For years, Bret Miller was told not to worry about the hard nugget the size of a lima bean underneath his right nipple.
By BEN PALOSAARI
Special to The Star
He first mentioned it to a doctor in 2003 during a physical to play high school football when he was 17. They were like, Youre 17. Its puberty, he recalled. It seems like a calcium buildup. Youre in puberty. It will dissipate. They come and go.
But it didnt go away. Because it wasnt calcium. It was breast cancer.
In fact, Bret Millers cancer wouldnt be diagnosed for another seven years one of the reasons he has committed himself to being the male face of a cancer that is 100 times more likely to be found in a woman.
The color pink has become symbolic of breast cancer awareness. Each fall, during National Breast Cancer Awareness Month, the world is awash in it.
Miller, a 27-year-old resident of downtown Kansas City, knows thats a good thing for the disease thats the second leading cause of death by cancer in women.
But Miller and his mother, Peggy Miller, want to add a little blue to the conversation. The year he was diagnosed, they started the Bret Miller 1T Foundation.
This is still a womens disease, Bret Miller said. Its always going to be that way. Im not trying to steal the thunder from anybody. I have gotten some dirty looks from some women, but Im not trying to steal their thunder.
Im just trying to educate people and let them know that it is possible. Thats where the whole foundation came from.
With his foundations pink and blue ribbon tattooed on his chest and proudly displaying his mastectomy scar, Miller is determined to let men know: Breast cancer can happen to you. too.
His ultimate goal is to build the Bret Miller 1T Foundation into the Susan G. (Komen for the Cure) of male breast cancer.
He and his mother are clearly motivated. They got Missouri Gov. Jay Nixon and Kansas Gov. Sam Brownback to designate a Male Breast Cancer Awareness week in late October.
Miller has been interviewed for an upcoming HBO documentary about mens breast cancer. A short documentary about his case is shown to students at his high school alma mater, Shawnee Mission East. And hes one of only two men named as Models of Courage for Fords Warriors in Pink breast cancer awareness campaign. For that program, hes made widely distributed videos telling his story and encouraging men nationwide to start thinking about breast cancer.
One of the reasons Millers cancer went undetected for so many years is that breast cancer in men is exceptionally rare. It makes up only 1 percent of the cases of breast cancer nationwide. The National Institutes of Health estimates that while 232,340 women will be diagnosed with breast cancer this year, 2,240 men also will be. Almost 40,000 women will die of it; 410 men also will die.
In fact, the disease is so rare that Medicaid guidelines arent written to include testing and treatment for men enrolled in the program, which leads to men often being denied treatment.
Several months after his football physical in high school, Miller had another physical before entering the University of Kansas as a freshman. He mentioned the lump. And again the doctor said it was likely just calcium and nothing to worry about.
He thought the same exact thing as the doctors before calcium deposit, keep an eye on it if it changes size or what-ever, he said.
While he was at KU, though, the hard ball began to worry him a little bit, especially when pressure was applied to it.
It had kind of started hurting. Not a lot, just a little pain, he said. If I did squeeze it, there was a yellow-orange-ish discharge. (I was) thinking it was a cyst or whatnot. A fluid buildup.
The discharge didnt alarm him; he figured it was dissolving. I was just thinking, maybe its finally going away just like the doctor said, Miller said.
After graduating from KU in 2008, he moved back to the Kansas City area and took a job managing facilities at the Carriage Club country club in Kansas City. In 2010, about a year after getting health insurance for work, he again mentioned the hardness under his nipple to a doctor.
This time, though, the doctor said it needed to be checked out. Miller was sent to a clinic for an ultrasound. The physician never uttered the word cancer.
He drove to the clinic for the ultrasound, and that was when he first realized he didnt fully understand what the lump could be.
So I walk in there big ol letters: Womens Clinic, he said.
Still, the possibility of having breast cancer didnt register. Its where they have the (ultrasound) machine, thats all Im thinking. Nothing is clicking that its breast cancer, he said.
He even remembers chuckling at the forms he had to fill out in the clinic waiting room. They hand me the clipboard, Im filling it out. Name, address, insurance When was your last menstrual cycle? Are you pregnant? he recalled.
But things got serious quickly.
The technician doing the ultrasound called the on-call doctor.
She comes in and literally does a triple-take. Shes looking at the screen, looking at me. Looking at the screen, looking at me.
The doctor order a mammogram. Is this physically possible? Miller thought. He wasnt even sure how the doctor was going to conduct the scan: What are they going to squeeze?
The mammogram showed a mass, and Miller consulted a surgeon who was confident that it was a deposit of calcium and that it should be removed. On April 27, 2010, Miller had surgery to remove the mass.
The next day, Im back at work at the country club. More numb than anything, Miller said. As Im leaving the country club, I get a call from the surgeon. He doesnt ask me if Im sitting down, if Im driving, whatever. He kinda goes, The preliminary pathology reports have come back, and it says its breast cancer.
I love them all dearly, Peggy Miller says of her children. If God had to choose anyone to give cancer to, this is the one out of the four of my kids.
Bret Millers eyes remain dry, and he rarely gets emotional when talking about his ordeal.
His mom, though, lets her emotions flow freely.
Bret is the kid who doesnt get fazed, she said. After all, Brets her kid who played nose tackle for the Shawnee Mission East Lancers while weighing only 130 pounds as a freshman. Brets her kid who routinely works 50 hours between his Carriage Club job and a gig tending bar at Tengo Sed Cantina in the Power & Light District and still remains cheerful and active when hes not on the clock. Hes the kid who recently volunteered his bar tips to get tumors removed from the legs of the familys boxer.
Hes the most unflappable member of the family. Even when he got the cancer call from the surgeon.
I was like OK Uh? All I was thinking was, am I getting punked right now? Wheres Ashton (Kutcher) and the cameras? he said of the MTV show that filmed pranks on people.
Peggy leapt into action. Her first task was to reach out to every member of their extended family to put together a complete family history of cancer. The good news was that there was no direct line of cancer in Brets genetics. That meant that after surgery, the chances were lower that the disease would return.
A second opinion confirmed the need for more surgery. Since the cancer hadnt spread into his lymph nodes, and no cancer was detected in his left breast, he opted for a single mastectomy. He went under the knife May 18, 2010.
The surgery, done at St. Joseph Medical Center in south Kansas City, was a success. The cancerous tissue was removed, and Miller came through fine. He was left with a scar several inches long, and no right nipple, but the cancerous tissue was removed, and so far it hasnt spread anywhere else.
A prayer Peggy Miller said the morning of her sons mastectomy to the patron saint of lost causes set the family in motion for raising awareness about male breast cancer.
I have big faith in St. Jude, she said, through tears. We prayed to God and to St. Jude that morning. You make Bret well, I will promise you I will tell the world.
With her son on the road back to health, Peggy Miller, an Episcopalian, began to follow through on the promise she made to God and to educate people about breast cancer in men.
Her son had already started educating the public through Facebook posts about his diagnosis and surgery. Even in those early days, he showed a flair for fun a key part of his foundations attitude. Just before the surgery, he posted a comic goodbye to his right nipple. Its been a good 24 years, he posted.
Peggy Millers activism lands somewhere between a hobby and a part-time job. My husband, my other three kids probably would wish I would stop talking about it, she said with a laugh.
There have been a couple famous men with the disease, including the late The Price Is Right announcer Rod Roddy, who advocated late in his life for men to get mammograms; Shaft actor Richard Roundtree; and Kiss drummer Peter Criss. But its rarity is why Peggy Miller doesnt blame doctors for missing it in her son.
Why would I ever expect a male doctor to look at a male patient, especially Brets age, and say, Oh, I think you have breast cancer? I wouldnt, she said.
And thats exactly why she and Bret are working together to build the Bret Miller 1T Foundation, a 501(c)(3) nonprofit, to educate young people, especially men, about breast cancer.
By launching his own organization, Miller aims to spread his message of early detection. The foundations mission is to build awareness and early detection for young women and men through the knowledge of survivors.
He plans to send breast cancer survivors to colleges and high schools nationwide to educate students about detection.
During the process of learning about male breast cancer after her sons diagnosis, she had what she calls her Oprah a-ha moment. She asked Bret and her husband, Bob, if doctors had ever checked their breasts.
They both said, No. They check everything, down to the testicles, But not our boobs. I said, Oh my gosh, you men dont even have a chance in hell. You dont even know, she said.
Indeed, the National Institutes of Health notes that survival rates are the same for men and women when the cancer is caught at the same stage. Men, however, are more likely to be diagnosed at a later stage.
Lon McCroskey, the breast surgeon who performed Brets surgery, has been practicing since 1981 and treated about 15 to 20 cases of male breast cancer in his career. He said the treatment for male breast cancer is very similar to the treatment of female breast cancer. Its important to catch it early, he said.
Male breast cancer is very curable, just like female breast cancer, if its caught early, he said.
Brets work to raise awareness of breast cancer in men is particularly important because breast cancer in men can indicate that breast cancer is in a familys genes.
Male breast cancer is a red flag for a problem in the family, McCroskey said.
If male breast cancer is found, he said, other family members should get tested to see if they have elevated likelihood of getting cancer.
If that family is tested, you might find that other members are at risk, McCroskey said. And you can prevent breast cancer in those patients if you know that theyre at high risk of developing breast cancer.
The revelation that men arent checked for breast cancer sparked Peggy Miller to pursue a simple mantra for the organizations mission. The first point she makes to people is that you dont have to have large amounts of breast tissue to get cancer. Any amount of breast of tissue can become cancerous.
If you got boobs, this can happen to you. It doesnt discriminate, she said.
Spend any time with Peggy in the cluttered home office that serves as headquarters for the familys film production company and the Bret Miller 1T Foundation, and its clear she has done her research into breast cancer. As far as she can tell, Bret is the youngest man ever to be diagnosed with breast cancer. Usually men arent diagnosed until they are in their 60s.
To help raise awareness, the Millers worked with the National Consortium of Breast Centers, a nonprofit professional membership organization, to create online videos showing up-to-date and doctor-recommended methods for self examinations for both men and women. The videos have been viewed by people from around the world, Peggy Miller said. And her familys new activism is already paying off for herself. Using the methods in the videos, she found two noncancerous lumps in her own breasts a couple months ago.
It has saved lives. People have found their lumps. I found mine, because of it, she said.
Bret Miller wants his foundation to be full of fun hosting events at bars.
Everybody has a 5K or a fun run. You have to do something different. Think outside of the box, he said during the foundations first fundraiser in late September at the bar and concert space Kanza Hall in the One Block South development in Overland Park. While the family had participated in charity walks and hosted fundraisers for other breast cancer nonprofits, this was the first for the Bret Miller 1T Foundation.
There was a resoundingly nontraditional feel in the bar. A video of Bret chatting with female breast cancer survivors played on TVs throughout the space. And a couple dozen volunteers milled about in blue T-shirts, selling raffle tickets and tending bar. The night culminated in a country rock concert by the band Walker McGuire. It had the feeling of a fun night out, and 342 attendees raised $3,647 for the foundation.
Miller wants to appeal to a younger crowd and get young men educated.
To quote George Carlin, saliva over a long period of time, swallowed in small amounts, can cause cancer. It seems like no matter what we do in our society or world, cancer is inevitable. Its going to happen. It strikes people that are in phenomenal shape. Its a genetics thing, he said.
The Millers are finding out that promoting education about breast cancer among men can cause friction between them and traditional, female-focused breast cancer charity groups.
Peggy Miller says that experiences with those groups have been a little prickly. She recalled asking one cancer patient support group that she didnt want named to help Bret. A member of the groups leadership told her that the organization is for female patients only.
I said, Well you know what? As these men get this cancer, you guys need to rethink your purpose. She said, Well, I dont know if that will ever happen, Peggy said.
Theres also resistance among some traditional breast cancer nonprofits to highlight the disease among men on their websites and in marketing campaigns.
Friction between breast cancer nonprofits is a fact of the industry, said Leawood resident Barbara Unell, founder of the nonprofit Back in the Swing. Unell started her organization focusing on getting survivors post-treatment care in 2000 after her own battle with breast cancer.
I dont feel like Im in competition or running against them, she said of other cancer organizations, but theres only so much money to go around. There is a fight, if you will, for that dollar.
She added that because most research and breast cancer nonprofits are focused on female breast cancer, raising awareness of the disease in men is a laudable focus. A male friend was recently diagnosed with breast cancer, and she said theres a tight connection between population groups targeted by awareness groups and research funding.
Where research dollars go, thats where a lot of the awareness follows. And vice-versa, she said.
The Millers are determined to grow their foundation. They have found success in getting several states to declare a week in October for male breast cancer awareness.
Additionally, the foundation is organizing an event in April called Tops Off New York, a photo op in which male and female breast cancer survivors will pose topless. The fundraiser will benefit the Millers foundation as well as the male breast cancer organization PecCheck4MBC.org and the Memorial Sloan-Kettering Cancer Centers male breast cancer research project.
As they get the Bret Miller 1T Foundation going, Peggy says their message needs to be simple: The public needs to stop thinking about breast cancer the way it does now.
Its not just pink. Its a pink and blue world now. If youve got boobs, you can get it, she said.