Male breast cancer survivor on why men fear 'emasculating' diagnosis

Editor's note: This story was originally published Oct. 29, 2018 as part of a first-person series on those affected by breast cancer. With the news of Matthew Knowles's diagnosis, we thought it would be valuable to share once more.

This is the story of Bret Miller, 32, as told to Beth Greenfield for Yahoo Lifestyle. Miller, of Kansas City, Kan., was diagnosed with stage 1 breast cancer after years of being told by doctors that the lump he felt was “fatty tissue.” After undergoing a mastectomy, he founded the Male Breast Cancer Coalition to spread support and awareness.

It all started my senior year of high school. I was 17, sitting home watching TV, when I stretched and scratched across my chest, and felt this lump under my right nipple. I showed it to a doctor at a physical for sports a week later, and he said it was a calcium buildup from puberty that would dissipate, and nothing to worry about. When I had to get a checkup for college, with a different doctor, he said almost the same thing, verbatim.

I had no insurance at all during college at the University of Kansas, and during senior year I had started to get a discharge from my nipple if I were to squeeze it. I didn’t say anything to anybody, and I thought maybe this is the way of it “dissipating,” so no big deal. Finally, I got insurance and went for a physical, and the doctor was almost out the door when I stopped him, because he said, “Everything is great,” and they don’t do men’s breast exams. So I had to stop him and bring him back in and tell him, “Hey, I’ve had this lump for 7 years.” He touched it real quick and immediately set me up to get a sonogram.

I had to go to the women’s clinic, which is a lot of fun to walk into. You could tell the other men there were waiting for their significant other or mom to come out. And then the form — they’ve changed it since — but it had name, insurance, “when was your last menstrual cycle” and “are you pregnant?” You know — awkward.

The nurse technician got the pictures we needed and called in the on-call doctor that was there. She did a triple take and called for an immediate mammogram. The more I look back, the more I think she knew immediately.

I knew male breast cancer existed, but it was one of those things I kind of forgot about. The first man I had heard of having it was Richard Roundtree, the original “Shaft.” (Years later, I was lucky enough to be on the Katie Couric Show with him to talk about male breast cancer.)

The next day the surgeon calls me as I’m leaving my job at a pool and country club, where I manage an ice rink. I’m driving downtown to go bartend. He doesn’t ask if I’m in a safe place, sitting down, not driving, whatever — just comes right out and tells me they sent it to pathology and the initial report is that it’s breast cancer, and that he’d call me back to follow up. This was about the time of Ashton Kutcher’s show Punk’d, so I was waiting for the cameras to come out. I thought I was getting punk’d.

But I let it sink in for a minute. I thought, they got the lump out, so how bad could it be?

So it was barely stage 1, and the recommended treatment at the time was a double mastectomy, for preventative measures. They didn’t really know what to do with men, because there wasn’t much research, and there still isn’t much research. In my case, they just recommended what they do for women.

[My parents and I] asked if he’d ever done a double mastectomy on a man, and he said no, that I would be his first. We were like, “We’d like to get a second opinion.” And we did, and he did say the same thing, but he said we could just do one side at first. He sent my case around to other top local doctors and those around the country. I was the second male in a study at MD Anderson Cancer Center, and the morning of my surgery, a doctor from there called mine and said, “Do not treat men just like women. Do the single mastectomy and that’s all you have to do.”

My mastectomy was definitely an interesting day: I had Fox 4 and Channel 9 local news here in the surgery room videotaping. One of the local news reporters, who is a breast cancer survivor, got wind of my story. The surgeon told me that based on my age, if I’m willing to share my story, I could help many other people — many other men. So that’s when we started broadcasting it out. What I wasn’t told until a couple days after surgery was, because the length of time I had the tumor, the surgeon told my mom there was a possibility that it could be everywhere.

I formed the Male Breast Cancer Coalition in 2014, and my brother designed a T-shirt that had two handprints and the words, “Guys, don’t be afraid to touch yourself.”

We’re in Pinktober right now, and everything is pink and nothing is blue; not much is said about men. The American Cancer Society is the greatest, but the other organizations have just recently started adding “and men.” It’s all about women — and I get it; there are more women diagnosed and dying. But often by the time men are diagnosed, it’s metastatic. It’s because of men not thinking they can get it, and how some of them are like, “I don’t have breasts, I have pecs.” Well, you still have breast tissue.

Absolutely, there is a stigma. A Million Little Things on ABC actually wrote in a character with male breast cancer, a main character. [Things like that are] getting men to be more vulnerable, more comfortable in speaking to their friends about emotions, mental health, and breast cancer. Men are not usually comfortable in speaking about our health or emotions. If we think it’s emasculating, we won’t say anything. We don’t go to the doctor unless we’re on our deathbed or our arm is dangling off. It’s one of the reasons I waited so long to go to the doctor. I was like, “I’m not dying, so I should be good.”

We need more doctors in a physical exam to do a breast exams on men, to take the time. We need to quit hearing the “it’s only 1 percent excuse,” as it’s 30 seconds of your time to do the exam. That’s not worth your time to do the exam that could save [your] life?

I met my girlfriend Tasha on Labor Day weekend 2011, at the restaurant where we both worked. She ran up to my bar with her name and number on a piece paper, threw it at me, and ran away. We just got married on Oct. 20 at the country club I have worked at since I was 15 years old.

I was very open about being a breast cancer survivor from the start. I think I cracked a few jokes about having only one nipple. At the very beginning, I was self-conscious, but that quickly went away. If someone I met wasn’t comfortable with who I am and how I look, we weren’t meant to be.