Breast cancer is the most common type of cancer in the UK where approximately one in eight women are diagnosed with breast cancer during their lifetime. Although breast cancer is often thought of as a disease that only affects women, men can get it in rare cases. Approximately 390 men are diagnosed each year in the UK compared to 54,800 women.
When men develop breast cancer – which usually (but not always) occurs in men over 60 - it develops in the small amount of breast tissue that men have behind their nipples. Despite it being considered to be a female hormone, all men produce small amounts of oestrogen and high oestrogen levels in men have been linked to a higher risk of breast cancer. Men can have high oestrogen levels if they are very overweight, suffer chronic liver conditions such as cirrhosis or if they have inherited faulty genes that increase their risk of breast cancer.
Men with a family history of breast cancer that involves close female relatives such as mother or sisters have an increased risk of breast cancer. That risk increases further if the women in their family were diagnosed below the age of 40. The same treatments are available for men as for women with a breast cancer diagnosis and the earlier that a diagnosis is made, the better the chances for successful treatment and a cure.
The most common symptom for men with breast cancer is a lump in the breast area. This is nearly always painless but should not be ignored. Other symptoms include nipple oozing or discharge, breast swelling, nipple retraction, nipple rash and lumps under the armpit.
Men therefore need to report any worrying breast symptoms as soon as they notice them and GPs need to be aware of the need to consider a breast cancer diagnosis in a man and to refer urgently for investigations. A man with breast cancer then requires the same careful and skilled surgical and oncology care as a woman with breast cancer. If that care falls short for any reason, it can have a devastating effect on the man involved.
As far fewer men suffer breast cancer than women, there is less case law on litigated male breast cancer claims. However, one man received £17,000 for a two-year delay in diagnosis of his breast cancer due to poor radiology care, which was admitted by the defendant NHS trust.
The claimant, a 67-year-old man, was referred to hospital by his GP for investigation of a breast lump. An ultrasound was undertaken and, although the breast lump could be seen, it was not defined cytologically. No consideration was given to its nature, structure and pathology and a non-specialist radiologist tried to perform a fine needle aspiration. No biopsy was taken and the man was discharged from hospital care believing that all was well.
His breast symptoms continued until he saw his GP again almost two years later. He then underwent further breast clinic investigations and a biopsy was performed and considered by a specialist breast cancer team which made the breast cancer diagnosis. The man required a breast mastectomy to remove the tumour surgically, lymph node removal and radiotherapy. The claimant established that the hospital care he received initially had fallen below an acceptable standard. He claimed that if his breast cancer been diagnosed two years earlier, he would probably have only required a lumpectomy – a less extensive surgery than a mastectomy - and would not have required radiotherapy.
Alison Johnson, a partner in Penningtons Manches Cooper’s clinical negligence team, undertakes oncology claims including breast cancer cases. She says: “It must be extremely hard for anyone to cope with a breast cancer diagnosis. Women often report feeling shocked, frightened and confused but men may also feel isolated and even embarrassed as breast cancer is much rarer in men and there seems to be very little information and support specifically for men with this diagnosis.
“I urge men to come forward to report any breast symptoms to their GP so they can be treated as early as possible and maximise their chances of survival.”