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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.

Breast cancer remains one of the most prevalent cancers among women, yet it is often shrouded in myths and misconceptions that can deter individuals from seeking timely care. In an era dominated by digital information, misinformation about breast cancer spreads rapidly through social media, blogs, and casual conversations, often perpetuating unfounded fears and misunderstandings. Dr. Lyronne Olivier, a consultant breast surgeon and associate lecturer at the University of the West Indies, St Augustine, has addressed and debunked several common myths to empower individuals with accurate knowledge and encourage proactive healthcare decisions. One prevalent myth is that breast cancer is solely hereditary. In reality, only 10% of cases are linked to genetic factors, while 90% are sporadic, influenced by environmental and other non-hereditary elements. Another misconception is that breast cancer always presents with pain. However, many cases involve painless lumps, emphasizing the need for clinical evaluation regardless of symptoms. Concerns about mammogram radiation are also unfounded, as the exposure is minimal and significantly outweighed by the benefits of early detection. Additionally, not all breast lumps are cancerous, and lifestyle choices, while beneficial, do not guarantee immunity. Men, though rarely, can also develop breast cancer, and treatment options extend beyond mastectomy, with oncoplastic surgery offering breast preservation. Breast cancer is not a singular disease but comprises various subtypes, each requiring tailored treatment. Mammograms are safe for individuals with breast implants, and products like antiperspirants and underwire bras are not linked to cancer. Finally, eliminating sugar from the diet does not selectively starve cancer cells. Public education and awareness are crucial in combating these myths, fostering early diagnosis, and improving survival rates. Dr. Olivier urges individuals to consult a breast surgeon for any concerns, as early detection remains the cornerstone of effective treatment.

When men receive a breast cancer diagnosis, their initial reaction is often disbelief, followed by questions about survival, sexuality, and masculinity. Dr. Nazreen Bhim, a clinical oncologist, highlights that breast cancer in men is frequently misunderstood as a ‘woman’s disease,’ leading to denial, delayed treatment, and heightened stigma. This misconception exacerbates the emotional burden men face, compounding the physical challenges of cancer treatment. Many men struggle with embarrassment, particularly when discussing issues like surgery scars, sexual dysfunction, or body-image changes. Dr. Bhim emphasizes the importance of normalizing language around breast cancer to reduce shame and encourage open dialogue. She advocates for pre-operative counseling, which includes discussing scar patterns, reconstruction options, and tattoo alternatives to help men prepare emotionally and physically. Masculinity and self-image play a significant role in how men process their diagnosis and recovery. Reframing treatment as an active, courageous choice rather than a loss of control can help align care with their sense of self. However, men often underutilize counseling and peer support due to societal conditioning around male strength and emotional restraint. Dr. Bhim recommends gentle but assertive encouragement to increase uptake of these resources. Early psycho-oncology referrals, male-inclusive support groups, and practical checklists for surgery or chemotherapy days can significantly improve coping and recovery. Dr. Bhim also calls for greater visibility and inclusion of men in breast cancer campaigns, urging the medical community and society to feature male survivors in media and expand genetic services to include entire families. Emotional healing, she stresses, is as vital as physical recovery, and men should be encouraged to seek help early through counseling, peer support, or faith-based guidance.

Breast reconstruction is more than a medical procedure; it is a transformative journey toward restoring normalcy and self-assurance for women who have undergone breast cancer surgery. Dr. Rajen Rampaul, a leading breast oncologist and reconstructive surgeon in Trinidad and Tobago (TT), has been at the forefront of oncoplastic surgery, a specialized field that integrates cancer treatment with reconstructive techniques. This approach not only helps women survive breast cancer but also reclaim their sense of identity and confidence.

Breast reconstruction encompasses a wide range of surgical interventions aimed at restoring the breast’s natural form or appearance. While it is commonly associated with women who have had part or all of a breast removed due to cancer, it also benefits individuals with congenital abnormalities or underdeveloped breasts. Dr. Rampaul emphasized that reconstructive surgery differs fundamentally from cosmetic surgery, as the former focuses on restoring normalcy after injury, disease, or abnormal development, rather than altering what is already normal.

In TT, over 95% of breast reconstruction cases are linked to breast cancer, with the remaining 5% addressing congenital issues. Dr. Rampaul has pioneered various techniques, including oncoplastic surgery, autologous fat grafting, and free flap deep inferior epigastric perforator (DIEP) breast reconstruction. These methods allow for a combined approach that restores both form and function, tailored to the patient’s specific needs.

The timing of reconstruction—whether immediate, delayed, or immediate-delayed—depends on factors such as cancer type, stage, and the need for radiation therapy. Dr. Rampaul highlighted that physical activity levels also influence the choice of reconstruction method. For instance, highly active women may not be ideal candidates for latissimus dorsi flap reconstruction due to potential loss of back strength. Similarly, gym enthusiasts may experience “animation” of implants during chest exercises, prompting surgeons to opt for subcutaneous implant reconstruction using autologous fat grafting.

Recovery times vary, with implant-based reconstruction offering the shortest recovery period and free flap reconstruction requiring the longest. Dr. Rampaul cautioned that while reconstruction can restore physical appearance, it does not restore sensation, and patients must be thoroughly counseled about its limitations.

Beyond the physical, breast reconstruction has profound emotional and psychological benefits. Studies show it significantly aids in recovering from the emotional trauma of breast cancer surgery. However, Dr. Rampaul noted that some patients may still experience regret, underscoring the importance of pre-surgery counseling. Intimacy and self-confidence are critical areas often overlooked in breast cancer literature, with many patients struggling with body image and sexual health post-surgery. Breast reconstruction has been shown to improve these aspects, though breastfeeding may be affected depending on the surgery type.

Dr. Rampaul also addressed the evolving awareness of breast reconstruction in TT. A decade ago, it was often misunderstood as a cosmetic procedure, but today, it is increasingly recognized as an essential part of rehabilitation. Despite cost challenges, the value it adds to a patient’s recovery—both physically and emotionally—is immeasurable. He advised young women considering reconstruction to educate themselves thoroughly, consult qualified surgeons, and understand both the benefits and limitations of the procedure.

Ultimately, breast reconstruction is not about recreating what was lost but about empowering women to regain their confidence and re-enter the world with a renewed sense of normalcy.