On the season 8 premiere of Shameless, Kevin (Steve Howey) spends some "extra time" with a customer at the gay club where he works, to make a quick $200. While the customer is feeling up Kevin's chest, he pauses to ask when Kevin last performed a breast self-exam. "You have a lump," he says, while Kevin stands stunned in nothing but a gold lamé bikini.
Kevin goes to a doctor, and is surrounded by frail female patients and woman-centric breast cancer literature. He's told that he indeed has a large lump, and needs to have it biopsied — so we don't know yet whether he has or will have breast cancer this season.
In an interview with Variety, John Wells, the show's executive producer, said that this plot was inspired by a true story, because one of his (male) friends had breast cancer. "The hardest part for him was that he thought it was a joke that men can get breast cancer," Wells said. Indeed, men can get breast cancer, too. But if you are a man and you're shook by this information, here's what you need to know.
Like women, men have breasts that are made out of fatty tissue and some ducts, according to the American Cancer Society (ACS). And the cells in a man's breast tissue can mutate and cause cancer, just like it can in women. Breast cancer tends to be less common in men, simply because they have significantly less breast tissue than women, Deborah Lindner, MD, FACOG, a gynecologist and chief medical officer at Bright Pink, told Refinery29 last month. Men also tend to have lower levels of estrogen, which can affect the growth of cancer cells. Given this, breast cancer is a whopping 100 times more common in women than it is in men, according to the ACS.
So, how many men actually get breast cancer? In 2017, an estimated 2,470 new cases of invasive breast cancer will be diagnosed in men, and about 460 men will die from breast cancer, according to the ACS. A man's lifetime risk of getting breast cancer is about 1 in 1,000. These numbers are comparable minuscule to the stats for women: In 2017, an estimated 252,710 new cases of invasive breast cancer will be diagnosed in women, and about 40,610 women will die from breast cancer. A woman's lifetime risk is 1 in 8.
The big risk factors for male breast cancer are age, family history, exposure to radiation, and hormone imbalances, according to Memorial Sloan Kettering Cancer Institute. Interestingly, age tends to be the biggest risk factor, and most men are diagnosed around age 68, which is much later in life compared to women, according to the ACS. Kevin's character on Shameless is presumably in his mid-30s, so he would be considered "young" for breast cancer, especially among men. According to a 2011 study, breast cancer is "extremely rare" in men under age 70.
Men can also carry BRCA1 and BRCA2 genes, the latter of which accounts for about 1 in 10 cases of male breast cancer. If you are a man who carries the BRCA2 gene, then your lifetime risk of breast cancer would be about 6 in 100, according to the ACS. Additionally, men with Klinefelter syndrome and/or liver disease may have a higher risk of breast cancer, because they tend to have higher levels of estrogen. (Heavy drinking might also increase a man's risk of breast cancer, because of its effect on the liver.)
As with women, early detection of breast cancer in men is important. A painless bump may be a man's first warning sign (like the one Kevin's very thorough customer found), but they can also experience changes in their nipples (like flattening, redness, or discharge), according to Memorial Sloan Kettering Cancer Institute. Most of the time when a man is diagnosed, the breast cancer is at a much more advanced stage than with women, just because it takes longer for them to discover it. Perhaps because stories like Kevin's are so rarely told.
So, although breast cancer is technically uncommon in young men, it's important to be mindful of your breast health no matter your gender, so you can tell when something is up. Even if you don't have a kind stranger who's willing to feel you up, you should perform a breast exam on your own, and talk to your doctor ASAP if you notice any changes.