Four years ago, Tammy Porter's husband, Mike, first started noticing symptoms of what turned out to be breast cancer: "a pea-sized lump under his areola on his left side," Porter described.
"He pointed it out to me one day, just kind of matter-of-factly… and I said, 'Oh, that's interesting.' And, you know, there was no discussion of it ever at all until probably three to four months later," Porter said.
She said her husband noted the lump was getting bigger and his nipple was inverting. After a visit to their physician, Mike was quickly scheduled for a mammogram.
"I think he was embarrassed a little," Porter recounted. "It was really hard for him to mention the words 'breast cancer.' He would say, 'I have cancer,' but it was hard for him to actually discuss the breast cancer part… It was very ostracizing, walking into a clinic that's full of pink."
She said the mammogram room even had a sign, "Women only."
Mike underwent a radical mastectomy and radiation, but the cancer metastasized to his lungs, spine and brain. Two-and-a-half years after diagnosis, Mike passed away.
"If we had known three or four months prior, you know, it may have been a stage one diagnosis. It was an aggressive cancer. And so… it might've been very different, had we known," Porter said.
Particularly in men, early detection is critical.
"In general men have lower survival rates than women do after they get diagnosed with breast cancer," Dr. Sharon Giordano of the MD Anderson Cancer Center said.
accounts for about 1% of all breast cancer cases. This year it's estimated close to 2,670 men in the U.S. will be diagnosed with breast cancer. About 500 men will die this year from breast cancer, compared to more than 41,000 women — but the mortality rate in men is higher.
One third of Giordano's patients are men, and she says men often get diagnosed with more advanced breast cancer in part because of lack of education.
"Some of the risk factors in men include genetic factors such as BRCA mutations, exposure to radiation therapy in the past, a family history of breast cancer," she said. "So if they have a first-degree relative" — a parent or sibling — "who has had breast cancer, they have more than double the risk of having breast cancer themselves."
It was knowing his family history that helped former NFL player Paul Dombroski.
"My mom was a breast cancer survivor for about 25 years, so as soon as I felt the lump, I just knew right away that it was breast cancer," Dombroski said. In 2013 he was diagnosed breast cancer.
"I immediately thought, 'How do I battle this? What's the next step?' It's almost like a football player where you're injured. How do I get back on the football field?" Dombroski said.
He is now in remission, and his mission is to raise awareness.
"A lot of guys I played with… they say, I didn't know men could get breast cancer. I said 'Bro, you got breasts. Call them what you want.' We used to call them pecs, your chest. It's anatomy. ... The rarity thing, I think we should kind of drop that term because it's not rare to that man, and to that man's family," Dombroski said.
As for Porter, she hopes sharing her loss will help save lives.
"He vocalized a number of times that he hoped that his life wasn't in vain and that it would mean something and that we would be able to change someone else's life by telling his story," Porter said, choking up with emotion.
For men, the symptoms are usually a lump behind the nipple or some bleeding.
The FDA recently put out guidance recommending men be included in breast cancer clinical trials. It's typically only women participating in these trials.