Breast cancer in men has a low incidence compared to women, since it represents 1% of all cases of this tumor; however, according to various epidemiological studies, an annual increase of 1.1% is taking place. With the aim of making visible, de-stigmatizing and raising awareness of this tumor, the GEICAM Breast Cancer Research Group and the INVI Male Breast Cancer Association have launched a emotional campaignon the occasion of Father’s Day, which is celebrated on March 19, in which various patients share with their children how their experience with this tumor has been.
These videos portray how this pathology has impacted various Spanish families and show conversations between parents and children in which they speak openly regarding diagnosis and treatment, but also look to the future thanks to research. In relation to the diagnosis, it explains what the first indications were in each case, the fear and shame of going to the health professional, the confusion when receiving the results, what measures to take when diagnosed with hereditary cancer and the reaction in the environment family.
Regarding the treatment, it is detailed what those first months were like in which the medical team explained to them what it consisted of and what the options were. Finally, the emphasis is placed on improving care in these cases and the importance of advancing knowledge regarding male breast cancer, since, due to its low incidence, there is little interest in developing specific research studies.
Given the current lack of knowledge of the population of this pathology in men, GEICAM and INVI agree on the need to increase awareness of its existence to avoid very late diagnoses. The Dr. Ander Urruticoechea, researcher at the Gipuzkoa Cancer Management Unit and member of the GEICAM Board of Directorshighlights that “it is essential to make breast cancer visible in men because it helps reduce the social stigma that disorients men from seeking health care and because it would prevent them from reaching a consultation in very advanced stages as they are unaware that they can also suffer from it.”
In this line, the president of INVI, Màrius Soler, points out that in order to reduce the cases in which the disease is so advanced, it is crucial to reinforce early education. “Children from primary school must learn that men also have breasts, in this way, when they grow up, they will be aware that they can also suffer from this type of tumor and will go to their doctor more quickly,” he emphasizes. Another aspect that Soler considers very positive is to increase the training of primary care professionals on symptoms, with the aim that they carry out the appropriate tests as soon as possible to analyze whether it is a tumor.
The relevance of genetics as a risk factor
Genetics is one of the most relevant issues in the development of breast cancer in men. Population studies indicate that between 10 and 15% of men have mutations in the genes that are transmitted from one generation to another, which increases the risk of developing this pathology, unlike women, in whom the component hereditary has less weight (5%). The most common mutations are BRCA1 or BRCA2, although they also occur in other genes such as CHEK2, CYP17 and MLH1 or new variants such as PALB2. One of the criteria to look for hereditary causes is to carry out genetic studies, in addition, it is important to carry out a continuous and more global approach because these hereditary cancers in men are associated with others such as prostate cancer”, says Dr. Ander Urruticoechea.
In this sense, the Dr. Noelia Martínez Jáñez, medical oncologist at the Ramón y Cajal University Hospital, in Madrid, and member of the Board of Directors of GEICAM, points out “we must not forget the weight of the family history, in case there are several first and second degree relatives with this disease. On the other hand, it also highlights, among the risk factors, conditions that alter the estrogen/androgen balance, as happens in people with obesity or with liver dysfunction who are producing less testosterone, among others.”
First registry of Breast Cancer in Men
To achieve progress in the investigation of this tumor, it is essential to know its incidence in Spain. With this objective, GEICAM works in the First National Male Breast Cancer Registrywhich retrospectively analyzes a thousand cases in recent years, in which approximately 60 Spanish hospitals participate.
Dr. Urruticoechea, one of the medical coordinators of the registry, indicates: “For GEICAM it is a challenge and we are making a great effort to gather this number of cases that allows us to have more contrasted evidence, analyze how it is being addressed and generate a biobank of tissue that gives us the possibility of better molecularly studying this pathology in men. In addition, we seek to develop a tool that, through molecular analysis, offers us more information regarding the prognosis of a patient’s response to a certain therapy, beyond the clinical-pathological similarity with women”.
Dr. Martínez Jáñez, also the medical coordinator of the registry, highlights that important advances have been made in these years, such as the recruitment of almost a total of 600 patients and the first funding to start these molecular studies. “However, we still need more commitment from the different participating centers to have more patients and increase funding, because it is not easy to find it to carry out studies on this pathology, due to its prevalence,” remarks this specialist.
To continue advancing in the investigation of this pathology, both professionals agree that “regulatory entities must also show their support by starting up clinical trials to jointly develop new treatments for these patients.”
For his part, Màrius Soler considers the development of this research project essential, which will allow progress in understanding the disease with information on the real incidence in Spain. “The latest data we have is that handled in the United States, but, not having this national reference, we are not aware of the magnitude of the problem. This registry is a very important step to improve the management of these patients », he underlines.
