Mammograms boost early detection of breast cancer

Breast cancer is the leading type diagnosed among women in Kenya, just as is the case in a majority of the countries globally.

Since the disease mostly affects women, most awareness campaigns, as well as research on diagnosis and treatment of the cancer usually focuses on females.

An example is the gold standard test for detecting the disease, which is known as mammography. The technology has been tested and studied extensively in women.

As such, so much is known about the impact of this diagnostic tool in women, compared to men who often seem ‘forgotten’ yet they can also get breast cancer.

A new study published in the Radiology Journal sought to address this gap. Findings of the study showed that mammography was more effective at detecting cancer in high-risk men than is the norm for women at average risk of breast cancer.

During the study, researchers from New York University (NYU) School of Medicine assessed 1,869 men aged between 18 and 96 who had undergone a mammogram test between 2005 and 2017.

Some did so because they felt a mass (lump) in their breast, while others had no symptoms and wanted to be screened because a family member had recently been diagnosed with the disease.

In total, 41 men were found to have breast cancer, as confirmed by breast tissue biopsy. Among the 271 men who had screening exams, five had the disease.

All the people diagnosed with breast cancer underwent surgery (mastectomy) to remove their tumour.

This was the largest review in the United States of medical records of men who have had a screening mammogram.

For every 1,000 exams in these men, 18 had breast cancer. The detection rate for women is roughly five for every 1,000 exams.

The researchers attribute this result in part to the lower amount of breast tissue in men. Having more tissue, which is common in women, can mask the detection of small tumours.

"Our findings show the potential of mammography in screening men at high risk for breast cancer and in detecting the disease well before it has spread to other parts of the body,” said Dr Yiming Gao, the lead author of the study from the NYU School of Medicine, Perlmutter Cancer Centre.

Most national cancer care guidelines recommend mammogram tests for women above 40.

Men are not usually targeted unless they exhibit breast cancer signs like lumps in the breast.

Results of the new study indicate that men at high risk of the disease can benefit from mammograms that will allow doctors to detect the cancer early, before symptoms develop.

This will enhance treatment success and survival outcomes.

Another main finding of the study was that men who had already had breast cancer were 84 times more likely to get it again than men who had no history of the disease.

Men with an immediate relative who had breast cancer, such as a sister or mother, but not a cousin, were three times more likely to develop the disease.

"Men at high risk of breast cancer often seek testing because a female family member had the disease," stated Dr Samantha Heller, a radiologist and senior investigator of the study from the NYU Perlmutter Cancer Centre.

"In general, men need to be more aware of their risk factors for breast cancer and that they too can develop the disease."

Indeed, most of the men in the study sought testing because of concerns about a breast mass.

HIGHER RISK

According to Heller, the lack of targeted screening for men at high risk, as well as the tendency to wait to feel a lump before seeking care may explain why men have a higher risk of dying from breast cancer. Yet, the disease is much more common in women.

Other risk factors for breast cancer in men are genetic mutations such as BRCA1 or BRCA2.

Those with these mutations are up to seven times more likely than men with no genetic risk to suffer from the disease.

Before any changes to national cancer clinical guidelines are made, the researchers noted that more research is needed to determine at what age and how often mammograms should be performed in men at high risk.

"With increasing numbers of women and men seeking genetic counselling for breast cancer, there is a need for advice to both men and women about their actual risk,” said Gao.

“They also need guidance about the best screening practices to make sure if they do get the disease, that it is detected and treated early," says Gao.