Did a schoolboy joke save Robert Pfleghardt, a 60-year-old American? Probably. A friend’s intrusive gesture during a guys’ outing uncovered a lump in his chest…and likely saved his life.
An invisible cancer pointed out
In 2021, Robert Pfleghardt, close to sixty, leaves accompanied by several friends for Las Vegas for a trip between men. The atmosphere is festive, and the men, who know each other well, enjoy a drunken evening. As a “tasteful” joke, one of his friends then pinches his nipple. But the pain he feels and which persists beyond the gesture surprises him.
“We are good friends, we had a little drink and we were having fun”remembers Robert Pfleghardt, now 62 years old.
A week later, and back in real life, Robert feels his chest more precisely. And discovers a small induration right next to her nipple.
A mammogram, and everything comes together to survive
Robert doesn’t panic. To tell the truth, he doesn’t imagine that it could be cancer. “It was a bit strange, but I skipped it. I thought men couldn’t get breast cancer, so I didn’t pay attention to it.”he confides to People magazine.
But the lump does not go away and Robert makes the wise decision to have it examined. A mammogram and several exams later, the verdict is in: the man suffers from breast cancer, and the tumor has already spread to a lymph node.
Robert finds himself faced with the choice offered to many women: mastectomy? Breast-conserving surgery? He opted for the latter and received 29 radiotherapy sessions. A decision which allows him, five years later, to be there to talk about it.
Breast cancer also exists in men
Of more than 50,000 cases of breast cancer detected each year in France, less than 1% are detected in men. This pathology remains poorly understood among them, including among health professionals.
“This cancer is spontaneously associated with women”,
recognizes in a previous True Medical article Professor Hervé Curé, professor of oncology. “When dealing with a man, doctors still think about it too rarely.”
This lack of knowledge explains in particular why the disease is often diagnosed at a more advanced stage in humans. The absence of organized screening and sometimes non-specific symptoms also delay treatment.
The prognosis is therefore less favorable than in women, with a five-year survival rate estimated on average at 69%, compared to 80% in women. The risk of metastases is also higher.
One thing is certain: the earlier the diagnosis and treatment, the better the prognosis for the patient.
Why can men get breast cancer?
Robert’s story is not surprising. Mammary glands exist in humans, even if they are poorly developed. The milk ducts are notably much thinner than in women. Cancer cells can therefore also appear in the chest.
In the vast majority of cases, male breast cancer is an infiltrating ductal carcinoma. The tumor begins in the milk ducts before gradually invading the surrounding breast tissue.
As in women, certain genetic factors can promote its appearance. Around 15% of breast cancers in men are linked to a hereditary mutation of the BRCA1 or BRCA2 genes. A family history of breast cancer is therefore also a risk factor.
What signs should alert men?
The symptoms of breast cancer are generally similar in men and women. An unusual change in the chest should prompt consultation, in particular:
- A lump in the breast, often painless, discovered during self-examination;
- Nipple retraction or deviation;
- Redness, swelling or a feeling of warmth in an area of the breast;
- Localized pain;
- Palpable lymph nodes in the armpits;
- A discharge from the nipple, especially if it is colored or bloody.
One of the most commonly reported signs in men is the palpation of a painless mass, usually located behind or near the nipple, at the areola.
Too often, in men, the discovery of breast cancer is by chance.
How is the diagnosis made?
“It is following the discovery of a lump in the breast that the patient consults. After the clinical examination, it is then the sequence of a suspicious ultrasound, followed by a mammogram, which reveals the cancer. A breast biopsy will then confirm the doubts, reporting tumor cells typical of breast adenocarcinoma.explains Professor Hervé Curé, professor of oncology, in a previous article in True Medical.
A lymph node biopsy may also be performed. Other examinations may then be offered depending on the situation in order to assess the extent of the disease and look for possible remote locations.
Several treatments can then be offered depending on the type of cancer, its stage and the characteristics of the tumor: surgery, radiotherapy, hormonal therapy, chemotherapy or targeted therapies.
As in women, treatment is now personalized according to the profile of each tumor.
Surgery is often the first-line treatment. It can be supplemented by radiotherapy, chemotherapy or hormonal therapy, depending on the characteristics of the disease.
Hormone therapy aims in particular to block the action of certain hormones likely to promote the growth of cancer cells. Chemotherapy and radiotherapy can be used before or after surgery depending on the situation.
“My friend saved my life”
Robert Pfleghardt is convinced that he probably would have discovered his tumor much later if not for his friend’s joke.
“My friend, who pinched me, saved my life. Otherwise, I would not have found the tumor and the cancer would have spread further.”
He can now laugh about it with his friends: “Men’s travel saves lives”. Her story has the merit of reminding us that men are also affected by breast cancer.