Emmy-Winning Writer-Director Rob Greenberg Recalls His Breast Cancer Diagnosis at 40 After Feeling ‘Sharp Pain’ in His Chest and Nipple Irritation

According to the American Cancer Society (ACS), approximately 2,670 U.S. men will be diagnosed with invasive breast cancer this year. Men have an average lifetime risk of roughly 1 in 755, though individual risk varies with personal risk factors.

Leading up to his 2009 diagnosis, Greenberg recalled wrestling with his two young boys a month earlier.

“Ted, my five-year-old, rammed his head into me. A sharp pain shot through my chest, lasting a few seconds. I forgot about it until it happened again a week later,” he shared. “I was concerned it was my heart, but my nipple felt strangely irritated — as if I had chafed it while riding a boogie board.”

After the third “jolt,” Greenberg went to see his internist. “While kneading my chest like a wad of sourdough, [he] discovered a small lump. ‘It’s probably nothing,’ he assured me, ‘but get a mammogram to be on the safe side.'”

Two days later, Greenberg went to a breast center for a mammogram (where he noticed the intake forms and setting were geared toward women). During the exam, he was told the scan looked suspicious, though he was repeatedly assured it was “probably nothing,” and ultimately advised to get a biopsy.

Looking back, he recalled going to a breast clinic later that day, where a receptionist asked if the appointment was for him. He was then given a short pink gown with cap sleeves and prepared for a biopsy, which he described as having “a fat needle” inserted into his chest — a pain unlike anything he’d felt before, which he described as “a white-hot burning sensation.”

Days later, he was told he had breast cancer.

‘A Sense of Isolation’

“After the initial shock [of the diagnosis], everything started to move quickly — PET scans, blood tests, specialists, more waiting. Driving from appointment to appointment, I became acutely aware of the gap between the sick and the healthy; we inhabit two very different worlds,” said Greenberg.

“But I was also navigating a disease that did not cater to my gender — less than 1% of all breast cancer cases in the U.S. occur in men. I was starting to feel a sense of isolation.”

He described feeling as if he was on a “desert island,” unable to fully relate to the unique challenges many women with breast cancer face, including “body image, sexuality, societal beauty standards” and decisions about reconstruction.

Greenberg, whose mother had battled stage 3 breast cancer, was ultimately told he needed a mastectomy.

He underwent surgery to remove the affected breast, along with the tumor and several sentinel lymph nodes [the first lymph nodes that receive fluid draining from a tumor and may be the first place cancer cells spread]. His left nipple was also completely removed, and he went home with surgical drains.

‘A Dude With One Nipple’

Greenberg recalled waking up from surgery “wearing a sports bra with a tasteful floral pattern and scalloped edges, revealing just a hint of midriff,” and being told his surgery was a “success” as the tumor was removed.

However, he later learned his diagnosis was “stage 2A, high-grade, estrogen-positive tumor” — meaning the cancer was somewhat advanced but still contained in the breast area (stage 2A), growing and spreading faster than average (high-grade), and fueled by estrogen, which meant hormone-blocking treatments were likely part of his care plan (estrogen-positive), according to the ACS.

“Then she told me that since male breast cancer was so rare, with very little research, my treatment would be modeled on that of a postmenopausal woman. I would have to do chemo, then radiation therapy, followed by Tamoxifen, a daily estrogen blocker pill for five years,” he added.

RELATED: What is Tamoxifen for Breast Cancer?

Greenberg—who is grateful to call himself healthy, alive, and cancer-free, and whose sons are now 19 and 22— still remembers finishing treatment and finding a support group flyer, signing up, only to be turned away because he was a man; the staff worried his presence would inhibit the women.

Feeling isolated, he opened up to the director about his struggles. A month later, he joined the board, where he found unexpected acceptance and connection despite their different experiences.

“It took a few sessions, but I started to let my guard down. And then I couldn’t stop. It poured out: all the things I had been longing to say to my wife and my brother and my friends,” Greenberg said.

“I talked about the lingering nerve pain from my mastectomy, the PTSD of chemo, the nighttime hot flashes from Tamoxifen, and most of all, my ever-present and terrifying fear of recurrence. I didn’t have to sugarcoat it. I felt understood without judgment. And when the Kleenex box was inevitably passed to me, I smiled to myself — a dude with one nipple finally found his people.”

Male Breast Cancer Risk & Symptoms

Like women, men have breast tissue and can develop breast cancer. Breast cancer starts when cells in the breast start growing out of control, typically forming a tumor that’s felt as a lump.

WATCH: Men Get Breast Cancer Too

A man’s risk of developing breast cancer may be higher if there’s a history of breast cancer in the family. Typically, male breast cancer manifests as lumps in the chest area. Factors such as a patient’s race can affect the prognosis.

Five types of standard treatment are used to treat breast cancer in men:

• Surgery for breast cancer in men mirrors the procedure in women. A modified radical mastectomy removes the whole breast with cancer. The result may involve removing the nipple, according to the National Cancer Institute.
• Chemotherapy involves cancer-killing drugs to prevent the cancer cells from growing. Chemo drugs are usually taken orally or intravenously.
• Hormone therapy involves removing hormones or blocking their effects on cancer cells to help them grow.
• In radiation therapy, high-energy beams such as X-rays are aimed at cancer cells to kill them.
• Targeted therapy treatment uses drugs designed to target specific cancer cells.

WATCH: Marc Futterweit shares his breast cancer journey.

When Marc Futterweit was told to get a mammogram by his doctor, hewas in disbelief.

“I said, What do you mean by a mammogram?’ I don’t have breasts,” Futterweit recalled saying.

However, a second opinion from another physician confirmed Futterweit had breast cancer.

“When I was first diagnosed, I didn’t tell my wife. I thought I was holding it together,” Futterweit said.

When his family learned he was battling breast cancer, they supported him. Having a support group filled with loved ones is an important part of a cancer patient’s journey toward survivorship, according to experts SurvivorNet has spoken to.

He realized that with their support, having male breast cancer is nothing to be ashamed of.

“Men are basically standing in the shadows, they’re ashamed or embarrassed,” Futterweit says. “Just remember, it’s nothing that you have done to cause you to get breast cancer. It’s nothing to be embarrassed about. It’s not a woman’s disease.”

Possible Risk Factors for Male Breast Cancer:

• Age. Breast cancer risk increases with age, and most cancers are found in patients over 50. The average age of a man diagnosed with breast cancer is 72.
• Family history. Men with close blood relatives who have had breast cancer are at higher risk for the disease.
• Genetic mutations. Patients may inherit gene defects that make them more susceptible to breast cancer. Men with a mutation in the BRCA2 gene have a 6 percent lifetime risk of developing breast cancer, and men with a mutation in the BRCA1 gene have a 1 percent lifetime risk. These gene mutations are most commonly found in families with strong histories of breast or ovarian cancer, but they have also been found in male breast cancer patients without a family history.
• Klinefelter syndrome. Men with Klinefelter syndrome are born with at least one extra X chromosome, which may increase a man’s breast cancer risk by producing high levels of estrogen (a hormone responsible for female sex characteristics) and low levels of androgens (hormones responsible for male sex characteristics). This condition affects about 1 in 1,000 men and can raise the risk of breast cancer by 20 to 60 times that of the general population.
• Hormone therapy. Men who have been treated with drugs containing estrogen are at a greater breast cancer risk. These drugs were once used to treat prostate cancer, and they are still used in sex reassignment processes.
• Conditions affecting the testicles. Testicle injuries, swelling, or removal surgery can increase a man’s risk for the disease by disrupting normal hormone levels.
• Liver disease. Diseases that impede the liver (like cirrhosis) may raise men’s estrogen production and lower their androgen levels, therefore increasing breast cancer risk.
• Alcohol. Heavy drinking is known to raise the risk of breast cancer (which may be related to alcohol’s effect on the liver).
• Radiation therapy. Men who have received radiation therapy to their chests (for conditions like lymphoma) have a higher risk of developing breast cancer.
• Obesity. Fat cells can transform androgens into estrogens, boosting the possibility of an overweight man developing breast cancer.

If any of the above risk factors applies to you, consult your doctor and feel free to ask questions. While it’s true that men can work to lower their breast cancer risk by exercising and maintaining a healthy bodyweight, the most important element of effective cancer treatment is an early diagnosis.

Symptoms of Male Breast Cancer Can Include:

• A lump developed in the breast (usually painless), or a thickening in the breast tissue
• Nipple pain
• An inverted nipple
• Discharge from the nipple, which may be clear or bloody (this was Mathew Knowles’ first symptom)
• Changes to the color or texture of the nipple and areola
• Changes to the color or texture of skin on the chest
• Enlarged lymph nodes under the arm

If You Feel Something, Say Something — Men Ignore Symptoms Too Often

Treatment for male breast cancer is largely the same as female breast cancer. A person’s options depend greatly on a variety of factors, including the size of the tumor and how far the cancer cells have spread, but possibilities include surgery, chemotherapy, hormone therapy, radiation therapy and targeted therapy.

Meanwhile, a self-breast exam is an easy way to monitor your breasts for abnormalities. It involves feeling the breast for swelling, bulging, or changes in the shape of the breast or nipple.

WATCH: How to perform a self-exam.

Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found that is concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.

Help Coping With a Breast Cancer Diagnosis

If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.

“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.

WATCH: How to cope with complex and changing emotions.

If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, lifestyle changes (like exercise and diet), joining a support group, or many other approaches.

SurvivorNet experts suggest that women who need a little extra help coping with a breast cancer diagnosis.

• Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
• Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
• Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
• Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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