Bret Miller is a 10-year breast cancer survivor, and he’s a guy.
He was 17 when he first found a lump in his breast, but he was not diagnosed with breast cancer until he was 24. Bret lived with that lump for 7 years, being told repeatedly by his doctors that it was a calcium buildup, it was just puberty, and it was nothing to worry about.
He went to get a routine physical at age 24, and his doctor told him he was completely healthy and good to go. “But I stopped him before the end of the exam, because they don’t do breast exams for men during a physical,” he said at the Academy of Oncology Nurse & Patient Navigators 11th Annual Navigation & Survivorship Conference. “I asked him to come back in to look at the lump I’d had under my right nipple for 7 years, give or take.” He says that’s when his doctor stopped, turned around, and came back in the room.
After looking at and feeling the lump, Bret’s doctor immediately sent him for a sonogram at a local imaging center. He walked into the imaging center (unaware that it was a women’s clinic), and completed his sonogram. He remembers the doctor doing a triple-take at the monitor and immediately sending him for a mammogram.
“So there I was, walking down the hall in my pink gown to get my mammogram,” he recalled. The imaging from the mammogram did not immediately lead to a diagnosis (they still assumed it was a calcium buildup), but it did help his doctors decide that surgery to remove the lump was the best path forward. The day after removing the lump, on April 28, 2010, Bret received a call from his doctor telling him that the preliminary reports suggested breast cancer, and that he would be in touch again in 3 to 5 days.
“There was no bedside manner,” he said. “No, ‘are you sitting down?’ or anything like that. It was like a bomb; I was shell-shocked.”
After he let his mom know the news, they planned to meet with the doctor the following day (rather than 3-5 days later). His parents, he says, helped set him up with his “angels.” His nurse navigator was named Mary Williams, and she helped him “tremendously” throughout his cancer journey. “She helped get my case into the hands of some of the top local doctors, and that helped me to get the best treatment,” he said.
The surgeon who performed his mastectomy had “amazing” bedside manner, he added. Even more than that, this particular surgeon saw something in Bret and told him that if he was willing to share his story, he could be the face of male breast cancer and could help other men feel more comfortable with a breast cancer diagnosis. He told Bret that he had performed mastectomies on 12 men before him, and “pretty much every single one of them took time off work, had their surgery, then went back to work and acted like nothing happened.”
“Hearing that from a surgeon who had only known me for 15 minutes really opened up my eyes to the fact that this was bigger than me, and bigger than a diagnosis,” he said. “This is something that needs to be talked about, as more and more men are getting diagnosed with this. This is not a women’s disease. This is a people’s disease.”
Since then, Bret has devoted his time to helping men become their own biggest advocates and to know their own bodies. Approximately 2600 men will be diagnosed with breast cancer just this year, though he maintains that those numbers are likely skewed. “If you feel something, say something,” he said. “Go to the doctor; get second, third, and fourth opinions, whatever it takes until you feel comfortable.”
After his single mastectomy on May 18, 2010, his oncologist encouraged him to undergo genetic testing, through which he learned that he did not carry the BRCA1 or BRCA2 genetic mutations. After surgery and 4 rounds of chemotherapy, he continued treatment with Arimidex for the next 5 years, and he has been free of cancer ever since.
In 2014, he helped to co-found the Male Breast Cancer Foundation, a global resource support group for men diagnosed with breast cancer. “We want to let men know they’re not alone when they hear the words, ‘You have breast cancer,’” he said. “We need to make sure that men are getting included in the research, in the trials, in the terminology, and in the ads on TV.”
Inclusiveness is crucial, and according to Bret, the language around breast cancer should reflect that (eg, try saying “people diagnosed with breast cancer,” rather than “women diagnosed with breast cancer”). He added that although men sometimes call it “chest” or “pec” cancer, the breast tissue is what actually contains the cancer, and men should not feel ashamed to call it what it is.
Many men do not know they have breast cancer until they have stage IV metastatic disease, but if they were included more often in the research and in the dialogue surrounding breast cancer, they might be getting diagnosed at earlier stages, when their cancer is more treatable.
“Through it all, I went through some hurdles because it’s always framed as a women’s disease,” he said. “There were times I was addressed as a female in paperwork, and I had to go to women’s clinics for treatment, which was very off-putting and emasculating. But if we could involve men in the terminology, putting a splash of blue in a sea of pink, I think we’d be in a better place.”