Improving Outcomes for Men With Breast Cancer Starts With Awareness: Michael Hassett, MD

Male breast cancer accounts for just 1% of all breast cancer cases, yet its rarity and the lack of public awareness surrounding it often lead to delayed diagnosis and unique challenges in care. In this interview, Michael Hassett, MD, MPH, chief quality officer at Dana-Farber Cancer Institute in Boston, explains why raising awareness is critical, how treatment approaches compare with those used for women, and why dedicated research and better understanding of treatment-related adverse effects in men are essential to improving outcomes.

This transcript has been lightly edited; captions were auto-generated.

Transcript

Breast cancer in men is one of your clinical interests. Compared with breast cancer in women, we hear so much less about breast cancer in men. How can we change this?

It's tough. I think talking about it and raising awareness is the most important thing; 1% of all breast cancers occur in men. Breast cancer in men is more common than some sarcomas or other rare cancers, and so being aware of it is important. I say that because if we don't think about it, if we don't address it, then men tend to present with more advanced cancers because they're not thinking, "Oh, I need to worry about this being a breast cancer." They sort of don't make that mental connection, and then the cancer is more advanced when it presents. I think just making sure that we think about it, and that's less on me as a medical oncologist, and more on trying to just get the message out there in the public and in the primary care provider space so that when we see problems develop, we can think of that as a treatment option.

Breast cancer in men, fortunately, most of the treatments are similar to the approaches that we take in women, but not 100%. And I think another thing that we can do to address some of this challenge is to do more specific studies of breast cancer in men, and we have Dr [Jose Pablo] Leone and folks who are trying to conduct clinical trials to help us understand: are there specific differences, particularly in how we treat breast cancer in men with these estrogen blocking hormonal treatments, and are there ways that we should be thinking fundamentally differently about them? We think, in general, that chemotherapy, for example, is going to be used sort of similarly in men vs women. But there are still some questions, I think, about how we use hormonal treatments.

The last thing that I'll say is—and this ties in with what we were talking about before—about symptoms and adverse effects from treatment. We have to understand for men with breast cancer, especially those who are on hormone-blocking medicines, how do we address the side effects that they experience. That's a very real thing. We spend a lot of time now, fortunately, thinking about managing the sort of menopausal side effects that women experience on estrogen-blocking treatments. But men have side effects, obviously, as well, and I think we don't know as much about how to manage some of those side effects safely without affecting their cancer risk. And some more research there would be helpful.