This time last year, Owings Mills resident and Beth El Congregation member Rick Yaffe was preparing to undergo a medical procedure that not many men have to prepare themselves for, for a condition not many men experience.
A year after his mastectomy, part of his treatment for breast cancer, the 64-year-old paramedic, EMT, and 25-year veteran of the volunteer fire service is sharing his story to raise awareness among other men.
Men with breast cancer tend to have worse outcomes than women, according to research recently published in JAMA: The Journal of the American Medical Association. Looking at patients with a breast cancer diagnosis during a 10-year period, researchers found that male breast cancer patients had a 19% higher mortality rate than women.
Dr. Paula Rosenblatt, a breast medical oncologist at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, agreed that male breast cancer is a relatively rare form of the disease. There are approximately 2,600 cases of male breast cancer a year in the US, constituting “only 1% of breast cancer cases,” she said.
According to Rosenblatt, around 500 men die from breast cancer each year, though she emphasized that most men who succumb will first live for many years with the disease. “Five-year survival [rate] is 84%,” she said.
Yaffe’s cancer journey began with a seemingly normal physical with his doctor.
“He found a small lump on my breast, and he asked me what that was,” said Yaffe. “I said ‘I have no idea.’ He suggested I get a mammogram, which I never had before.”
Yaffe was sent to Dr. Michael Schultz, head of the University of Maryland St. Joseph Medical Institute’s Breast Center, who ordered a few more tests.
“He was very good at explaining everything that was going on, and made me feel very comfortable,” Yaffe said.
When asked about his illness, Yaffe said he “took it more scientifically than emotionally, as a paramedic.”
“I did what needed to be done, and followed the doctor’s directions,” he recalled.
“Treatment of male breast cancer is very similar to female breast cancer,” said Rosenblatt. “Patients need surgery and may need chemotherapy, radiation, and hormone treatments depending on the specifics of the cancer.”
“Most men chose mastectomy over breast conserving surgery given the small amount of breast tissue, but this is a choice for the patient,” she said.
“I did not have radiation, I did not have chemotherapy,” said Yaffe. He did have to take an estrogen-receptor blocker called Tamoxifen in pill form.
When asked about his post-surgery experience, Yaffe said that not being able to take a shower normally for a few days “was probably the biggest challenge.”
“You had drains, and you couldn’t take a shower with drains, so I had to wait until the drains were removed. They put drains in under your skin, to make sure the skin tissue can adhere. Fortunately, there wasn’t a lot of pain.”
“I had very good care, and I was very fortunate in that sense,” he said.
The difficulty of recovery from male breast cancer can vary from patient to patient, said Rosenblatt.
“Depending on the type of treatment, the impact on quality of life can have significant differences,” she said. “A patient that needs a mastectomy but no chemotherapy may heal in weeks. A patient that needs chemotherapy will require months of therapy and can have longer term side effects. Most patients require a medicine that targets the estrogen receptor. This can cause hot flashes, mood changes, a drop in libido that impacts quality of life.”
Thankfully, “most patients are able to resume most of the activities from prior to the diagnosis,” she added.
Rosenblatt pointed out that Ashkenazi Jews have higher rates of BRCA mutations, and BRCA mutation is associated with increased risk of male breast cancer.
“Importantly, all patients with male breast cancer qualify for genetic testing for hereditary breast cancer,” she said.
It was advice that Yaffe took to heart. “I got tested for the BRCA gene to make sure mine wasn’t hereditary,” he said. “The test came back negative, so I did not inherit it from my family, so that meant that my kids did not have it either.”
Looking back on the experience, Yaffe offered the following advice: “Every male should check the breast for lumps or bumps or anything that looks unusual, and seek medical advice immediately.”
“I am always willing to share my story with the hope that I can encourage all males to get checked for breast cancer,” he said. “It’s important for males to know that early detection leads to better outcomes.”