Breast Cancer Awareness: Male breast cancer

Pretoria - The Council of Medical Schemes (CMS) has today said although the incidence of male breast cancer in South Africa is not well documented, the most recent South African cancer registry reported that male breast cancer accounts for 1.8% of all breast cancer cases, compared to less than 1% worldwide. Black men have higher incidence rates for all breast cancer subtypes.

"Male breast cancer can take on several forms, including ductal and lobular carcinoma, inflammatory breast cancer, and Paget's disease.

"Several factors increase the risk of developing this disease, including age, genetic mutations, family history, radiation and hormone therapy, obesity, Klinefelter's syndrome, and heavy alcohol use. It is important to detect it early as it can lead to favourable treatment outcomes. 

"Early detection of male breast cancer increases the likelihood of a successful treatment. However, many men put off visiting a doctor when they experience unusual symptoms or signs. Because of this, many cases of male breast cancer are discovered when the condition is more advanced," the Council said.

What is covered as PMB level of care?

Treatable breast cancer is included in the Prescribed Minimum Benefit (PMB) regulations under Diagnosis and Treatment and Pair (DTP) code 950J. Treatable cancers are defined in the PMB regulations as solid organ malignant tumours where:

• they involve only the organ of origin and have not spread to adjacent organs

• there is no evidence of distant metastatic spread

• they have not, by means of compression, infarction, or other means, brought about irreversible and irreparable damage to the organ within which they originated (for example, brain stem compression caused by a cerebral tumour) or another vital organ

• or, if points (i) to (iii) do not apply, there is a well-demonstrated five-year survival rate of greater than 10% for the given therapy for the condition concerned.

"Regardless of which benefit option a member or beneficiary is on, the medical scheme must pay for the diagnosis, treatment, and care costs of treatable breast cancer. Screening through a physical breast examination, consultations with doctors and other health professionals, surgery, radiology, pathology, chemo-therapy, and radiation therapy are included in what the medical scheme must cover," concludes the Council.