Bob Havens saw a lump on his left breast but thought it appeared because he had been trying to lose weight.
Then he noticed blood oozing from his left nipple.
Still, he didn’t think much of it.
The fact that he didn’t realize a lump and a bloody discharge were breast cancer is why Havens, 78, as well as his fiancée, want to get the word out to other men that they too can get the disease.
“The last thing in the world that ever went into my mind, and it didn’t until I was diagnosed, to be quite frank with you, was male breast cancer,” said Havens when he saw the lump, which he said was the size of a half dollar.
“I started getting a little bit of a discharge from my nipple, meaning blood. I was in the shower one day and I looked down, I see blood,” he said. “I thought I cut my hand or my toe, but I looked down and it was actually on my chest. I said, Oh well, that’s strange.”
Havens, who lives in Hamden, called his dermatologist, thinking it was dry skin or something having to do with his weight loss. “Again, never once entering my mind it was breast cancer.”
His doctor performed a mammogram and an ultrasound, and then a biopsy.
Once the results came back, “ Dr. (Elizabeth) Berger walked in and before she even sat down she said, the first thing I want to tell you both is this cancer is both curable and treatable,” Havens said. “And that really, if you’re going to talk to the patient, that’s the way to talk to a patient.”
Havens had invasive ductal carcinoma , the most common form of breast cancer, accounting for about 75% of cases, according to breastcancer.org . Male breast cancers are only about 1% of all breast cancers, said Dr. Jane Kanowitz , Havens’ oncologist, an assistant professor of medicine at the Yale School of Medicine .
“Ironically, male breast cancer usually presents at a more advanced stage than a woman’s breast cancer,” Kanowitz said. “And that really has to do with lack of knowledge that men get breast cancer. And I think Bob and his fiancée are trying to raise awareness so that people can be diagnosed at an earlier stage with presumably a better diagnosis.”
Kanowitz said Havens did not have a genetic predisposition, though many times men do. “Only 10 to 15% of women have a genetic vulnerability or predisposition whereas in men that genetic vulnerability is higher,” she said.
As with most cancers, Havens’ tumor was subjected to genomic profiling, Kanowitz said.
“What genomic testing or oncotype does is it does a deeper dive,” she said. “We actually extract DNA from the sample with the cancer and look at alterations in that DNA. And then we’re able to put together a signature as to how the tumor behaves. And that allows us to get a deeper understanding of the patient’s prognosis.”
That also helps the oncologist know whether chemotherapy will be helpful, she said.
Berger, assistant professor of surgery at the Yale medical school, said Havens is a good example of a change in how male breast cancer is treated.
“For men, it was always felt that we had to do a mastectomy, where we remove the whole breast and then we would not give them radiation treatments,” she said.
“Now what we know — and Mr. Havens is a perfect example of this — is that we do think it’s safe to save the breast, just remove the cancer and offer them radiation treatments after surgery. So that has been a big shift in treatment paradigm,” she said.
Another change is that surgeons used to remove all the lymph nodes underneath the armpit.
“Now we very much know that we can do what’s called a sentinel lymph node biopsy, where we just remove the first few underneath the armpit to make sure there’s no cancer in them,” Berger said.
Havens decided to have a lumpectomy rather than a mastectomy, even though he would have to have radiation in addition to chemotherapy with the lumpectomy.
“I went for 3½ months of chemo, one treatment every 21 days for that period of time,” he said. “Then we had to wait another month after that finished and then start 30 radiation treatments.”
He had extra radiation because the cancer had spread to the skin of the nipple, which was removed. He was fortunate, though, in that his lymph nodes were clear.
Both Havens and his fiancée, Catherine Szerszen, who is the current Ms. Connecticut Senior World , want to get the word out about male breast cancer. radiation treatments, Dr. Jane Kanowitz, Yale School of Medicine, Ms. Connecticut Senior World
“Ms. Connecticut Senior World has given me the opportunity to bring my platform, which is now male breast cancer awareness, not only to a national level, but it will also go globally,” Szerszen said.
“For four years, they’ve asked me to participate in their pageant. I didn’t have a platform, so I didn’t want to do it unless I could really give credence to something and really make a difference with it,” she said.
She’ll participate in the national pageant in November in Biloxi, Miss.
“Hopefully through this we can save some lives,” Szerszen said. “We had decided early on that what we were going through, the cancer really wasn’t going to define us. We were going to define ourselves as we always did. So what we did is work together to get through this, this challenge, this trial and it had lots of ups and downs in it.”
It turned out that the emotional side was harder than the physical recovery. “It’s hard because you see the person who’s the most important person in your life going through something, and you’re saying to yourself, I wish I was going through it rather than them. It’s very hard to watch,” she said.
“That was probably the toughest part for me,” Havens said. “Because I am independent and I don’t try to rely on anybody. … What happens is, the day before you have a treatment, you take steroids injected during the treatment and you take steroids about four days after that and you hit a brick wall at 150 miles an hour. So what happens is that you can’t move.”
It was so hard to get around that one day, while putting on his pajamas, he fell, hit the bathtub and broke three ribs.
“I’ll be honest with you, somebody said to me one time, Do you think that if you don’t have Catherine … do you think you would have gone through this? and I said, no. I said, I think I probably would have stopped the treatments,” Havens said.
Berger said men should check themselves and watch for any changes in their breasts.
“I think the biggest thing about male breast cancer is if a man notices any changes of their nipple: itching, discharge, skin peeling, that to me would be a concerning sign that they should present to their doctor and get it evaluated,” she said.
“I think the stigma around males with breast cancer is unfortunate, because I do think men tend to hesitate to present to their doctor about anything to do with their breasts because it seems somewhat stigmatized, and that it’s better (to do) early detection and better to … bring it to the attention to the doctor than not.”
Ed Stannard can be reached at estannard@courant.com .
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