"Only women can get breast cancer." This is a common misconception to make, because only women have breasts, right? A reporter, Andrew Dalton, begs to differ after he decides to go for a mammogram, and gives his own account of the process.
'I'm here for a mammogram'
When I arrived for my first mammogram it didn't take long for my sense of secrecy to shatter. Behind the counter were five young women, unoccupied and anxious to help.
"Andrew Dalton, appointment for 8:45," I say.
"What for?" one asks.
With five sets of eyes on me, I say, "mammogram", maybe a little too loudly, trying to prove I'm unembarrassed to be a man getting a procedure almost exclusively done on women.
"Oh," one says, "that's over at the breast centre."
Of course, the breast centre.
A familiar scenario
On one level, this is a world I know all too well. My family is fraught with breast cancer: My mom had it twice and died from it, and my big sister had it. My daughter, now 13, has the same history on her mother's side. But I found when it came to the details and realities, I knew nothing.
Here are a few things I learned:
- Men have a small amount of breast tissue, similar to girls before puberty. Like any set of cells, it can become cancerous.
- Breast cancer is about 100 times more common in women, according to the American Cancer Society. About 2 500 new cases of invasive breast cancer will be diagnosed in US men in 2017, and about 460 will die from it.
- Men's symptoms are the same as women's: lumps or thickening in breast tissue, changes to breast skin, nipple discharge.
My personal education began a week earlier with a routine physical, when I told my doctor of a slight pain near my lymph nodes. Because of my family history, she wanted a breast ultrasound.
The lab decided a mammogram would be more useful. In retrospect, the case was fairly thin for that, adding my experience to those highlighted in several major recent studies that found the tests are over-ordered. I confess curiosity helped drive me to forge ahead and that despite the seriousness of what the test might reveal, I see the humour in it.
"I should probably schedule a Pap smear too," I thought.
I start calling it my "man-ogram", thinking I've coined the term, then learn that's reserved for prostate exams. Also, I worry about how I'll look with my shirt off.
Which brings us back to the breast centre. I'm happy after check-in to see five men among the 20 people in the waiting room. I'm far from alone! Then I notice each is with a woman who presumably is the one readying for a mammogram. I'm also told I'll get an instant reading afterward. I was only braced for the process, not the diagnosis.
This sends me scrambling to group-text my sisters and girlfriend, all of whom have been through this, and whose support is a perfect hand-hold. "Hugs! Yeah, they typically tell you while you're there, if it's diagnostic and not a routine check-up," my sister Emily writes.
The waiting is the worst
I wish I'd asked them more before. I get emotional as I wait, imagining how often my mother sat through days like this, and much worse. A discreet nurse summons me into a small room. The medical technician looks at my button-down shirt and tells me I don't have to take it off, just open it.
If there's one thing I thought I knew about mammograms, it's that it's always a topless affair. I ask if she gets many men.
"Just had one yesterday," she says. "I get a few a month."
The machine looks like a combination dental X-ray and George Foreman Grill. I stand diagonal to it. She positions my "breast" between the two plates. I can see this would be easier if you had more "grabbable" breasts. She has to kind of squeeze my chest to "create" a breast, as a shirtless boy would, goofing off for his friends. Then the machine itself squeezes down.
I have a twinge of pain, but as medical procedures go it barely counts as uncomfortable.
"What's it like if someone is bone-thin, or has rock-hard pecs?" I ask.
"It can be a little harder," she says.
I, apparently, am not that hard. She takes two images on the right, then two, each at a different angle, on the left, where the problem was. It's over remarkably quickly. The moment of truth arrives within 10 minutes: The radiologist says I don't have cancer.
Phew, I'm cancer-free!
The problem is common gynecomastia, a slight excess of breast tissue. Its causes are many, its consequences few. I let loose a sigh of relief, but I'm mostly excited to spread the good news to the rest of the family. We've had too little of it when it comes to breast cancer.
My relief is sweet but brief. I realise all I've done is dodge one extremely rare cancer. All the ruthless everyday ones common for men – prostate, colorectal, testicular – loom large as ever. For men whose mammograms don't provide the relief mine did, survivor stories and resources can be found at the Male Breast Cancer Coalition.
Breast cancer in men
According to the Cancer Association of South Africa (CANSA) breast cancer in men is rare and accounts for 1% of all breast cancer cases. Yet, male breast cancer can happen. Because of the fact that it's so rare, men have unfortunately been excluded from trails and therefore there is little research and awareness on the topic. Where women often have a noticeable lump in breast tissue, it can be more difficult for men to spot potential symptoms, making diagnosis harder.
And while research is still scarce, it's good to know that there is a bit more awareness about male breast cancer.