When Ana Refinetti, M.D., discovered the details of her uncle’s illness and death, it reinforced what she already knew. Breast cancer in men may not be very common but it is serious and can be fatal.

          Dr. Refinetti is a general surgeon at St. Rose Ambulatory & Surgery Center; her specialty is benign and malignant breast disease.

          “My uncle had pain in his shoulder and thought maybe he had dislocated it,” Dr. Refinetti recalled. “He even had physical therapy for it.”

          But there was also a “little pimple” on his chest but he didn’t seek medical advice about it. Instead, a cardiologist was checking his heart one day and noticed the pimple.

          “My uncle said it was just something that hadn’t healed,” Dr. Refinetti said. “X-rays were taken and bone cancer was discovered. It had started in his breast and spread to his bones.

          “Guys are sometimes not aware they have breast tissue,” Dr. Refinetti said. “A woman who has any concerns about her breasts seeks help immediately. But the average time it takes for a man to have it checked is 10 months.”

          Symptoms of breast cancer in males and females are similar.

          “It could be a lump, a pimple, even a dimple,” Dr. Refinetti said. “It is usually a painless lump. I urge men who notice anything unusual to have it checked; don’t assume that it is normal. Maybe it is just a pimple, but maybe it isn’t.

          “Sadly, when some men do finally check into a concern, it is usually related to the disease spreading,” she added. “And when this is the case, the prognosis often is not good.”

          Dr. Refinetti speculated that men are reluctant to seek medical advice about the possibility of breast cancer because they “find it socially awkward or embarrassing. But we want them to understand that men have breast tissue and can have breast cancer.”

          While national awareness campaigns have done a good job of educating women, men have been neglected, she commented. Some risk factors, such as family history of breast cancer in males or females, are the same for both sexes.

          In addition, other male risk factors are a history of medical treatment involving radiation to the chest and taking hormones for whatever reason. The most common form of breast cancer in men and women is called “invasive ductal carcinoma.”

          “In men diagnosed with breast cancer, we also need to look for genetic mutations,” Dr. Refinetti elaborated. “If he has a specific mutation, he can pass it to the next generation. It can affect the whole family.

          “Breast cancer in men is a real disease and a real problem,” she said, noting that much more research needs to be done.

          The surgeon acknowledged that the number of men with breast cancer is very low. In 2013, 2,000 men were diagnosed with it and there were 400 deaths. During the same year, 230,000 women were diagnosed and there were 40,000 deaths.

          “That is quite a disparity in the numbers,” she said. “It may not seem important unless you are one of those men.”

          St. Rose is part of Centura Health, which connects individuals and families across western Kansas and Colorado with more than 6,000 physicians, 15 hospitals, seven senior-living communities, physician practices and clinics, and home-care and hospice services.