Rachel T Iredale, Senior Research Fellow Institute of Medical Genetics, Heath Park, Cardiff, CF4 4XN, Peter Barrett-Lee, Kate Brain, Liz France, Jonathon Gray and Buddug Williams It was heartening to see the editorial by Perkins and Middleton on male breast cancer in the US.1 We know that breast cancer in men is a rare condition - the median incidence in over 100 cancer registries world-wide is 0.5/100,000/ year2 and it accounts for less than 1% of all cases of breast cancer.3 Although the precise incidence of male breast cancer remains speculative, it is estimated that there may be up to 3,000 men across the UK with this diagnosis. We know that every year between 200 to 300 men in the UK are newly diagnosed with breast cancer. While the relatively common nature of female breast cancer has resulted in a high level of general awareness about the condition, male breast cancer is still a comparatively unknown entity, both by the general public and by health and social care professionals. Furthermore, despite government initiatives for modernising cancer services and raising standards of care, there is a paucity of information concerning the social and psychological impact of breast cancer in men. In 1999 we conducted a small pilot study using in-depth interviews with men with breast cancer.4 Our findings showed that major issues for men with this condition include delay in diagnosis, shock, stigma, altered body image, lack of emotional support and the provision of inappropriate information. All of the men in our pilot study had been given literature designed for women, and many were seen by ill-informed professionals. We concluded that male breast cancer is a neglected area and that there may be a need for gender-specific information and guidelines. In order to take forward our earlier research we began the MATCH Project (Men's Attitudes Towards Cancer and Health). Our main objective is to explore patient needs, treatment and management, and information provision with as many men as possible living with breast cancer across the UK. Our working hypotheses are: *That men react differently to women when given a diagnosis of breast cancer *That men with breast cancer require a different approach to treatment and care than women. *That men's ability to cope with their breast cancer diagnosis is affected by the treatment and care they receive from healthcare professionals. *That there are a number of organisational, cultural, professional and other factors which militate against the optimal management of men with breast cancer which can be identified and addressed. *That it is feasible to develop gender-specific guidelines for healthcare professionals dealing with male breast cancer. This research project uses a mixed method approach that includes, inter alia, a series of focus groups with men and women with breast cancer, and with healthcare professionals; sending out questionnaires to men diagnosed with breast cancer across the UK, and following up with semi-structured in-depth interviews. Although this study is on-going, some preliminary analysis of the data reveals that any literature received by men covers a wide-range of topics relating to cancer, but that all are written specifically for women. The men in our study have suggested that a section within existing leaflets and booklets incorporates information about male breast cancer, rather than having gender specific material. In addition, photographs of a male mastectomy are perceived to be extremely useful for patients. Most male participants in this study receive support from their partners and families and are unlikely to use formal sources of support. They appreciate the opportunity to discuss issues with a breast care nurse, but are more focused on problem-based coping i.e. getting to grips with the practicalities of their condition, than with emotion based coping. The prospect of attending a support group or talking to other men with breast cancer is not very appealing to men who see themselves as clear of cancer. However, for men just beginning their treatment matching patients on a one-to-one basis for support and after-care is perceived to be an important aspect of service provision. Further analysis will focus on the psychological and social consequences of a diagnosis of male breast cancer; sources of information and support; current management practice, and how different healthcare professionals can best provide for men at different stages of their illness. If you know of a man who has had breast cancer and would be willing to participate in our study please contact us at the address below. References 1. Perkins GH, Middleton LP. Breast cancer in men. British Medical Journal 2003; 327:239-240. 2. Sasco AJ. Epidemiology of male breast cancer. International Journal of Cancer 1993; 53: 538-549. 3. Young IE et al. The CAG repeat within the Androgen Receptor Gene in male breast cancer patients. Journal of Medical Genetics 2000; 37: 139- 140. 4. France L, Michie S, Barrett-Lee P, Brain K, Harper P, Gray J. Male cancer: a qualitative study of male breast cancer. Breast 2000; 9: 343- 348. Competing interests: This study is funded by Breast Cancer Campaign Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.