It's pretty awkward being a dude with a "female disease."
Breast cancer is largely a "female" disease, with close to 250,000 women diagnosed every year, but it can affect men, too. This month, the cancer-support organization Living Beyond Breast Cancer published a guide for the 2,600 men diagnosed with breast cancer every year. As the guide says, being a man diagnosed with a "woman's disease" can be isolating, even embarrassing. Here's how Bret Miller came to find out he was one of those men—and how he's coped since.
Miller, now 30, first noticed a lump under his right nipple when he was 17. His doctor, and doctors he mentioned it to during the few routine checkups he had over the several years that followed, told him it was probably just a harmless calcium deposit. The lump was never painful, and breast cancer was the last thing on his mind. Even when he squeezed his nipple and a yellowish-orange discharge came out, it didn't immediately raise a red flag. And why would it? Men aren't ever told to check their breasts for cancer. Men don't think of themselves as even having breasts. Pecs, maybe, but not breasts.
About a year and half after Miller, who lived in a suburb of Kansas City, Missouri, first noticed the discharge, he made an appointment for a routine physical. On his way out of the doctor's office, he thought of his mom.
"I knew my mom would kill me if I didn't mention the lump," he told VICE.
This time, the doctor took it more seriously, and Miller was sent to a diagnostic imaging center for an ultrasound. There was no mention of the C word.
When he showed up for his appointment, he was directed to Suite 200, which was filled with women awaiting ultrasounds and mammograms. He filled out his name, address, and phone number on his patient registration sheet. "The rest of the questionnaire was like, 'Are you menstruating? Are you pregnant?'" he remembered. "It was awkward being the only male in there who wasn't waiting for his wife."
After a few uncomfortable minutes in the waiting room, Miller was called in for his ultrasound, and then a mammogram (which hurt like hell thanks to his lack of breast tissue). "They had to grab my nipple and breast and pull it to make sure that it was in the machine while I was hunched over," he said.
After being referred to a surgeon, the doctor decided to remove the lump, even though he too thought it was just a calcium deposit. Miller's insurance company was just as doubtful, and initially denied the claim for the lumpectomy.
The day after surgery, he got a call from his surgeon, who abruptly told him he'd read the preliminary report and it looked like Miller had breast cancer.
"I was like, am I getting Punk'd right now? Did that just happen? What the hell?" Miller recalled. "Once it sunk in I was like, 'Oh crap. He just said I have cancer.'"
At that time, Miller, 24, was the youngest man to be diagnosed with breast cancer in the US (since then, another man was diagnosed at age 22).
After rushing to some of the top doctors in the area, the message was clear: have a double mastectomy. "I was like whoah, whoah, whoah, hold up," he said. "I'm not going to lose both nipples."
His case was so perplexing, it was brought to the local board of surgeons in the Kansas City area, and he ended up in the hands of Lon C. McCroskey, MD, a surgeon at Menorah Medical Center in Overland Park, Kansas, who had performed twelve male mastectomies, a relatively large number. McCroskey told him he could have the second breast operated on several months down the road.
On May 18, 2010, the day of the mastectomy, Miller was given a shot containing radioactive isotopes so the doctor could perform a procedure called a sentinel node biopsy. After removing the nipple, breast tissue, and a one-inch margin around the breast, the isotopes were "lit up," allowing the doctor to determine that his lymph nodes were clear—that, to their surprise, after seven years with the tumor, his breast cancer hadn't spread. He wouldn't be needing that other breast removed after all.
That July, he started his first of four rounds of chemotherapy, a preventative measure that his doctor said could lower his chances of the cancer coming back within ten years from 22 percent to 12 percent. "I figured that if we could drop this number to as low as possible, I have a better chance of doing what I want with my life without ever having to worry about cancer again," Miller said.
Miller never felt sick, but he did lose his hair, including his eyebrows and eyelashes. That's the first time he started to look sick. He thought he looked pretty good bald, but the experience of watching his hair fall out in clumps was deeply disturbing. "In my mind, I was healthy," he said. "I wasn't dying, I was living, but the chemo made me look as if I was dying."
Despite getting off relatively easy, Miller felt like he had nowhere to turn after his diagnosis. The large breast cancer advocacy organizations only serve women—one actually turned Bret away on account of needing "to dedicate their resources to women." Most men have their surgery, heal up, and go back to work like nothing ever happened. It was a lonely feeling not being able to connect with anyone in the same boat.
"There was no support," he said. "I didn't have anyone to talk to. I wished I had someone to tell me that I was walking into the women's clinic. I wished I had someone to talk to about the treatments, the surgery, and so much more."
When Miller decided to tell his friends, he knew they'd be pretty confused by his diagnosis. So he posted a long explanation on Facebook. People were shocked. He was met with a ton of questions. His girlfriend, whom he started dating shortly after treatment, was curious about his scar when they met. "She was like, 'Well, can I see it?'" he laughed. "I get a lot of girls saying that, and I'm like, well, can I see yours?"
Shortly after the experience, he started the Bret Miller 1T Foundation—"1T because there's one T in my name and I have one tit," he laughed. Through this foundation, and now the Male Breast Cancer Coalition, Miller helps share the stories of other men who have been diagnosed, and gives them some of the support he wishes he'd had.
More than anything, Miller marvels at his good luck. "I do wonder how much worse it could have been if I had let this go any further, or if it had spread more than it did," he said. "Would I be in metastatic stages? Would I have died?" But his focus on the grim alternative outcomes is less about his own fate and more about his chance to affect that of others like him. "If I had died, who would have been there to help these other men who don't talk about it?" he said, "men who end up dying because they don't know they can get breast cancer?"