Nine years ago this month, 50-year-old Stephen Sala, of Eagleville, Pa., received a diagnosis he never expected.

The healthy 41-year-old husband and father of three had discovered a lump in his right breast. When he visited his primary care physician, he was told it was most likely “just a cyst.”

Not satisfied with that answer, he pushed for further testing, including scans. A mammogram revealed HER2-positive cancer in both breasts.

“I was 100% in shock,” Sala said.

Many of his male friends were too. “I didn’t know that men get breast cancer,” they said.

Within a week, Sala underwent a double mastectomy. The cancer was caught early and only 10 years of the hormonal drug tamoxifen was necessary. BRCA genetic testing later came back negative.

Now, Sala is grateful to be in good health. During Breast Cancer Awareness Month, he shares his story to encourage others — especially men — to take breast changes seriously.

“If it’s caught early, others can have the same positive outcome I did,” he said.

His experience highlights an often-overlooked reality: Breast cancer affects men, too.

Dr. Emil Fernando, a breast surgeon with Allegheny Health Network who practices at Allegheny General Hospital and the Health and Wellness Pavilion in Wexford, treats patients with a full spectrum of breast surgeries, including male breast cancer.

“Each year, fewer than 1% of breast cancer cases occur in men — about 2,800 nationwide — compared with more than 300,000 in women,” Fernando said.

At AHN, Fernando sees only about two patients a year. Yet he stresses that men should remain vigilant about their breast health.

“The biggest reaction I see is surprise and disbelief when they hear the diagnosis,” he said. “But awareness and early treatment are crucial for survival.”

Dr. Shannon Puhalla, a medical oncologist and hematologist at UPMC Hillman Cancer Center, said in an email that the highest rates of male breast cancer occur in non-Hispanic Black men. Risk factors include older age, family history — especially with BRCA gene mutations — and gynecomastia, a condition where breast tissue is enlarged, often related to hormonal issues or medications.

“There is also an increased risk for men who are diabetic, overweight or obese, or who have a history of radiation to the chest,” she added.

Both doctors emphasized that a lack of awareness or ignoring a lump often prevents men from discovering breast cancer early, when it is most treatable. Men should be alert to lumps in the breast or armpit, nipple changes or a family history of breast cancer. In some cases, BRCA testing detects mutations of the BRCA1 and BRCA2 genes that increase the risk for ovarian, pancreatic, breast and prostate cancers.

Living with a diagnosis that traditionally is associated with women can be difficult for men, but many find ways to navigate treatment, share their stories and seek support through traditional breast cancer networks or emerging male-focused resources.

Sala found support serendipitously. The day before his scheduled breast surgery in October, he and his wife had scheduled a birthday trip to the TODAY Show in New York for his twin daughters. They decided not to cancel their trip.

Upon entering the studio, the Salas saw 10 women and one man dressed in pink who were there to discuss breast cancer.

Sala went over to the lone male, who turned out to be Michael Singer, a six-year cancer survivor. The two spoke, and Singer, who founded the Male Breast Cancer Coalition, a nonprofit patient advocacy organization aimed at educating the world about male breast cancer, reassured Sala.

“He really helped me with the emotional piece of it,” Sala said. “And we are good friends to this day.”

Here in Western Pennsylvania, patients and families have access to a wide range of services.

UPMC Hillman Cancer Center and the AHN Cancer Institute provide medical oncology, radiation, chemotherapy, immunotherapy, genetic counseling, nutrition guidance and psychosocial support, with locations in both Pittsburgh and Butler. Cancer Bridges in Pittsburgh and 412 Thrive offer wellness programs, peer support and caregiver assistance.

The American Cancer Society provides a 24/7 helpline, transportation to treatment, free lodging and community events.

Butler also hosts local support groups at Butler Memorial Hospital and Trinity Lutheran Church.

These programs and other national ones such as Man Up to Cancer and Male Breast Cancer Global Alliance ensure that patients and their loved ones can find care, education and emotional support close to home.

The possibility of cancer should always be on a man’s radar when discovering a lump, Fernando said.

“Cancer is very treatable, if caught early,” he said.

It’s a message Sala echoes — one he hopes will encourage others to listen to their bodies and seek answers that could save their lives.