Mammograms for men: Procedure, risk factors and what to expect

I show up for my appointment. A nurse asks me to undress from the waist down and put on a gown with the opening in the front. I can’t for the life of me find the right way to tie the pom poms on the dress. When I mentioned this feat of incompetence to the technologist in the exam room, she told me that I could have just taken off my shirt. The nurse, she said, “is not used to male patients for mammograms.”

Thus began my first of many regular mammograms, screenings that, as a man, I never thought I would need. I guess this nurse didn’t expect it either.

Let’s be clear, the statistics on breast cancer in women are downright frightening: one in eight women will be diagnosed with breast cancer in their lifetime. For men, this figure is only 1 in 726. Considering these numbers, it is obvious and even reasonable to understand why breast cancer is considered a greater threat to women’s health. But much of the culture surrounding the disease seems rooted in a gendered mold, including those pink awareness ribbons, pink merchandise, wigs, fraternities, and the general idea that men don’t have breasts in the first place, so why the hell should they worry about getting breast cancer?

In fact, some of us should be worried. Breast cancer in men is not so rare that it has not affected a few male celebrities, like Peter Criss, drummer of KISSactor Richard Roundtree (star of “Shaft”), and famous by association, the father of Beyoncé, Matthew Knowles. Despite these high-profile diagnoses, the perception of breast cancer as a threat to men’s health has difficulty becoming widespread.

Cheri Ambrose founded the Male Breast Cancer Global Alliance more than a decade ago after learning that her friend’s husband had been diagnosed with breast cancer. She searched the Internet for information about it. “And to my surprise, there was nothing for men,” she told me. “It was crickets.”

Dr. Aditya Bardia is a breast cancer oncologist at UCLA. He has been in this field for 15 years and has treated over 20 men in that time. He says men should watch out for nipple bumps, pain, discomfort or inversion. “If you have it, have it checked with an ultrasound,” says Bardia. “Otherwise, if a man is only at average risk, then a mammogram is not necessary. But if he has BRCA and a family history, then a mammogram is recommended.”

The genetic risk factor

These major risk indicators inspired me to embark on my own cancer prevention safari. My mother was diagnosed with breast cancer in 2000 and my grandmother a decade earlier. Add to that the fact that I am of Ashkenazi descent and am about as susceptible to breast cancer as any man.

To get a more accurate genetic indicator of cancer risk, my mother encouraged me to have my DNA tested for the BRCA1 gene mutation. Sure enough, I tested positive for BRCA1, and now my doctors and I are on alert not only for breast cancer, but also for related cancers like prostate and pancreatic cancer. (While it is not publicly known whether Richard Roundtree was BRCA1 positive, he survived his battle with breast cancer only to die decades later from pancreatic cancer, suggesting he may have carried the genetic mutation.)

The mammogram experience

After testing positive for BRCA1, the geneticist I spoke with pointed out that my biggest new health problem would be prostate cancer. So I was a little surprised when my GP recommended a first mammogram. I didn’t know what to expect.

This is where I have to say that the scope of what I don’t know about women’s health is probably broader than I’d like to admit. My first exposure to the realities of what a mammogram procedure actually entails came while watching the pilot episode of “Girls5eva.” We meet the character of Sara Bareilles for the first time when she is in the process of obtaining one, clinging in a somewhat medieval way to a mechanical vice which dominates her well. I knew that uncomfortable breast compression was involved; I just didn’t realize that a machine did all the work. “Girls5eva,” if you’re unfamiliar, isn’t an old show, which means I’ve been ignorant for most of my life about how a mammogram actually works.

Yet as I headed to my appointment, I wondered, because I’m a man, how my own mammogram would be different from the one I saw Sara Bareilles take on TV. Turns out it wasn’t much different at all.

After taking off this gown, the technician positioned me chest forward against her own mechanical vice. I was asked to hold my breath while the machine gave me two tight squeezes on the left and two tight squeezes on the right, each squeeze lasting a few seconds. Yes, it was uncomfortable, but relatively light as far as medical procedures go – simple, brief and non-invasive. My biggest irrational fear was that the machine might squeeze much harder than necessary and I would be stuck there in immense pain until someone unplugged the cord. Of course, that didn’t happen. In fact, nothing else happened. I was in and out of the building in less than 15 minutes.

The results? “No masses, calcifications or other significant findings are observed in either breast.” Good to know.

Navigating and breaking gender stigma

The mammogram itself was a breeze, but I have to admit that there were times during this journey of learning about cancer risk when I felt like a tourist poking through someone else’s health story. It wasn’t just the gown incident or the geneticist who assured me that prostate cancer would be my main BRCA-related concern. When filling out a required questionnaire before scheduling my mammogram, I had to answer questions like, “Have you had an entire breast removed?” “” and “Is your bra size larger than 42DD?” I said no, but if there had been a “N/A” option, I would have chosen that instead.

Bardia acknowledged the disconnect. “Because it’s relatively rare for men, the guidelines and management for men are informed by the guidelines and management for women,” he told me.

In a different context, some people might misinterpret these gender hiccups as microaggressions. Personally, I don’t feel that way, but I try to be fair, taking into account both the tremendous toll that breast cancer inflicts on women’s bodies in far greater numbers and the stigmatic pain that men might experience in their own breast cancer journey.

Let’s be real: stigma against men is real and it has consequences. “Even though it’s much rarer, the mortality rate for breast cancer in men is 19% higher than in women,” Ambrose says. “It’s because of the lack of awareness and, I think, the stigma.”

Much of this stigma, Ambrose believes, is the unfortunate proliferation of the association of breast cancer with the color pink. “Pink is not a cure,” she says. “Unfortunately, in October, it became a source of income for everyone, not just breast cancer organizations. People are making pink bagels, pink pens and even little pink ducks. People are making money from that. And honestly, it’s not pink, it’s not fluffy, it’s not a happy disease. It’s breast cancer. And anyone who suffers from it, male or female, regardless of their gender, the pink ribbon is definitely stigmatizing.”

Even Mathew Knowles publicly manipulated the real name of his diagnosis, opting instead for “breast cancer” and also “male breast cancer,” which falsely imply a male version of the disease.

But I can’t help but wonder if some of the stigma comes from other places, too. In some parts of America, the idea of ​​a man doing anything that could be perceived as feminine is politically charged. I also need not point out that we live in an age of aggressive transphobia, which plays a significant role in today’s political divisions. For some political leaders, there is nothing more frightening than the possibility of sharing a public toilet with a woman born a man. Even drag queens can’t read books to children at the library without facing political backlash. In this societal construct, how are men supposed to take seriously a disease that is named after a body part so associated with the opposite sex?

Then again, Peter Criss has spent his entire career wearing makeup to look like a glamorous cat, but if that didn’t stop him and his KISS bandmates from winning Kennedy Center Honors last year from our current president, then I don’t think it should stop anyone from following Criss’ advice to take charge of our own health.

I’m grateful that I don’t feel bothered by this perceived stigma. I can understand it, but I can also accept the feminized aspects. I guess if I’ve learned anything from this experience, it’s that everyone has breasts – just different types and all prone to disease. After all, what part of my body was affected by these mechanical defects during my mammogram?

In the days following my appointment, I saw a few friends I hadn’t seen in a long time. When they asked me what was new, I told them that I had just had my first mammogram. Some of them, both men and women, thought I was joking, but I assured them it wasn’t a joke.

I share this anecdote with Ambrose and she dives straight into the matter: “You helped raise awareness and break the stigma,” she says with a gratitude I didn’t expect. “That’s what every person who tells their story does.”