I show up for my appointment. A nurse asks me to get undressed from the waist up and put on a gown with the opening in front. For the life of me, I can’t figure out the correct way to tie the gown’s tassels. When I mention this feat of incompetence to the technologist inside the examining room, she tells me I could’ve just taken off my shirt. The nurse, she says, is “not used to male patients for mammograms.”
Thus began my first of what will be many regular mammogram screenings, screenings that, as a man, I never expected I’d need. I guess that nurse didn’t expect it either.
Let’s be clear, the breast cancer statistics for women are downright frightening: One in eight women will be diagnosed with breast cancer in their lifetime. For men, it’s only 1 in 726. Looking at those numbers, it’s obvious and even reasonable to understand why breast cancer is treated as a greater health threat for women. But much of the culture surrounding the disease seems ensconced in a gendered mold, including those pink awareness ribbons, pink merchandise, wigs, sisterhood and the general idea that men don’t have breasts in the first place, so why on earth would they have to worry about getting breast cancer?
In fact, some of us do have to worry. Breast cancer in men isn’t so rare that it hasn’t affected a few male celebrities, like KISS drummer Peter Criss, actor Richard Roundtree (star of “Shaft”), and famous by association, Beyoncé’s father, Mathew Knowles. Despite these high-profile diagnoses, the perception of breast cancer as a threat to men’s health has struggled to go mainstream.
Cheri Ambrose founded the Male Breast Cancer Global Alliance more than a decade ago after learning her friend’s husband received a breast cancer diagnosis. She looked on the internet for some information about it. “And to my surprise, there was nothing out there for men,” she tells me. “It was crickets.”
Dr. Aditya Bardia is a UCLA breast cancer oncologist who’s been in the field for 15 years and, in that time, has treated over 20 men. He says that men should watch out for lumps, pain, discomfort or nipple inversion. “If you have any of that, get it checked out with an ultrasound,” says Bardia. “Otherwise, if a man is only at average risk, then a mammogram is not necessary. But if he has BRCA and a family history, then a mammogram is recommended.”
The genetic risk factor
Those major risk indicators are what ushered me into my own cancer prevention safari. My mother was diagnosed with breast cancer in 2000, and my grandmother was diagnosed around a decade earlier. Add to this the fact that I have an Ashkenazi background, and I’m about as at-risk for breast cancer as any man can be.
To get a more accurate genetic indicator of cancer risk, my mother encouraged me to get my DNA tested for the BRCA1 gene mutation. Sure enough, I tested positive for BRCA1, and now my doctors and I are on high alert not just for breast cancer but also linked cancers like prostate and pancreatic cancer. (While it’s not public record if Richard Roundtree was BRCA1 positive, he survived his bout with breast cancer only to pass away decades later from pancreatic cancer, suggesting that he possibly carried the gene mutation.)
The mammogram experience
After testing positive for BRCA1, the geneticist I spoke with emphasized that my biggest new health concern would be prostate cancer, so I was a little bit surprised when my general practitioner gave me a referral for my first mammogram. I had no idea what to expect.
This is where I have to say that the scope of what I don’t know about women’s health is probably wider than I’d care to admit. My first exposure to the realities of what a mammogram procedure actually entails came from watching the pilot episode of “Girls5eva.” We first meet Sara Bareilles’ character while she’s in the middle of getting one, latched in somewhat medieval fashion to a mechanical vice that towers high over her head. I knew uncomfortable breast squeezing was involved; I just didn’t realize a machine did all the work. “Girls5eva,” if you’re unfamiliar, is not an old show, which means I’ve been unaware for most of my life how a mammogram actually works.
Still, as I headed to my appointment, I wondered, because I’m a man, how my own mammogram would differ from the one I saw Sara Bareilles getting on TV. It turns out, it wasn’t very different at all.
After getting rid of that gown, the technician positioned me chest-forward against her own mechanical vice. I was instructed to hold my breath while the machine gave me two tight squeezes on the left and two tight squeezes on the right, each squeeze lasting a few seconds. Yes, this was uncomfortable, but comparatively breezy as far as medical procedures go — simple, brief and noninvasive. My greatest irrational fear was that the machine might squeeze far tighter than necessary and I’d just be stuck there in immense pain until someone unplugged the cord. Of course, that did not happen. Actually, nothing else happened. I was in and out of the building in under 15 minutes.
The results? “No significant masses, calcifications or other findings are seen in either breast.” Good to know.
Navigating, and breaking down, the gender stigma
The mammogram itself was a piece of cake, yet I have to acknowledge that there were times on this journey of cancer risk self-discovery when I felt like a tourist prying into someone else’s health narrative. It wasn’t just the incident with the gown, or the geneticist assuring me that prostate cancer would be my major BRCA-related concern. While filling out a required questionnaire before scheduling my mammogram, I had to answer questions like, “Have you had an entire breast removed?” and “Does your bra size exceed 42DD?” I answered no, but if there had been an “N/A” option, I would’ve gone with that instead.
Bardia acknowledged the disconnect. “Because it’s relatively rare for men, guidelines and management for men are informed by the guidelines and management for women,” he tells me.
In a different context, some people could misinterpret these gendered hiccups as microaggressions. I don’t personally feel that way, but I’m trying to be fair, taking into account both the overwhelming impact breast cancer inflicts on women’s bodies in much greater numbers and the stigmatic pain points that men might be experiencing in their own breast cancer journeys.
Let’s face it: The stigma for men is real and it has consequences. “Even though it’s much more rare, the mortality rate for men is 19% higher for breast cancer than for women,” says Ambrose. “That’s because of lack of awareness and, I think, the stigma.”
A big part of that stigma, Ambrose believes, is the unfortunate proliferation of associating breast cancer with the color pink. “Pink is not a cure,” she says. “Sadly, it’s become a moneymaker for everyone during October, and not just the breast cancer organizations. People are making pink bagels, pink pens and even little pink ducks. People are making money off of it. And honestly, it’s not pink, it’s not fluffy, it’s not a happy disease. It’s breast cancer. And anyone going through it, male or female, or any gender, the pink ribbon is definitely stigmatizing.”
Even Mathew Knowles has publicly fiddled with the true name of his diagnosis, opting instead for the not-quite-accurate “chest cancer” and also “male breast cancer,” which falsely implies a masculine version of the disease.
But I can’t help but wonder if some of the stigma comes from other places as well. In parts of America, the idea of a man doing anything that can be perceived as feminine is politically charged. I also don’t need to point out that we live in a time of aggressive transphobia, which factors heavily in today’s divisive politics. For some political leaders, there’s nothing scarier than the possibility of sharing a public restroom with a woman who was born a man. Even drag queens can’t read books to children at the library without getting political blowback. Under this societal construct, how are men supposed to take seriously a disease that bears the name of a body part so associated with the opposite gender?
Then again, Peter Criss spent his entire career wearing makeup to look like a glam kitty cat, but if that didn’t stop him and his KISS bandmates from earning Kennedy Center Honors last year from our current president, then I don’t think it should stop anyone from heeding Criss’ advice to take charge of our own health.
I’m grateful to not feel bothered by this perceived stigma. I can understand it, but I can also roll with the feminized aspects. I guess if I’ve learned anything from this experience, it’s that everyone has breasts — just different kinds and all of them prone to disease. After all, what part of my body went into those mechanical vices during my mammogram?
In the days after my appointment, I saw a few friends I hadn’t seen in a while. When they asked what was new, I told them I’d just had my first mammogram. Some of them, men and women, thought I was kidding, but I assured them it was no joke.
I share this anecdote with Ambrose and she dives right in, “You helped spread awareness and break down the stigma,” she says, with some gratitude I wasn’t expecting. “That’s what each person who tells their story does.”
More to Read
Disclaimer : This story is auto aggregated by a computer programme and has not been created or edited by DOWNTHENEWS. Publisher: latimes.com
