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The Oncologist, the Patient and CKN — Sharing Knowledge

Breast Cancer Screening Series: Khevin Barnes

KhevinBarnes4by Khevin Barnes, Breast Cancer Survivor

 

I remember the very moment my primary care physician announced that he was scheduling me for a mammogram.  It was May 3rd, 2014.  I watched the expression on his face as he told me this, hoping to discover some faint smile to indicate that he was joking with me. I looked at him incredulously, not quite understanding the words he had just spoken.  I waited for the punchline.  There wasn’t any.

 

“How do they do that on men?” I asked, giving no thought to the possibility that my left breast was actually harboring cancer at that very moment.

 

A mammogram?    Male breast cancer?  You’ve got to be kidding.

 

It all happened pretty quickly, and the truth is I just may owe my life to that. Oddly, I remember laughing with the technician who was working with me with my first ever mammogram experience.  I told her I was renaming the procedure a “man-o-gram”.  She was kind enough to chuckle as she tightened the glass plates that held my little bit of breast securely.

 

I’m not a big guy and I weighed in at about 150 pounds at the time.  Squeezing enough breast to get a good image was no easy task.  There wasn’t much discomfort as I recall, though I could easily see why it can be a grueling exam for women.  I gained a deeper respect for women that day.

 

The minute my mammogram was over my doctor was looking at the results on the Internet from the other side of town—and he didn’t like what he saw.  He sent me across the hall for a biopsy. In less than 30 days from my original office visit I was dressed in a surgical gown, waiting my turn on the operating table.

 

I understand the controversy about mammograms. Detecting a tumor or even a lump in a man is relatively easy, so women rely more on the annual mammogram to discover breast cancer. Are they safe? Are they necessary?  Do they save lives?

 

I don’t know the answer.  I only know it probably saved mine.  But there were many other factors that came into play.  First and foremost was a sharp-eyed Osteopath–my first doctor in a quarter of a century.  Good timing helped.  Being self-employed all of my life I had no health insurance.  The state of Hawaii where I lived at the time decided to “give” me some, and so I chose my primary care guy, stopped by his office to say hello and the rest is history.  Good timing is everything.

 

So what have I learned, particularly where the mammogram is concerned?  As far as men go, I don’t see any probability that guys will line up to have their breasts squeezed and checked out any time soon.  Self-exams will save lives, but even that is a hard-sell where men are concerned.  Though it’s a very rare disease, men with breast cancer are much more likely than women to die from it, due to our reluctance to seek help.

 

I wish I could change that. In the meantime or “man time” if you prefer, the mammogram, though not the first choice of men will likely convince guys who are slow to take action to seek help.

 

And hopefully, save a life.

 

Click here to read the Table of Contents for the series:  Breast Cancer Screening, Mammography and “Alternative Facts”

 

The opinions expressed in this article are the author’s own and do not reflect the view of Cancer Knowledge Network or Multimed Inc.

 


 

 

Khevin Barnes is a male breast cancer survivor and speaker.  He’s currently writing and composing a stage musical about male breast cancer awareness—and dreaming of having it produced and performed in 2017.  www.malebreastcancersurvivor.com

 


 

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2 Responses to Breast Cancer Screening Series: Khevin Barnes

  1. Constantine Kaniklidis says:

    Khevin:

    You present some wonderful personal perspective in male breast cancer screening, AND with wit and humor! Must reading.

    I deal with male breast cancer rather regularly in my consults (dozens across the globe at any one time), so let me add a few a few points, drawn from personal experience in this arena over my many years as an oncology researcher (with breast oncology as my specialty).

    First, there is a place for mammography in men [Darkeh 2014] [Patterson 2006] [Swergold 2014], but the focus should necessarily be in high risk populations, which includes (simplifying for sake of this discussion):

    1. males with a previous personal history of breast carcinoma,
    2. males with a strong family history of breast cancer (defined as an affected mother or sister),
    3. confirmed BRCA2 mutation carriers (regardless of family history),
    4. males with a diagnosis of Klinefelter’s syndrome, and
    5. males employed in the chemical manufacturing or motor vehicle industry
    6. non-isolated exposure to systemic steroids
    (I remember that Kim Veasey, director of Breast Care Center at Memorial Hermann Southwest Hospital in Houston tells of encountering three men diagnosed with male breast cancer, each in his 20s who all worked out at the same gym and had taken the same steroids).

    And there are many cases in which the non-imaging modalities like BSE (breast self-examination) and CBE (clinical breast examination) can miss important signals, as when there is extensive dense muscle tissue, or when a tumor can (all too easily) hide behind gynecomastia, and in these cases mammography is likely to be needed, even above ultrasound imaging which may lack the penetrance to detect the hidden lesion.

    In addition, your experience was relatively positive and enlightened, but we still find in many smaller facilities, that men can be greeted with medical history forms (often in pink) asking about when they had their last menstrual cycle, so centers need to make the relevant accommodations in processing for male patients. This is especially important as the exam itself can be difficult since men typically have less breast, and more muscular/connective, tissue, which can make positioning complicated. Positioning more muscular patients requires a different positioning technique in which pectoralis muscle is moved back to obtain a better view, quite similar in fact to the positioning technique used to image an implant patient.

    So for high-risk male populations, mammography (and often follow-up ultrasonography) is imperative. And for this same group, they need to be trained in how to conduct a proper breast self-examination, as most people are inexpert despite the fact that more tumors are detected by BSE than be mammography. Although illustrated on women, for my many hundreds of consults I have uploaded onto my SpiderOak cloud server (open access, no password required) a set of instructional materials on optimal BSE [Kaniklidis 2016].

    References
    [Darkeh 2014] Darkeh M, Azavedo E. Male Breast Cancer Clinical Features, Risk Factors, and Current Diagnostic and Therapeutic Approaches. Internat J Clinical Med 2014: 5:1068-1086.
    [Kaniklidis 2016] Instructional Datasets on Breast Self-Examination (BSE). 2016. Produced for No Surrender Breast Cancer Foundation (NSBCF). Available at: https://spideroak.com/browse/share/edgeshare/BSE.
    [Patterson 2006] Patterson SK, Helvie MA, Azis K, Nees AV. Outcome of men presenting with clinical breast problems: the role of mammography and ultrasound. Breast J 2006 Sep-Oct; 12(5):418-23.
    [Swergold 2014] Swergold N, Murthy V, Chamberlain R. Males at High Risk for Breast Cancer: Who Are They and How Should We Screen Them? Surgical Science 2014; 5:320-331.

    Constantine Kaniklidis
    Director, Medical Research, No Surrender Breast Cancer Foundation (NSBCF)

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