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Breast cancer strikes men as well as women, and the survival rate is slightly lower

Tuesday, May 05, 1998

By Ellen Mazo, Post-Gazette Staff Writer

As a tribute to a dear woman friend who died of breast cancer, Don and Marcia Sgarlata walked their first Pittsburgh Race for the Cure in May 1996. "We thought this would be a really good way to remember her, and to do something for breast cancer research," Marcia Sgarlata, 59, said of the annual 5-kilometer run/walk in Schenley Park.

Little did they know a year later they would deal with breast cancer in their own family.

Don Sgarlata, 59, of Vandergrift, found a lump in his right breast, which turned out to be malignant.

"I had never heard of men getting breast cancer," said Don Sgarlata, a retired manager of health safety licensing at Babcock & Wilcox.

Not many have.

Breast cancer is diagnosed in about 1,600 men a year, compared with an estimated 180,200 women, according to the American Cancer Society.

Of the 43,900 people expected to die of breast cancer this year in the United States, 400 will be men.

The Susan G. Komen Breast Cancer Foundation in Dallas, which created the Race for the Cure, has encouraged male breast cancer survivors to make the public aware of the risks.

Sgarlata and his wife will walk in Pittsburgh's event on Sunday, as will Mark Goldstein, 65, a breast cancer survivor from Randolph, N.J.

Goldstein, diagnosed 10 years ago, has run about 40 of the 86 races held throughout the United States and abroad each year.

Goldstein first realized something was wrong when he noticed his left nipple was receding.

"I didn't do anything about it for three months," he said in a telephone interview. "I didn't believe it was of any consequence. I had fallen into the universal misconception that breast cancer is a women's disease. We get testicular cancer or prostate cancer."

Goldstein said that because there was not much fatty tissue in his chest, the cancer attached itself to the chest wall rather than the fatty tissue.

"That happens with men, and that's very lucky," he said, because the cancer does not spread as quickly.

Both men had mammograms as part of the diagnosis, which are a "highly accurate" detection device for men, said Dr. Alan H. Appelbaum of the University of Texas Southwestern Medical Center, Dallas.

Medical experts do not recommend regular mammograms for men - as they do for women after age 40 - because breast cancer in men is rare.

But they do encourage men to examine their breasts.

"It's not necessary to do a self-breast exam as frequently as women, [which is monthly]" Goldstein said. "But you should look at your chest periodically. Is there anything abnormal? A lump, a discharge, an inverted nipple.

"Don't be reticent. Breast cancer is not an assault on our masculinity."

Part of the problem with thinking about breast cancer and men is that most research and information about the disease involves women.

But treatment is the same, usually including surgery, radiation, chemotherapy and/or hormone therapy.

Goldstein, who works for a satellite communications company, considered himself lucky that the cancer in his left breast had not spread. He had a modified mastectomy, followed by chemotherapy and radiation treatments for eight months.

Sgarlata, on the other hand, had a radical mastectomy on his right chest, removing 21 lymph nodes.

The survival rate for men after five years is 70 percent, compared to 95 percent for women when their cancer is confined to the breast. The lower survival rate for men is mostly because the disease is often detected later.

As a teen-ager, Sgarlata had radiation treatments for severe acne. He had been warned to check his thyroid regularly because radiation was known to cause thyroid cancer. No one suggested breast cancer.

As with Goldstein, there was no history of breast cancer in the family.

Goldstein's two daughters, ages 39 and 36, now have regular mammograms. So do the Sgarlata's three daughters.

"Ever since Dad got sick, they do self-breast examinations, too," Don Sgarlata said.

Both men said they viewed their breast cancer as an opportunity to help others understand the disease in men.

"I'm willing to talk to anyone about this," Don Sgarlata said. "It's so important for everyone to know as much as they can about breast cancer - in men and women."


For More Information

A public symposium on tamoxifen, a drug that new research shows can reduce breast cancer rates by 45 percent when taken to prevent the disease, will be held 7 p.m. Thursday at Allegheny General Hospital.

The free forum will feature several local cancer experts connected to the recently concluded study who will answer questions and concerns about the drug's potential and risks. Drs. Norman Wolmark, D. Lawrence Wickerham and M. Denice Leonard of Allegheny General will be available.

More than 13,000 women who participated in the study were notified in late March about the dramatic results of tamoxifen in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial.

Seating is limited and registration is required. Call (800)367-2371.

?Cancer Care Inc. will hold its first national teleconference for women whose mothers have advanced breast cancer.

The free presentation via telephone will take place noon to 1 p.m. May 13. Participants must register by tomorrow by calling the Cancer Care Counseling Line at 800-813-HOPE. Breast cancer specialist Dr. Karen Antman of Columbia-Presbyterian Medical Center will talk about the disease and treatment options, and social worker Patricia Spicer of Cancer Care Inc. will offer coping skills for caregivers.

The Web site for Cancer Care, a national nonprofit organization that provides counseling services for cancer patients and family, is www.cancercare.org

?The Susan G. Komen Breast Cancer Foundation, (800)462-9273.

?The American Cancer Society at 800-227-2345.

?National Cancer Institute/Cancer Information Service, 800-422-6237.

?The Breast Cancer Information Service Web site is http://trfn.clpgh.org/bcis


The Race for the Cure

The Race for the Cure 5K Run/Walk and 1-mile Fun Walk will be held Sunday at Flagstaff Hill in Schenley Park. Call 412-521-2873 for an application or sign up at 7:45 a.m. in the park on race day.

The race, which has raised $1.85 million locally since 1993, finances the Mammogram Voucher Program. The voucher provides mammography screening and follow-up diagnostic services for women with no or inadequate insurance.

From July 1993 through March 1998, 10,236 vouchers were issued to 7,146 women in 22 Western Pennsylvania counties.

The voucher program is administered by the American Cancer Society and Family Health Council.

Seventy-five percent of money raised locally stays in Western Pennsylvania; 25 percent is directed to breast cancer national research.

To learn if you qualify for a mammogram voucher, call 412-261-4352 or 888-227-5445.



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