Last December, Christopher Gallo felt a weird lump under his nipple, about the size of a peanut. He put it out of his mind and went on with his life. By March, it hadn't gone away, and he and his wife became concerned. "I went to my doctor, and he immediately sent me to undergo more tests," says Gallo, 43. "On March 13, my diagnosis came back. I had breast cancer."
Gallo and his wife were shocked. It's not that he didn't know men could develop breast cancer, but it was something he never thought would happen to him. "I have one aunt on my mom's side with breast cancer," he says. "It's not like it runs heavily in my family."
Breast cancer is rare in men. Less than 1 percent of breast cancer cases in the United States are diagnosed in males, but according to the American Cancer Society, about 2,360 men will be diagnosed with breast cancer each year. Risk factors for men are the same as for women and include a family history of breast cancer, alcohol or tobacco use, being of Ashkenazi Jewish decent, obesity and high estrogen levels.
For Gallo, the culprit turned out to be genetics. "Right after I was diagnosed, my doctor referred me to a genetic counselor," he says. "I had the BRCA test, and I came back positive for the gene." The BRCA gene is a mutation that raises your risk for breast cancer by up to 85 percent and can be passed down in your family.
There's no difference between men and women diagnosed with breast cancer, says Marleen Meyers, an assistant professor of medical oncology with NYU Langone Medical Center. Detection, treatment and prognosis are the same. The only problem is that men tend to get diagnosed much later than women. "Men are not undergoing routine screenings," she says. "They only seek medical attention when they feel a lump, whereas women have routine screenings and get it identified earlier. By the time men come in, the tumor is usually at least 1 centimeter in size, and the cancer has often spread."
Gallo's tumor was 2 centimeters by time he went for surgery, and the cancer had spread to his lymph nodes. He opted for a double mastectomy and had his breast tissue and 30 lymph nodes removed. Then he started chemotherapy. "It was pretty rough," he says. "[I] did eight treatments over 16 weeks. It left me really nauseous and in incredible pain. I've been finished for almost a month now, and I'm still feeling the effects. It's turned my life upside down."
Gallo, who works in law enforcement in Tampa, Florida, has been unable to return to work since his diagnosis, as the chemotherapy has left him feeling constantly fatigued. Luckily, he says, his family and friends have supported him the entire way. "Everyone stepped up to help me," he says. "Whether it's cutting my lawn or giving me a ride to get my treatment, the support has been amazing. People bring food to the house and have even organized fundraisers to help me pay for treatment. It's been overwhelming."
Unfortunately, Meyers says, support for men cancer patients lacks at the national level. "Men don't have the funding or support groups that women have," she says. "Many studies open to women are not open to men. If there are trials out there, being a male is usually an exclusion to them."
Even in doctors' offices and treatment centers, male patients can feel like outsiders, Meyers says. "They're often surrounded by women and the color pink," she says. "It can make them very uncomfortable."
To address the problem, Meyers says doctors and patients need to use National Breast Cancer Awareness month to do what was originally intended -- raise awareness, only now, for breast cancer in men. This starts by simply talking about it. "It's hard in the midst of all this pink to have a man stand up," she says. "As more people talk about it, it will begin to lose some of its stigma."
Gallo agrees the biggest step toward removing the stigma is to change what Breast Cancer Awareness Month is all about. "It's very geared toward women, which is understandable, but it kind of excludes men from it," he says. "Make October about breast cancer in general, not just women's breast cancer."
But it's not just the public that needs to talk about male breast cancer patients and survivors, Meyers says. Doctors have historically done a bad job educating male patients about the disease. "Physicians don't recognize, think about or evaluate male breasts [enough]," she adds.
For that reason, men need to take the impetus to check their own breasts regularly, says Jamie Wagner, an assistant professor of surgery at the University of Kansas Medical Center's breast surgery division. "We promote self-exams for testicular cancer," she says. "This is no different. Know what's normal for you, and if you find something that's not normal, get it checked out. Don't put it off."
The best time to do an exam is while you're showering, Wagner says. "You're already feeling over that area," she says. "Take two seconds to feel what's underneath the soap."
Self-exams not only help detect cancer early -- they help protect your family against cancer as well, Meyers says, especially if you test positive for the BRCA gene. "We used to think that when we take a family history, you only needed to tell me about breast cancer on the mother's side," she says. "But we know now that BRCA is carried on both sides. And because male breast cancer is rarer, if your family doesn't have a lot of women it may not show up in family history."
Gallo has finished chemotherapy and will soon begin radiation treatment to hopefully get rid of the cancer for good. However, this doesn't mean his family will no longer have to think about the disease. He has two daughters, ages 9 and 12, who could potentially be carriers for the BRCA gene, which would put them at a high risk for breast and ovarian cancer. "They are too young to get tested for the BRCA gene right now, but once they're 16, we'll absolutely get them tested," he says. "Hopefully they're negative, but if not, we'll discuss options."
Ultimately, even though breast cancer research will likely continue to be focused on women, Wagner says as more men like Gallo share their stories, she expects men to make up a larger voice in the community. "It's very much a female disease," she says. "But recognizing that it's not exclusive to females will help us move forward to try and get us past the stigma. We need to understand that breast cancer is devastating, regardless of gender."