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It began with an itch I just had to scratch.
July 27, 2014 5:35 PM   Subscribe

Doesn’t every adventure begin that way? I was lying in bed reading on a Saturday evening, and without even looking I idly scratched a spot on the right side of my chest –- at that point I had a chest, not breasts. As I did, my fingers rode over a small something, a little like a speed bump about an inch below and two inches to the left of my right nipple. “That’s a lump!” I thought, and suddenly I had a right breast. With a lump in it.
posted by michswiss (31 comments total) 16 users marked this as a favorite

 
Cute story.

As a female friend said afterwards when she saw my photos, “If men routinely had to have mammograms the entire procedure would have been either eliminated or totally reinvented decades ago.”

That's such a weird statement. As if there weren't women with the motivation and capability to reinvent the procedure.
posted by Tell Me No Lies at 6:08 PM on July 27 [6 favorites]


As if there weren't women with the motivation and capability to reinvent the procedure.

Who would then have to convince their typically male bosses to invest their practice's time and money in developing it, when there's a risk that insurance companies who are also typically run by men will not initially support this new procedure, leaving the first wave of women who opt to use it, having to pay for it out of pocket.
posted by radwolf76 at 6:15 PM on July 27 [58 favorites]


I had two mammograms by the age of 30. My paternal grandmother died of breast cancer, so when I found a lump at age 26, and then another one at age 30, my doctor sent me for a sonogram - but the hospital didn't do those without a mammogram. Even though I was young and my breast tissue would be too dense for it to do anything. Whee.

But I was somewhat...petite then, and those pictures rang awfully true. One time the plates had a hard time "grabbing on", and they had to re-take one of the shots, only this time the tech was standing opposite from me next to the machine pulling my boob like it was a big hunk of saltwater taffy to sort of maneuver enough of it into place.
posted by EmpressCallipygos at 6:23 PM on July 27 [1 favorite]


In closing - mammograms are important, but they suck if you're an a-cup.
posted by EmpressCallipygos at 6:26 PM on July 27 [8 favorites]


It's interesting how he semantically moves from chest to breasts, aware that he sees them now where they weren't distinct on a male body before. Great piece.
posted by viggorlijah at 6:28 PM on July 27 [6 favorites]


That's such a weird statement. As if there weren't women with the motivation and capability to reinvent the procedure.

I think the implication is that men cannot tolerate pain.
posted by roomthreeseventeen at 6:31 PM on July 27


I think the implication is that men cannot tolerate pain.

Ah, that makes it more sense. If it was just a matter of resources we men would have re-invented the prostate exam a very long time ago.
posted by Tell Me No Lies at 6:34 PM on July 27 [2 favorites]


I found a lump at age twenty-two. The doctor poked at it, then poked at it some more. Hard as a rock. Seeing as how I was out in the boonies, there were no -grams or -sounds called for. Instead, I got a punch biopsy, right there, which didn't work out so hot because whatever it was had somehow adhered to a lining attached to my rib cage, so it got dug out. I could feel the tugging in my sternum. The local wore off during this part. What got dug out was long and alien-looking, cream-colored, with branches. It went into a little bottle, and from there to pathology.

If you've taken Home Ec, you know that sewing up a circle is usually a mess, but that's what I got, anyway. Walked home. Pulled my own stitches a week later, like I need help for something like that. A few months later, someone got around to calling me to let me know it wasn't a tumor. That's all I got.

I still don't know the how or the why of it. I wasn't one of those guys who would bounce the bar off his chest during a press, which is known to cause a lot of trauma in that area. Could have been an errant softball to the chest in grade school. Who knows?
posted by adipocere at 6:46 PM on July 27 [3 favorites]


I had, maybe a year and a half ago, a bit of a breast cancer scare. It turned out, embarrassingly enough, to be a callus from an ill-fitting underwire bra. It was still one of the more terrifying experiences of my life so far, with a persistent sick, naggling dread. Breast cancer is mercifully rare in my mother's side of the family, and I remain largely ignorant of my father's side to this day.

Having the unhealthily obsessive cast of mind that I do, however, I immersed myself in literature about it, and was a bit shocked when I found out that yes, this can happen to folks with a Y chromosome. Which is kind of a dumb misconception, I suppose, in hindsight.

...this is a well-told story, and I greatly appreciate the photographs. Thank you for sharing, michswiss.
posted by dogheart at 6:57 PM on July 27


I'm a man. I had a mammogram for a benign cyst in my left breast about five years ago. It was embarrassing and extraordinarily unpleasant. I tried to make a poorly-thought-out joke before the test about being the only guy to ever get one. The stone-faced technician said, "We get men more often than you think." I asked how many of them had breast cancer. She said I should ask my doctor. The rest of the test proceeded without further small talk.

She squeezed, twisted and pinched me in ways that I had been unaware that I could be squeezed, twisted and pinched. The only things missing were the lash, the hot poker and the demands to confess my sins.

I hope they come up with a better way because getting a mammogram sucks.
posted by double block and bleed at 7:09 PM on July 27 [2 favorites]


The other way is to have an MRI, so I assume the reason people still get mammograms is that they're cheaper to do? Maybe?
posted by elizardbits at 7:18 PM on July 27


I'll swap a prostate exam for a mammogram. Anyone?
posted by vapidave at 7:41 PM on July 27


vapidave, you're speaking largely to a population who already has to have pap smears on a regular basis.
posted by KathrynT at 7:49 PM on July 27 [53 favorites]


The other way is to have an MRI, so I assume the reason people still get mammograms is that they're cheaper to do? Maybe?

MRI cost 7 or 8x as much as a mammogram and since it is more sensitive there are also more false positives. So the question becomes whether there is enough of a decrease in mortality to counterbalance the very substantial increase in cost and the increase in false positives.
posted by Justinian at 7:50 PM on July 27 [1 favorite]


In women, MRI is more sensitive but less specific than mammography, so in isolation it has a higher false positive rate (leading to lots of gratuituous stress and miserable biopsy.) That's why it's generally reserved for women who've already had a positive mammogram.

(And vapidave, a lot of docs perform a rectal as part of annual pelvic exams, so there's no trade available unless you want to swap your prostate check for a mammogram and fingers in every lower-torso flap and orifice you have.)
posted by gingerest at 7:50 PM on July 27 [3 favorites]


Since this thread has veered into prostate exams, naturally, as there are so many guys on Metafilter (perhaps the percentage has been ascertained on MetaTalk…I'd be interested), my doc doesn't do PSA's or glove-poking. Many doctors don't, anymore.

The weird thing to me is how breast-self-examination was denigrated in the MSM a year or two ago. Why? That's how my wife discovered her (thankfully excised) cancerous lumps.
posted by kozad at 8:20 PM on July 27


The only way I can think to make a breast xray less of a painful procedure is to produce something like a very small MRI, where there's an xray emitter that rotates around a ring and a corresponding sensor on the other end of the ring.

Then the breast is stuck in a tube rather than squashed between two panels.

Presumably it's still too difficult to make xray sensors that are small enough and reliable enough to be used in such a fashion.

But otherwise, you always want to minimize the risk and maximizing the image definition by only passing the xrays through the minimum necessary body parts. So that means isolating the breast from the rest of the body, which means squashing between two panels or in a tube of some kind.

I leave the difficulties in desiging a tube of appropriate size or etc. to handle the necessary diversity as an exercise. And then leave the problem of men's or A-cup(minus) breast tissue for extra credit.
posted by jefflowrey at 8:23 PM on July 27


I think the implication is that men cannot tolerate pain.

I very much doubt it. The implication is that systems are designed by and for men, that society as a whole prioritises the improvement of mens experiences over womens experiences, and therefore that a procedure that is almost solely for women has not had the pressure for improvement that it would have if it were experienced by men.
posted by the agents of KAOS at 8:40 PM on July 27 [33 favorites]


kozad: "The weird thing to me is how breast-self-examination was denigrated in the MSM a year or two ago. Why? That's how my wife discovered her (thankfully excised) cancerous lumps."

Assuming this wasn't a rhetorical question: because (unfortunately) the weight of the evidence says that breast self-examination doesn't increase breast cancer detection nor decrease breast cancer mortality relative to no screening at all, and breast self-exam increases the rate of biopsy for benign conditions (that sticky false-positive problem again.)

The American Cancer Society still cautiously recommends BSE, but many other health authorities have moved towards a new notion of "breast awareness" - the idea that every woman should get familiar with her own personal landscape and what's normal for her, and see her doctor if she notices anything unusual. BSE can still be part of that awareness, but the scheduled rigorous put-your-fingers-like-this and move-them-in-circles-like-that regimen has been set aside.
posted by gingerest at 10:15 PM on July 27 [4 favorites]


Rusty, The Wonder Dog, she was a lumpy, lumpy pooch. Lots of dogs are lumpy, people, too, but Dobermans are very short-haired and a wiry confirmation, so they were easy to see. I'd find a new lump, get all in a sweat, take her to the vet, he'd do a needle-stick biopsy, always came back clean, no problem. He told me I'd know it, if there was something cancerous, he said it would be hard, like a pebble under her skin, and wouldn't move around as much.

I knew the instant I touched it. It was right where her back leg joins her torso, outside. I took her to the vet and he was pretty sure, too, biopsy and then surgery, he cut it out of her.

She beat it, or dodged it, whatever, maybe we just caught it in time -- I really did keep a close eye. We walked five miles the next morning, she had a tube sticking out her side for fluids to drip off and out, but no. way. was she going to miss Saturday Morning Walk. She was indomitable. She was unflappable. She was Rusty, The Wonder Dog. She was fkn great.

She was seven when it came down, she lived to twelve years old, a stroke took her.

Moral of that story? I had no idea that self breast exams were dissed. For me, I check my body for anything lumpy or unusual in any way, really, if I find a lump or a bump or whatever else, I'm gonna talk to my doc.

~~~~~

As far as my doctor giving me a finger wave on my yearly exam, who cares? He could shove a fkn fire hose up there if it'd help catch prostate cancer even an instant sooner. I don't want to lose control of my body, I don't want to have to wear diapers because I can't stop myself from pissing my drawers. And I like to fuck, fucking is, like, you know, great and stuff. Even jerking off -- hey, it's fun! (Kids -- try this at home!) You get prostate cancer too late, throw fucking out the window. Then what? Gardening? Birdwatching? Jesus christ.

Or it could kill me. I watched my brother die from lung cancer three years ago, it was horrible. As annoying as life can be sometimes -- never-ending war, mental illness, Limbaugh, a society plagued by selfishness, Texas A&M -- even with all of that, I love this place, and I'm in noo hurry to head out the door.

I trust my doc. He's not trying to get into my shorts, I'm not even wearing my shorts, I'm in one of those stupid gowns. And I've only had that roto-rooter thing once, maybe seven years ago, take all kinds of laxatives and enemas the night before, go to the hospital, count backwards from 100 laying on your stomach and only get to 96, wake up who knows how much later in a recovery room and dress and drive home against their specific orders, because fuck their orders, right? I haven't driven drunk in decades but when I did I got plenty of practice at it, and it's like riding a bike, you don't forget. Or something.
posted by dancestoblue at 11:28 PM on July 27 [8 favorites]


I'm on team Rusty.
posted by qinn at 11:45 PM on July 27


I sympathize with his guess that it was something he never noticed before losing weight. I'm in the process of slimming down (I'm really fat, have lost more weight than him and have way more to go) and am continually feeling things I didn't know were there. It's like my body is some sadistic lump factory.

I never knew what a mammogram entailed, that looks shitty. Fuck breast cancer.
posted by edeezy at 12:06 AM on July 28


So my own recent experiences mirror this guy's story. I'm male, I lost 25 lbs, I found lumps around my nipples, I went to the doctor with the big dreadful " . . . um, cancer?" hanging over my head. Except I'm 31 and my doctor only ordered an ultrasound, not a mammogram. I now feel partly lucky to have avoided such an unpleasant procedure and partly worried that, without it, my diagnostic is less than complete.

For me, gender poked its nose into the proceedings in only one way, but a way that was weirdly persistent.

At the initial exam, my doctor immediately felt my lumps and went "huh! well, you just won yourself an ultrasound." She said she was sending me to what she considered to be the best breast-scanning clinic in our region. An old acquaintance of hers is the head doctor there; she phoned her office from the exam room while I was still sitting there to make sure they would see a male patient. She was told that of course this was no problem. So I walked out with my referral in hand.

I phoned the clinic the next day to make my appointment. No one answered, so I left a message. When my call was returned, the receptionist suggested I must have meant to call a different clinic in the same building, as this was a breast clinic. I clarified and explained how my doctor had phoned ahead to make sure they'd see me for an ultrasound.

"So, you need your . . . abdomen scanned?"

"No. I have lumps in my breasts. Both breasts need to be scanned."

Then, when I showed up for the ultrasound, I was told, again, that I must have made some wrong turn at some point. I said "you guys always say that but look here's my referral. I believe my doctor has been in touch with you" and I gave a nervous smile.

Anyway. The good news is the ultrasound was fine. The doctors are certain this is not cancer - thank heavens. But the lumps are still there and they still give me some pause (the odd anxious "but what if they missed something?!" thought, you know). My doctor (who I really like) is sending me to a breast specialist to make absolutely certain, so who knows what's next? If these lumps could be removed without too much trauma, I would like that. I do not like these lumps even if they are just lumps.

Bodies are so weird.
posted by erlking at 3:19 AM on July 28 [2 favorites]


Moral of that story? I had no idea that self breast exams were dissed. For me, I check my body for anything lumpy or unusual in any way, really, if I find a lump or a bump or whatever else, I'm gonna talk to my doc.

I actually am like Rusty - in the "some dogs/people are just lumpy" sense.

Both of those breast lumps I spoke about earlier - which prompted both those mammograms - were just benign cysts, which showed up clear as day on the sonograms. After the second one, my doctor had a bit of a chat with me - I'd been doing the BSE's and caught them, and she gently pointed out that the point of regular BSE's wasn't necessarily an "if-lump-then-doctor" thing, but more to become familiar with one's body so you could notice any anomolies. But then she also pointed out that "look, you are just prone to cysts." She pointed out all the sebacous cysts I'd been plagued with all my life, the cyst in my ovary, and now two breast cysts.

"So maybe what this means," she says, "is that for you it's a little different. With you, if you find another lump, what you need to do is wait a month and see if it goes away on its own first. And if it doesn't, then you call a doctor."

And that's what I've done ever since. I've found a couple lumps since - one of them was kind of huge, too - but after a couple of nervous weeks, or sometimes even just a few days, they have always gone away all on their own.

I suspect that all the attention focused on "breast cancer awareness" is making a lot of people way more on-guard against it than they may need to be, and that may be part of why doctors are downshifting on BSE's - it's made a lot of boob hypochondriacs.
posted by EmpressCallipygos at 3:32 AM on July 28 [1 favorite]


Nice use of the "ouchie" tag.
posted by GrammarMoses at 4:50 AM on July 28


>I still don't know the how or the why of it.

There's a name, at least, I learned for this sort of thing: "Lipoma".
posted by one weird trick at 5:39 AM on July 28


I've been through the same process (getting a mammogram and ultrasound as a man) for what turned out to be a couple of lipomas. Thankfully the (female) techs and radiologists I had were skilled and very pleasant, but it did give me a certain gratitude that I don't have to do this regularly.

It is weirdly frustrating, the cultural crap that that accrues to men getting diagnostic procedures that are stereotypically "female" like mammograms. A colleague of mine was working with his doctor last year to improve his alarmingly poor cardiac health, and told me one day privately that he was getting a cardiac ultrasound. He said he was afraid to tell the rest of our (all-male) team because he figured if he said he was getting an ultrasound, they'd all tease him about being pregnant. Which seems like a ridiculously ignorant response to me, but I can't say his worry was unfounded.

Unfortunately, he died of a massive heart attack about a month and half later. He was in his early 50's. I certainly hope that sort of embarrassment about things like "ultrasounds" didn't keep him from seeking treatment earlier, but I can't help but wonder how often that kind of stigma does keep people from getting, or talking about, the help they need.
posted by McCoy Pauley at 9:22 AM on July 28 [3 favorites]


I was a cancer researcher for a decade or so surrounding my graduate school years. The presumption that men uncommonly experience breast cancer and/or mammography is one based in pop culture (including pop cultural gender critiques), not in the clinic. Low diagnostic frequency is no reason to assume the interior quality of an experience like invasive cancer screenings of any variety--they're all terrible, nerve-racking, anxious events.

As far as pop culture and male breast cancer go, though, I rather like the writing and speaking that KITH's Scott Thompson has contributed.
posted by late afternoon dreaming hotel at 11:01 AM on July 28


The presumption that men uncommonly experience breast cancer and/or mammography is one based in pop culture

What does this mean? Are you saying that in real life men make up a significant percentage of the people having mammograms and being diagnosed with breast cancer?
posted by the agents of KAOS at 11:56 AM on July 28


> no -grams or -sounds

Huh. I developed guitar nipple (don't jam your nipple into the side/back corner of an acoustic guitar people) 20 years ago & they (also) went right for cutting it out with no pre-screening. It was the size of a couple/few half-dollar coins stacked, so kind of nice to have out even though it tested benign. No pain in my case, though, even though I woke up a bit out the valium & demerol fog. Hey where am I? Oh, more drugs, OK, g'night.
posted by morganw at 2:43 PM on July 28


late afternoon dreaming hotel: " The presumption that men uncommonly experience breast cancer and/or mammography is one based in pop culture (including pop cultural gender critiques), not in the clinic. Low diagnostic frequency is no reason to assume the interior quality of an experience like invasive cancer screenings of any variety--they're all terrible, nerve-racking, anxious events."

I don't get what you're driving at. Of course if a man has a breast cancer scare, it's scary. But less than 1% of all cancer in men is breast cancer, less than 1% of all breast cancer is in males, and the lifetime probability that a man will experience breast cancer is 1 in over 1200, in contrast to the 1 in 8 or 9 figure for women. That makes male breast cancer rare by any metric, in the clinic and out.
posted by gingerest at 7:28 PM on July 28


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