Breast Cancer in men
Surgery for breast cancer in men
Surgery is usually the first form of treatment that a person with breast cancer will have. Men have much less breast tissue than women and so it is usually necessary to remove all of their breast tissue including the nipple on the affected side with a mastectomy.
When a woman is diagnosed with breast cancer, it is sometimes possible for her to have a lumpectomy rather than a mastectomy, but though it is less often possible for men, it may be an option in some cases. Rarely, a small part of the chest muscle is also removed during surgery if this has been affected by the cancer or if the lump is very close to the muscle. The surgeon also usually removes lymph glands (nodes) from under the arm to check whether any cancer cells have spread from the breast tissue.
If a pre-operative scan shows that the lymph glands appear normal, a sentinel lymph node biopsy is used to remove one or two lymph nodes to test whether the cancer has spread. If it is known that the cancer has spread to the lymph nodes, and it has been confirmed by biopsy of a lymph node in the armpit, then all of the lymph nodes in that region will be removed with an axillary lymph node dissection, a lymph node sample, or a lymph node clearance. These help the doctors decide whether further treatment is needed after surgery.
The size, grade and oestrogen receptor status of the tumour also helps to determine what treatment should be offered. A sentinel lymph node biopsy can reduce the chances of arm stiffness and swelling of the arm after surgery (see Lymphoedema). More information and resources about this are available in our resources section.
Breast conserving surgery for male breast cancer
In some cases, male breast cancer can be treated with a breast conserving surgery (lumpectomy or wide local excision (WLE)) rather than with a mastectomy. Breast conserving surgery in these cases aims to remove the cancer while keeping the nipple. Before breast conserving surgery, doctors may suggest having what is called neo-adjuvant treatment, including chemotherapy, targeted therapy or hormonal therapy to shrink the cancer.
As with a mastectomy, some or all the lymph nodes in the armpit will usually be removed with an axillary lymph node dissection, a lymph node sample or a lymph node clearance during the surgery.
After surgery, the tissue that was removed is examined to make sure the cancer has not spread: if it has, a mastectomy will be needed. Doctors will also typically suggest having radiotherapy after breast conserving surgery to reduce the risk of the cancer coming back (Macmillan Cancer Support 2024).
We have not yet been able to interview anyone who has had breast conserving surgery (lumpectomy, wide local excision) for male breast cancer. If you have had this type of treatment and are interested in including your experience, please reach out to us at hexi@phc.ox.ac.uk.
Experiences with mastectomy
Tom recalled how, before going into theatre for his mastectomy, he and the hospital staff had laughed at his compression socks being too long for him.
Tom recalled how, before going into theatre for his mastectomy, he and the hospital staff had laughed at his compression socks being too long for him.
I could remember the times going in, ten past one. I can remember them laughing about my socks because the socks apparently go by your calf measurement and I finished up with socks about four inches too long because I’ve got really sturdy calves… short, fat and hairy. I could… waggling about like that when I was on the [unclear] anaesthetist, “Look at that”. I says, “when you stick the needle in, don’t stick it in the spare end of my sock like, I want it in me, not that”. Of course, by then I was half way under because he’d…
Experiences post-surgery for mastectomy
David could not believe how well he felt when he came round after his mastectomy. He had no pain and felt that a load was lifted off his mind after the operation.
David could not believe how well he felt when he came round after his mastectomy. He had no pain and felt that a load was lifted off his mind after the operation.
So you look forward to this date and see how you’re going, and thinking you’re gonna go on a cancer ward but you’re just on a general surgeon ward and… I turns up for the hospital appointment, the operation was about 4pm and [wife] came to see me at 6 and I was just as right as a bobbin. Couldn’t believe how, how well, I felt, you know, you’ve lost all this side of your body and no pain, nothing. Just obviously coming round from the anaesthetic, but felt fine. Absolutely brilliant. [wife] was amazed and, you know, how well I looked. “You look really well” so I said “yeah, I feel really good.” And it were just like yeah, it’s happened, I’ve got rid, you know? A load’s lifted off your mind, really. I’ve come through the other side. Silly, in’t it, what you think? Anyway… get the hospital, the nurses and doctors said “what kind of painkillers do you want?” I said “well, what can I have?” They said “well, you can have anything from paracetamol to morphine, depending how bad the pain is.” I said well, actually, I’m not in any pain, which is unbelievable to think. As I say, you’ve lost all this side and you think there’s no pain. Obviously it’s in, you know, bandages and whatever else that you don’t really know, until they took the bandages off and sorta looking and you’re thinking .. they put a zip in, cos it’s just like, you see this staples from there and they disappear under your arm.
Ben describes what it was like immediately after his operation. He was able to raise his arms straight up very soon after his mastectomy.
Ben describes what it was like immediately after his operation. He was able to raise his arms straight up very soon after his mastectomy.
I was admitted into hospital and had the operation and from there I remember going down and them putting a needle in me and I thought I was going to, the usual thing, I was gonna be… count to three and you’ll be gone, and I said, “Have I got a…?” and I was gone. So I didn’t get to one, two or three, and so I went down and I remember waking up on the ward because I was first in, I had been told I was first in, I woke up and raised my head and had a look and I couldn’t see anybody else awake and there was a whole ward full of people that had been operated on that morning and eventually they came round and sort of dealt with me and helped me, and from there I was then taken back to this little small unit where there was I think four people in this little unit, and stayed in there and was… I’d been given two bags, bags for blood and residue, to be taken, and then my wife came in and sort of greeted my son and my wife and… I was able, even then I’d been told that the first thing ladies, or you should try and do is raise your arms and I was able to do that and there was ladies that couldn’t do it and I was able to raise my arms straight up straight away, so I kept doing that and then trying to do all the exercises that I’d been told to do at that particular time.
Bill talked about waking up after his mastectomy feeling very cold and in pain. The morphine that he took made him feel nauseous.
Bill talked about waking up after his mastectomy feeling very cold and in pain. The morphine that he took made him feel nauseous.
But the next thing, I do remember going to the anaesthetist, speaking with me and the cannula in my hand was already in my hand, and the next thing I remember waking up and I was absolutely freezing cold, I was very cold, in the recovery room. And I was aware of a big pressure bandage across my chest. And they put a, one of these- obviously a silver foil thing on me, and blew a heater into me to heat me up. And then they took me, once I was over that part, they took me back to the oncology unit in a single room, and hooked me up to different machines, and my arm seemed full of things. And I dozed in and out, people came to see me and I can’t remember much about that. And when I did come to a bit, they explained to me that I had this pain, pump thing, pain relief that I- if I was in pain then I could press this pump.
Bill said that his drains were removed several days after his surgery. He describes it as a 'very strange feeling'.
Bill said that his drains were removed several days after his surgery. He describes it as a 'very strange feeling'.
Anyway, the- the drains in my chest and arm began to run clear, after four days, Tuesday, Wednesday, Thursday, Friday… Saturday still draining a bit, and they said to me that I would be allowed home on the Sunday if the drains remained clear for that day. So in fact they did remain clear and they- I always remember, it was very strange feeling, having the drains taken away, cause you could feel them coming out. Ooh! Anyway, they took the drains out and gave me another dressing, put another dressing on the scar, and sent me home.
Experiences with recovery and complications
Steve developed an infection about a month after his mastectomy. He felt quite unwell, but the infection was quickly diagnosed and treated with antibiotics.
Steve developed an infection about a month after his mastectomy. He felt quite unwell, but the infection was quickly diagnosed and treated with antibiotics.
And then it was just the road to recovery then, over a period of weeks. I did have an infection in the drain, that did cause me a bit of problems, I was quite unwell for a fortnight with that.
Tim can feel his ribs in his chest since his surgery, which he said was as 'a funny feeling'. He has been left with a very neat scar.
Tim can feel his ribs in his chest since his surgery, which he said was as 'a funny feeling'. He has been left with a very neat scar.
And the operation was very successful, the whole breast tissue, everything was taken away, in those days still they took all the lymph glands.
But, you know everything was removed, as far as we were aware at that time, and then I was told to report back later, you know the operation healed up very quickly actually, it was amazing how little pain there was, and in fact looking at me you would notice that I only have one nipple, but it doesn’t bother me in the least actually, it’s a very neat scar, but you can feel my ribs right there. It’s a funny feeling. And I had a bit of trouble with the muscle underneath my arm and its attachment for some time. Probably for about a year. If I used that arm too much, it was the base of the muscle, it used to get very sensitive, because it hadn’t got anything to hold onto. It used to hold on to this piece of muscle here. But it’s settled down more or less now, cause we’re talking twelve years ago now.
Bill described how he felt the first time he saw his chest with only one nipple. He was annoyed about losing his nipple even though it had been the only option he had.
Bill described how he felt the first time he saw his chest with only one nipple. He was annoyed about losing his nipple even though it had been the only option he had.
And, after a few days, I think the operation was on the Tuesday, and I had drains in of course, two drains, one in my chest and one under my arm. The bandage had loosened a bit and I became very nosy and managed to ease it off mostly and, was just a huge scar right across my chest, which ended under my arm.
Derek still experiences some stiffness under his arm, even some years after his surgery.
Derek still experiences some stiffness under his arm, even some years after his surgery.
And how was your wound?
It was fine, yeah. I just didn’t realise how big or large it were or… were quite long. I didn’t realise that. I’ve not much recollection of that, of the operation or anything. I’ve not much… can’t really remember much about it. Obviously stiffness, I still get stiffness now after all this time because apparently when I go to the doctor’s to ask her about this, it was, it says it’s because of the depth of how far they’ve gone down through and my lymph glands here, I was very fortunate as well I didn’t get any bloating or nothing like that.
Steve described getting the movement back in his arm over the 6 months since his mastectomy. He still has a 'weird' sensation under his arm which feels a bit like sunburn.
Steve described getting the movement back in his arm over the 6 months since his mastectomy. He still has a 'weird' sensation under his arm which feels a bit like sunburn.
I was told that obviously if I had any problems with the tissue area, that I should go back, but I haven’t. It’s still, it’s a funny sensation, for people who’ve not had surgery, it’s a little bit like having sunburn.
Roy had a bilateral mastectomy and chest muscles removed on both sides. He had been working as a builder up until his operation but was not able to carry on with such heavy work afterwards.
Roy had a bilateral mastectomy and chest muscles removed on both sides. He had been working as a builder up until his operation but was not able to carry on with such heavy work afterwards.
Last reviewed November 2024.
Last updated November 2024.
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