most cases are treatable when caught early.