Breast Cancer Strikes 1,000 Men Annually : Health: The symptoms are the same for men as for women. But it often goes undetected because it is thought of as a woman’s disease.

RICHMOND, Va. —  Walter, a 64-year-old, considered himself to be in great physical condition. He regularly worked out at the gym. He ate all the right foods.

When he felt a lump in his chest last November, he asked his doctor about it.

“He stuck a needle in me, took some cells out and put them under the microscope,” Walter said in a telephone interview from his home in the Milwaukee area. “My life came crashing down right about that moment.”

Not only did Walter have cancer, he had breast cancer--a so-called woman’s disease.

“I was in total disbelief,” he said. “No one ever brings up the subject of it happening to men.”

Walter, not his real name, isn’t alone.

Every year, about 1,000 men are stricken with the disease, about O.5% to 1% of the total number of breast cancer cases, according to Dr. Harry D. Bear of the Medical College of Virginia in Richmond.

Bear, a surgical oncologist at MCV’s Massey Cancer Center, specializes in breast cancer.

The problem is much more common among women because they have more breast tissue and because of the hormonal influence of estrogen, which Bear said affects breast cancer although doctors aren’t sure how.

It once was believed that men who have gynecomastia--excessive development of breast tissue--were more at risk, but that condition no longer is considered a factor. Age, however, is a major factor. The disease usually strikes middle-aged or elderly men.

The symptoms are the same for both sexes: a hard lump, changes in the nipple, or changes in the skin. In men, the lump usually develops immediately behind the nipple. The most common location in women is the upper outer quadrant toward the underarm.

Bear said treatment varies according to how advanced the cancer is. Treatment includes chemotherapy, radiation, anti-hormonal therapy, lumpectomy and mastectomy.

“It’s a serious disease, just as serious in men as it is in women,” said Dr. William L. Donegan, a professor of surgery at the Medical College of Wisconsin in Milwaukee. “But the incidence is too low to justify screening mammograms for men on a routine basis.”

Donegan estimates that he has seen 20 to 30 cases of male breast cancer.

About 200,000 new cases of breast cancer will be diagnosed this year, said Stacy Charney of the American Cancer Society in New York. The disease will kill 46,000 women and 300 men.

Bear said men who seek treatment usually have a more advanced stage of the disease.

“That’s because they don’t recognize what’s going on because they don’t feel like it could be breast cancer,” he said. “When it’s been carefully looked at, the prognosis for men is almost identical to that for women at the same stage.”

While support groups abound for women with breast cancer, there is no such help exclusively for men.

“I think there’s less of a psychological, emotional trauma associated with the treatment for men than there is for women,” Bear said. “I don’t think men attach the same psychological and cosmetic importance to their breasts as women do.”

He has treated about a half-dozen male breast cancer patients in his 15-year medical career. He said the patients didn’t seem to be embarrassed because they had the disease.

“They end up with a scar and they’re minus a nipple, but they don’t usually get cosmetic surgery,” Bear said.

Walter underwent hormone therapy and a mastectomy, the most common treatment for breast cancer in men. His prognosis “has been very good,” he said.

However, only his family knows about his disease.

“I can’t share it with friends,” Walter said. “In my profession, if anyone knew I had cancer and there is a risk in the future, it would be the end of my career.” He declined to disclose his occupation.

He said he always has a towel draped over his right shoulder at the gym now, but he won’t consider cosmetic surgery. He said he isn’t embarrassed by what happened to him.

“What I did feel was terrible sorrow for some of the women that have to go through it,” he said. “Now I know what they go through.”