Male Breast Cancer: A Review of the Literature and a Case Report

Abstract

Received December 14, 2001; accepted December 28, 2001. From the Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Bronx, NY, and the Albert Einstein College of Medicine, Bronx, NY; the Barbara White Fishman Center for Psychological Counseling, the Department of Psychiatry and Behavioral Sciences, Memorial SloanKettering Cancer Center, New York; and the Weill Medical College of Cornell University, New York. Address correspondence and reprint requests to Dr. Massie, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021; massiem@mskcc.org (e-mail). Copyright 2002 The Academy of Psychosomatic Medicine. Breast cancer in men is rare, and there are no large prospective studies that address either the medical/ surgical treatment of breast cancer or the psychological issues. We review the scarce psychological literature; summarize the common risk and prognostic factors, familial tendency, pathology, and primary treatments; and report a 2-year psychotherapy that illustrates both the psychological issues of a man treated for Stage III breast cancer and the similarity of men’s and women’s emotional reactions to this disease. Breast cancer in men accounts for less than 1% of all breast cancer in the United States and less than 1% of all cancers in men. About 1,500 new cases of male breast cancer are expected to be diagnosed in 2002; about 400 men will die of the disease. Breast cancer in men was once believed to be biologically more aggressive than in women and more lethal. Because of the low incidence, until very recently there were few reported studies of treatment and survival among demographically matched male and female pairs and virtually no reports in mass media or professional journals describing the psychological issues of men with breast cancer. Most men and women were surprised to learn that men can “get” breast cancer, knowledge imparted during the last decade through reports about breast cancer susceptibility genes. The following report of a 2-year psychotherapy with a man with Stage III breast cancer illustrates the common cancer treatment and psychiatric/psychological issues in a man with breast cancer and a family history of breast cancer.