Real Men Don't Need Nipples

Observations from a Male Scientist and Breast Cancer Survivor

As I proceeded through life as a male, I wondered why men are born with what is arguably an unnecessary set of nipples.   These same two nipples on a woman serve as evolutionary confirmation that nipples can indeed provide functional as well as aesthetic benefit.  These benefits appear to be woefully missing in males.

As a scientist, I spent a 50+year career involved in pursuit of biological sciences and clinical research.  Among the subjects studied on my path to a double science major Ph.D. degree, I was fascinated by Darwin’s theories of evolution and natural selection. Among the theories involved in Darwin’s research was the now proven observation that those individual species with heritable traits better adapted to the environment will survive.  The result is that superfluous traits will eventually cease to exist.  This is a central theme in Darwinian theory.

These principles caused me to wonder why nipples (and even more surprisingly mammary glands) in men have survived throughout millennia of evolutionary opportunity for change in spite of their seemingly passive role.  If nipples on a man are unnecessary, then mammary glands (which men possess) must clearly be over the top in relation to natural selection evolutionary theory.  

So why do men have nipples and mammary glands?  Doesn’t Darwinian theory dictate this apparent waste is supposed to be resolved through evolutionary change leading to a better-adapted species?  The less than perfect adaptation I saw when I looked down my chest must be the result of a flawed theory.  Or could there be other answers?

It may come down to the fact that in the human species, natural selection may simply not have had enough time to fully weed out the unnecessary or superfluous. Or maybe it could be that the early developmental process determining whether a human embryo is going to be a male or a female is simply going to proceed on parallel male and female paths until chromosomal and hormonal changes induce gender differentiation.  So lacking selective pressure to alter male breast development, male nipples and breast tissue from an evolutionary sense, are going to be around for a while.  

Fast-forwarding to the present, when I found a small pea-sized lump directly behind my left nipple as a result of self-breast examination.  I was 67 years old at the time. A biopsy subsequently proved the tissue extracted from under my left nipple was positive for cancer.  

Ironically, I did my Master’s and Ph.D. degree theses in the early 1970’s on toxicity and carcinogenicity of several naturally occurring metabolites of mold at the time commonly found in food. I also did research on aflatoxin, one of the most potent naturally-occurring carcinogens known to man that, at the time, was found in ground nuts as well as other food products.

While it cannot be stated for certain, this background could be relevant to understanding why I experienced cancer development.  As is well documented, there are many potential causes for cancer development ranging from heredity, environmental risk factors, lifestyle, immunity-enhancing factors, etc.  While I never smoked in my entire life, I grew up in a household with two chain-smoking parents who smoked in our house, in the car while traveling, etc. Furthermore, smoking was permitted in public places for much of my early life including in offices and conference rooms in the workplace.  

When I searched further for answers to the “why me” questions that inevitably surface in the minds of cancer victims, I could easily conclude that my graduate school environmental exposure alone included a daunting list of who’s who in the world of (now) known carcinogens, noxious/carcinogenic solvents such as carbon tetrachloride, chloroform, benzene, etc.  At the time I did my graduate research, the risks associated with environmental exposure to these toxic/carcinogenic chemicals was not known to the extent it is today.  Add to this my exposure to second-hand smoke and I can only conclude that my cancer development should not be surprising.  

In graduate school, I saw first hand how quickly cancer can spread, i.e., “metastasize” to surrounding tissues.  And subsequently, life can be greatly compromised once this cascade is in full swing.  Given the small size of my lesion and the early detection of it, time was on my side in relation to full recovery. I had a mastectomy that included removal of the glandular breast tissue (including the nipple and areola) contiguous skin and a sentinel lymph node biopsy.

Immediately after the surgery, I also began a regimen with Tamoxifen, a drug that blocks the hormone estrogen in the body.  It is prescribed to fight estrogen-dependent breast tumors that depend on estrogen to grow.  And yes, men do produce estrogen through the effect of an enzyme, aromatase that transforms their testosterone into estradiol, a most potent estrogen in females.

The final step in my treatment involved conduction of testing that verified my genetic makeup by itself likely does not make my offspring genetically vulnerable to breast cancer in their futures.  Now several years removed from the surgery, my cancer appears to show no evidence of return.  

So after all is said and done, just like the case with women, early detection of breast cancer in men is key to successful breast cancer treatment and remission.  This all starts with the realization that men are vulnerable to breast cancer, we possess sufficient biological vulnerabilities to development of the disease and need to pay close attention to our bodies and the signs that indicate we have heightened risk.  Guys, breast cancer in men is real. Ignoring this fact is playing with your life. I ought to know; a self-breast exam saved my life.