Dear Reader,

"Men don't have breasts!" No doubt half of you reading this question thought this, or yelled it across the library. Truth is, all men do have breasts — there's breast tissue behind the nipples of their chests. When boys go through puberty, their breasts often grow, becoming swollen and tender. This is totally normal, and gradually goes away. Abnormal causes of enlarged breasts in men (a.k.a. gynecomastia), however, can include a hormonal imbalance, certain diseases or tumors, and estrogen therapy.

It's rare for men or boys to get breast cancer, and even more rare for it to affect someone under the age of eighteen. The average age of a male breast cancer patient is nearly 65 years.

Alice is wondering what makes you think that you might have male breast cancer. Have your breasts grown? Have you discovered a lump or bump in one or both breasts? Are you having bleeding from the nipple? Lumps or bumps in the breast or bleeding from the breast is more concerning.

You ask how someone gets male breast cancer. While no one knows why some boys or men get breast cancer and some don't, here are some factors that might increase a person's risk:

• other male family members who have had breast cancer
• use of certain hormone medicines (those that contain estrogen)
• Klinefelter's syndrome (a condition in which a boy is born with an extra X chromosome)
• exposure to radiation
• history of testicle injury or infection, or undescended testicles

Remember, from what you have said in your e-mail, as well as from what is written here, it is highly unlikely that you have breast cancer. Telling your parents, or someone you feel closer to (e.g., another family member, a friend's parent, a school nurse), is an important next step. They can provide the support you need to get to and talk with a health care provider, perhaps someone you've been seeing for a long while, someone you like well enough and can trust.

You mention that you're afraid of talking with your parents about this. However, they likely care a lot about you and would want you to have peace of mind. Even though this is hard, it's important to do, and can be a way to create closeness. "Mom or Dad — Can I talk with (your health care provider's name) about... I know it may sound weird... breast cancer in men? I know men can get it, and I want to make sure that I don't have it... cause I'm a little worried that I do." If your parents, for some reason, are not emotionally available to care for you, perhaps some of the other people you talk with can help you make an appointment, and maybe even go with you. When you have a major concern such as this one, it's really important to get it checked so that you can either take action or, whew, allow yourself to let go of your worry.

Alice

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