BIG against breast cancer small Pink Ribbon
 Think BIG News
 25 March 2014
Male breast cancer does not always get a significant amount of attention. Breast cancer is mostly viewed as a female disease. People often do not know that it can also affect men. Because of the rarity of male breast cancer, which accounts for less than 1% of all breast cancers diagnosed worldwide, not much has been published or discussed on the topic and very little has been done in terms of scientific research.
In this issue of Think BIG news, we will shine the spotlight on male breast cancer, and talk with Dr. Fatima Cardoso, Director of the Breast Unit at the Champalimaud Cancer Center in Lisbon, Portugal, who is one of the initiators of a BIG / NABCG sponsored programme to study male breast cancer.
We gathered the largest ever collection of male breast cancer samples. What's next?
Male patient
Men affected by breast cancer find little support in their fight against the disease. They are frequently excluded from breast cancer trials, and, in deciding which treatments to offer, their doctors usually extrapolate from the therapies given to the women with breast cancer.

In 2006 two top experts in breast cancer, Dr. Fatima Cardoso and Dr. Sharon Giordano, decided that it was time to better understand this rare disease and raise awareness and interest among the scientific community.  They brought the project to the table for discussion with BIG and its American counterpart, the North American Breast Cancer Group (NABCG). This is how the first international academic research programme to study male breast cancer was born under the BIG-NABCG umbrella.

Now called the “International Programme of Breast Cancer in Men,” it is being led by the European Organization for Research and Treatment of Cancer (EORTC) with the help of the American Translational Breast Cancer Research Consortium (TBCRC). This purely academic programme is funded by several grants, including a significant support from the Breast Cancer Research Foundation (BCRF).  
Its objective is to gather and analyse critical medical information about the biology and evolution of male breast cancer, in order to help cancer physicians learn more about this rare disease and to guide them towards better treatments and support for their patients in the future.

The programme is divided into three parts. Part 1 started in 2010 and was closed in September 2013 with a total of 1822 patients enrolled in the programme.  According to Dr. Cardoso, "We have built the largest collection of male breast cancer samples ever! About 1800 samples were sent to two central laboratories, one in Europe and one in the US. Samples are now being analysed to better understand the biology and the evolution of the disease. Analysing data for past patients will also enable us to understand how this disease has been treated and to have an idea of the efficacy of the different therapies used for these patients."
Meet Dr. Fatima Cardoso, principal investigator of the International Male Breast Cancer ProgrammeDr Fatima Cardoso
Are you often confronted with male breast cancer patients in your daily clinical practice?
I would not say “often” because male breast cancer is actually a very rare disease. It represents about 1 % of all breast cancer cases and less than 1 % of all male cancers. However, I have always been concerned and interested by this rare disease and, since there are only a few experts in this field, colleagues often refer to me when they have male patients.
Do you see that men react very differently to the diagnosis, compared to women affected by the same disease?
Part of the reaction is of course similar for women and men. Cancer diagnosis is scary for everyone, and patients very often feel lost.
Additionally, men affected by breast cancer have to carry the burden of a rare disease, and a disease with a “female connotation”. Men often do not realize that they also can be affected by this disease and they are shocked when they hear the words “breast cancer”.

After the diagnosis, male patients have mixed reactions: some of them try to understand the disease and want to know more, whereas others prefer to hide it and do not feel at ease telling friends or family. In both cases, however, men often suffer additional stress when they learn from their doctor that little is known about the disease and that they will be treated like their female counterparts until we are able to better understand the disease and find a therapy tailored specifically to them.
What prompted you to set up the male breast cancer programme?
Up to now we do not know how to treat men affected by breast cancer; we extrapolate from the therapies given to women affected by the same disease. This has to change. The scientific community has to tackle that issue and awareness should be raised among scientists, but also among the advocacy world.
When I decided to start this project I faced huge difficulties to find support in the first years. No cooperative group was interested. Dr. Giordano was also very interested in this issue, so we joined our efforts and proposed the project to the BIG-NABCG collaboration. Under the auspices of BIG-NABCG, a working group made of European and American experts was created to set up the research programme.


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