Bret Miller is celebrating three milestones in 2020: His 34th birthday, his 10th anniversary as a manager for a recreational facility, and a decade of being free of male breast cancer.
In the summer of 2003, 17-year-old Bret was anticipating his senior year of high school and his final year as a member of the football team. One day, he was scratching his chest and felt a mass or lump behind his right nipple. His family did not have medical insurance at the time, so Miller opted to mention the unusual lump to the physician who performed his football physical. “Let’s keep an eye on this. It looks like calcium buildup because you’re in puberty. It will go away,” said the doctor.
One year later, the lump was still there. During a hospital visit to get his meningitis vaccination before heading off to college, he mentioned the lump to another physician who also said it was nothing to worry about.
Missing the Symptoms of Male Breast Cancer
Although the lump did not go away as predicted, the doctors’ assurances helped Miller dismiss his concerns. “I don’t think any doctor thinks a 17-year-old male is at risk for breast cancer,” he told Everyday Health. “Besides, it wasn’t noticeable and you had to feel directly behind the nipple to detect it.” He lived the next seven years of his life without a physical exam. After all, Miller was young and had no health problems.
It was not until 2010 when a yellow-orange discharge began coming out of his nipple. “If I had bothered to look, the symptoms for breast cancer would have been there.” A lump or thickening of the breast tissue, discharge from one or both nipples, and any changes to the nipple and skin of the breast are the common symptoms of male breast cancer.
An Unexpected Diagnosis of Male Breast Cancer
Following a job promotion, Miller finally had health insurance and got himself checked. However, like most physical exams for males, the doctor paid no attention to his breasts. “He was almost out the door when I asked him to take a look at the lump,” recalls Miller. “He said there probably wasn’t anything to be concerned about, but he suggested I have a sonogram.”
The next day, he found himself at a women’s health clinic wearing a pink gown. The doctor had a concerned look on her face as she stared at the monitor. She ordered a mammogram right away and scheduled Miller for a lumpectomy with a surgeon the following week. Instead of worrying and feeling scared as most women would be if they were in Miller’s position, having the unusual mass removed gave him a sense of relief. A call from his surgeon a few days later snatched that feeling away.
“The preliminary report shows you have breast cancer,” Miller recalls the doctor saying with no hesitation. “I haven’t read the pathology report in full, but I will call you back in several days and we will figure it out.” Less than 1 percent of all breast cancers develop in men, and Miller is living proof that no one is safe from this malignant disease.
The “Embarrassing” Truth of Coping With Male Breast Cancer
Following his diagnosis, Miller’s first objective was to find a new doctor. The physician he was working with previously had poor bedside manner and had no experience in treating male breast cancer, something which Miller considered fundamental to the success of his treatment. He ultimately entrusted his care to a doctor who treated 12 male breast cancer patients.
Since the lump in his breast had been around for almost seven years, his cancer care team tried to prepare him for the worst. However, he was luckier than most. Miller received a diagnosis of stage 1 ductal carcinoma in situ (DCIS). This cancer type is slow-growing and unlikely to spread beyond the milk ducts. Therefore, Miller’s tumor had either grown remarkably slow over the last seven years, or it was benign (noncancerous) until recently.
Even though Miller felt relieved about the stage and prognosis of his disease, he considered the diagnosis an embarrassing betrayal. “You think boobs, you think women,” he uttered. “I couldn’t understand it. I didn’t know how to process everything and how I was going to tell everybody.”
Deciding Not to Get Breast Reconstruction
On the 18th of May 2010, surgeons removed Miller’s right breast and four lymph nodes found under his right arm. He had no plans of undergoing chemotherapy until a doctor informed him about Oncotype DX, which is a genomic test that predicts the odds of breast cancer recurrence and helps determine if a patient could benefit from chemo.
The results of Miller’s test showed that having chemo could reduce his likelihood of recurrence by 10 percent. He decided to push through with the treatment, even though DCIS is not typically used for addressing DCIS. “People asked, ‘Are you worried about losing your hair?’ I’d just lost my nipple forever, but my hair would grow back!”
Miller had decided to forgo breast reconstruction as well, saying “This is my scar and this my story.”
Finding Support and Changing the Stigma of Male Breast Cancer
In many cases, finding a supportive community is easier for female breast cancer patients. Male patients and survivors like Miller, on the other hand, often feel isolated. In response, Miller has made it his mission to bring more attention and awareness to male breast cancer. He founded The Male Breast Cancer Coalition, a nonprofit patient advocacy organization focused on helping eliminate the stigmatization of male breast cancer that pushes too many men and physicians to ignore warning signs and delay the need for treatment. Miller is also hopeful that his advocacy helps remove the institutional biases that men with breast cancer endure, including exclusion from clinical trials and treatment denials. But most of all, he aspires to encourage more men to be proactive about their health. “If something feels off, go to the doctor. If you don’t feel okay with the first answer you get, get a second or third opinion.”
Some Thoughts to Keep in Mind
Male breast cancer is very rare, but it is real. If you or someone you know has symptoms of this disease, do not stop until you receive a logical explanation and accurate diagnosis from your doctor. If malignant cells are present, explore the alternative breast cancer treatments available to you by scheduling a consultation with our cancer care team at New Hope Medical Center. Call us now at 480-757-6573.
