Breast Cancer in men

Experiences of having tests and getting the results

Once a man has seen his GP about any symptoms which could indicate that he might have breast cancer, further tests in a hospital are needed before a definite diagnosis can be made. The tests which help to diagnose breast cancer include a mammogram, an ultrasound, and a fine needle or core biopsy. People will undergo several tests before a diagnosis can be made (including a clinical examination, imaging and a core biopsy). Once a definite diagnosis of breast cancer has been made, more tests are needed to help plan treatment and to check whether the cancer has spread.

Some hospitals run a ‘one-stop clinic’ for investigating breast symptoms where all of the first diagnostic tests are done and the results are given on the same day. In other hospitals, a further appointment will be made to get the test results. After a physical examination, often the first test that people have is a mammogram or an ultrasound scan. A mammogram is an x-ray image of the breast tissue which is taken by a radiographer. The breast tissue is compressed between two x-ray plates and images are taken from different angles.

Roy describes what it is like to have a mammogram as a man.

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Age at interview: 67

Sex: Male

Age at diagnosis: 65

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And you’re just saying there about, you know, it being easier to find because you were a man and didn’t have a lot of breast tissue?

Yeah, well obviously it just sat on the top of the muscle, really.

But then you were saying that the other side of that was that it was pretty uncomfortable to have a mammogram, as a man, with not much breast tissue?

Yeah, it was very uncomfortable. Yeah, it hurt – and I thought, “Ooh, they’re gonna,” you know, like, coz they’re trying to make something, and I didn’t have, you know, like a lot of chaps of my age have got sort of man boobs anyway, haven’t they, but I hadn’t got to that stage, you know? And they’re trying to make these boobs to get in this mammogram.

So they’re really kind of heaving you about?

Yeah, and they just squash it, and it, you know, I thought, “Oh, she’s gonna stop in a minute,” and it just kept going and going, you know?

So did that just really feel like the skin was getting pulled, then?

Yeah, yeah, yeah, yeah. It was really uncomfortable.

And did they do that on both sides, then?

On both sides, yeah, they done it on both sides, yeah. And it was really uncomfortable.

BT explains that the mammogram is uncomfortable but not painful.

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Age at interview: 65

Sex: Male

Age at diagnosis: 64

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They did one-

A mammogram?

[Laughing, mispronouncing word] Mammo- they did that. And then yeah, then they said “oh we’ll take a sample”.

Right.

I think I had to go back a week later for them to take a sample.

Right.

And then, a week later after that to get the result.

And how did you find the mammogram?

Strange. But, interesting because obviously all the- technicians and what not, all the nurses, they’re all female that are doing it. And, I mean the first time they did it I said, “Oh you’re going to struggle here”, and she looked at me and she said, “Your breast is bigger than some of the women!” [Laughs] So I said, “Oh all right then”. So she said, “We won’t have any problems”. But I found it difficult, you know, you put your- hand behind you and you push, get on and push. One way or another, so that you- then you squash it all up and it’s-

Is it painful?

It’s not painful it’s-. Nah, it’s not painful, it’s just uncomfortable but not painful. And it don’t take long, it’s very, very quick.

Okay. And then you had the biopsy the same day?

No, as I say, I went back a week later.

Oh you went back-. Right okay. For that?

And I think it were a week after that, then they sent for me again and said we’ve got some bad news.

When I- when they did the biopsy and I went, I expected them just to say “oh fine, everything’s okay-“

Did you know at that point that cancer was a possibility?

Oh yes.

You did know.

Oh yeah.

But you just didn’t think it’d be-

Oh no, no, no, no. It’s- no you don’t. I suppose some people might have, but I didn’t. I just thought it were- it’s just one of those things that’ll go away. I mean even when they did tests- they did mammogram and then they did tests you know they have this machine, and they push and shove, and then they go round, there’s been many a time and they looking at the screen, and they said, “Oh there’s a lump, oh that’s all right”. And there were one time, we were having a laugh about it, cause she says, “Oh you’ve got a couple of lumps on this side”. She said, “Let’s have a look at them”, oh she says, “Oh that one’s all right. Oh that’s great”, so I said, “What’s that”, and she said, “Cause I’ve just shifted that right over your breast”. [Laughs] She said, “It’s down the bottom but it’s gone to the top now”. She says … “So we won’t worry about there”. So, you know, but that sort of thing you get, the sort of, all the time trying to relax you and, brilliant.

An ultrasound scan may be done to get a different type of picture of the breast tissue, or it might be used to help the doctor to see where a lump is so that a sample of cells or a piece of breast tissue can be taken to look at under a microscope (a biopsy). A biopsy on a breast lump may be done either using a fine needle to draw off a sample of cells (Fine needle aspiration) or using a larger needle to obtain a small amount of the tissue (core biopsy).

David W was sent to a general surgery clinic. When they heard his lump was in the breast, he was...

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Age at interview: 57

Sex: Male

Age at diagnosis: 52

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So… went for the… on to the clinic, it were just a general surgery clinic, for them to have a look and I just, you know, mentioned that it was in the breast area and then he just looked and he just said “it’s not really – if you’d have been a woman and you developed a breast, that lump would be well underneath and nowhere near the breast anyway, so… but we’ll have it looked at” and he just felt around a little bit and went “mmm… I think we’ll have a scan on it”, you know, ultrasound. So they did an ultrasound and… bit of a jokey guy, I’m watching this little black blotch shape on the… I said is that… “Can you tell if it’s a boy or a girl?”, so we had a joke about that. And they went “mmm…” and they brought this picture of the thing on the screen. Nothing mentioned, and I didn’t know that, you know, as I say, cancer was nowhere in my thoughts cos I didn’t even know that men could get cancer. So from then on, I mean, it was like ten, eleven weeks before I got to the hospital, but once the pictures had started coming up, everything seemed to go into overdrive then. And from, say, going for the scan, we had a mammogram on… again, laughing, joke, said, “You won’t get my little things in” but, “Oh yeah, we can”. So we had a mammogram and then it were… because we’re based in [city], and [hospital] and another [hospital] are the same, or more or less the same health authority, it was a case, can you get to [hospital] for a biopsy? You know, we want to have a look at this… this thing going on. So I said yeah, when are we talking about? And this were, like, Monday. Can you get there for Wednesday? Yeah, yeah, fine, no problem. So as I said, made my way to the clinic in [hospital] which happened to be a breast clinic, and then walking round there, looking for a… “Well, what you doing? This is breast clinic?” You know? I said well, “I’ve been summoned”, I showed my papers, they went “oh, yeah”. “Come for a biopsy”. So… went for the biopsy. That’s uncomfortable, that. Shooting, shooting… it’s just like being… well, I’ve never been shot but it’s just… oh, stab! And took about five pieces of this thing out.

David S first had the lump removed, but two weeks later he was told that he would need a mastectomy.

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Age at interview: 60

Sex: Male

Age at diagnosis: 51

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I discovered a lump about 10 years ago.

I didn’t do anything for about 4 or 5 months. Then I went to my GP. He examined me and he said he didn’t think there was anything to worry about, but would send me for a check up and about two weeks later went to the breast care ?? to see the surgeon. Had a needle put in to take something out.

A biopsy?

Had a mammogram… had a scan. I was told to come back the same afternoon. But I got back, they said I had breast cancer.

Right.

About a week later I had a lumpectomy. I had the lump out. I stayed in hospital two nights. Two weeks later I went back to hospital and they said it had spread a bit and had to it all taken out.

Some men found it helpful or interesting to see the images from the mammograms and ultrasounds. The atmosphere whilst the radiologist was doing the tests sometimes gave the men an understanding that all was not well.

Steve describes what it was like to have the biopsy and mammogram and how he was interested in...

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Age at interview: 58

Sex: Male

Age at diagnosis: 58

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And what about the experience of the mammogram? I don’t think any of us find them comfortable but I mean, for a man they’re…?

Right. Yeah. Because of the physical lack of tissue, the breast is squeezed between two plastic plates, so literally, for me, it was quite – I can’t say it’s painful as such, it’s quite awkward, because of the angles, the different angles that they’ve got to take the actual shots. And it was uncomfortable, I think is the phrase, it’s not a painful procedure, but it certainly, you know, I was on my tiptoes at one stage because they tilted it, and I thought, well, I’ve got to go with this!

(overtalking and laughing)

And it was more painful because I had the pain in this breast, I think that was more painful, but I think if I’d have presented without the, sort of, the lumps, it would have been more, much more comfortable. Didn’t feel anything on this side.

I was going to say, so the left side, was that...?

The left side was very straightforward, yeah. Yeah, sure.

And you were saying that the biopsy itself was quite uncomfortable, you’re saying cos that went into the nipple?

Yeah. They put a topical anaesthetic, you know, a cream on you, to sort of null the pain at the, sort of, the biopsy site. And again, I only had a couple of minutes, you know I had no warning that this was going to actually take place, so I had no thinking time to, “Oh, I don’t like this,” I really went from one room straight into the next room, and lying on a couch, but the procedure’s very well explained to you, the biopsy gun makes, you know, it is a gun effectively, you know, it makes a noise, like a cap gun going off, so they actually fire it for you so that you can be aware that that’s the noise you’re going to hear. And the needle goes in, and I was more interested because it was on actually on the ultrasound screen, so...

So you were kind of watching it as it happened?

...as the nurse was doing it, I was watching it, and going in, and they did three points around the actual tumour itself, and then when the gun goes, it’s a bit of a shock, but, I mean, it’s a dull pain, it’s not a nasty pain, I wouldn’t class it as that. And then you just wait, then, for three or four days, while they do the histology and you get the results.

David C describes having a mammogram, ultrasound, and biopsy. The type of ultrasound he had...

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Age at interview: 72

Sex: Male

Age at diagnosis: 71

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Did you have a mammogram as a test?

Yes, and it was rather – it wasn’t painful, but I can imagine, if I’d been a female, it wouldn’t be very nice at all. I know some of my friends who say it’s not the nicest of things to happen to them.

Yeah. Can you remember all the tests they did? So they did a scan – I take it…

Ultrasound one, yes.

And that’s the one where you could see it was…

Could see all the blood beginning to form its own little blood supply. That was frightening.

Right. And then they did a mammogram as well?

Did a mammogram too.

Can you just explain what they did?

Well, it’s two metal plates – I think it’s an x-ray, and they try and squeeze the breast quite hard, and then it takes an x-ray of the breast, plus the lump itself, as well too, and then they can check to see if it’s cancerous. So it’s just one of the checks that they did to make sure it was a cancerous problem.

And they did a biopsy as well?

They did a biopsy as well, too.

Can you remember – was it just once in with a needle, or how did they do it?

They gave me a little injection, first, to freeze it, and then they used their little clipper and little thing to get samples of it, and I never felt a thing of that. Although I know one friend who said she was in agony with it, but something happened there – I don’t know what. Maybe she didn’t get the injection for some reason, I don’t know.

Right – and is that all the tests you had?

That’s all the tests I had.

Tom asked the radiologist to give a commentary to help him interpret the images on his ultrasound...

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Age at interview: 54

Sex: Male

Age at diagnosis: 50

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The actual diagnostic procedure was sort of pretty unpleasant. Of you know biopsy being taken with a thing like a sort of industrial stapler, and ultrasound, and I remember being in a darkened room with the ultrasound and the radiologist being completely silent, and me encouraging her to give a commentary on what she could see on her screen, because just like any sort of electronic diagnostic apparatus there's a matter of interpretation and although it's second nature, obviously, it's a bit like someone looking at a radar screen, isn't it- second nature for someone who does it every day, it's a lot of sort of spots and funny shapes and things for anyone who's not familiar with it on a day-to-day basis. So I tried to encourage her, and she looked extremely grave and said ‘it was not good news’. And then sort of strangely went away in another office and allowed someone else to show me out. A sort of very peculiar, alienating situation.

Right. So she didn't actually say at that stage that she thought it was breast cancer, she just gave an indication through using words like grave.

She didn't use grave, that was my word, I think she said it was ‘not good news’.

And I remember the radiologist’s last words she said was ‘good luck’, when I left. Because she had actually shown me this structure, and I had no idea what the structure was other than it was quite possibly cancer, I didn’t… you know I didn't know whether there were other things it might look that on x-rays, because I'm not a trained x-ray radiographer. So, she looked very uncomfortable so, putting all these things together, things didn't seem very good.

A core biopsy or a fine needle aspiration biopsy can be uncomfortable or painful, although often a local anaesthetic is applied. These tests can lead to some bruising afterwards.

Bill describes having his core biopsy and the wonderful' bruise that he developed after the test.

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Age at interview: 54

Sex: Male

Age at diagnosis: 46

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The worst thing though was, that day they told me I had cancer, they took a core biopsy, and they had given me some local anaesthetic and then taken this core biopsy, and the bruising was just so extensive and so horribly sore. It was absolutely wonderful bruise if a bruise could be described as wonderful, this was a wonderful bruise, all over this side of my chest. And the pain! And they had put this big pressure bandage on it. But, I’d often thought I could get to the front of a queue if I just exposed this bruise to people. And- but I remember that as the most painful thing actually.

Very often when men were at the hospital for their outpatient appointments and for their initial tests, they were the only man in a waiting room full of female patients, although some of the women had their husbands or other male family members or friends with them (see also ‘Experiences as a man in different breast cancer treatment settings’). It was not unusual for the men to be ‘pioneer’ patients in their hospital, and most of them said that they had been the first man with breast cancer that their medical team had treated or done diagnostic tests for breast cancer on.

BT felt embarrassed whilst he was waiting in a hospital gown for his biopsy.

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Age at interview: 65

Sex: Male

Age at diagnosis: 64

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And I went to [name of hospital] for a biopsy, and that were embarrassing.

Was it?

That were very embarrassing. Well you can imagine that you’re sat there in a dressing gown, in the waiting room, full of women and they’re all looking at you and thinking, what’s he doing here? [Laughs] So that, that, you know, I mean that’s one drawback I’ve got when you go for the thing, you’re sat with women. I’ve… Obviously when you go for check-ups, there’s husbands with them and what not, so they don’t know really. But when they call you they know that it’s you. But that’s a little bit embarrassing

Roy had to have further tests after his mammogram showed possible signs that the breast cancer...

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Age at interview: 67

Sex: Male

Age at diagnosis: 65

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I had a mammogram, which is very uncomfortable.

Yeah.

Especially being a man, you’ve got nothing to put in there, you know, which makes it worse, you know? They’re trying to pull something together to put in there. So I went and had a mammogram on both sides, and then I went for a biopsy the same day, which obviously the lump was there, they found it and they diagnosed it immediately, and then I, they obviously told me there and then what it was – all on the same day, sort of thing, what it was, but they had found some crystals in the left side, which they were, you know, a bit worried about. So what I had to do, I had to go back and have a steriotactic table top biopsy. The first man to have it done.

Right, oh right.

I had a letter from them stating that I was the first man had this done, which I had done. It’s quite interesting, actually – even though it was happening to me, it was sort of quite interesting. But they found definite cancer crystals in the left breast, you know and I’m the only man there and there’s about a hundred women all sitting in the waiting room and me, you know? It was a bit daunting, really.

Then I had the biopsy – but it, apparently, they done all the – I mean, I thought I’d have the mammogram, they’d send me home, then they’d have a look at that and then I’d have to go back – but they didn’t.

You weren’t expecting the whole one stop?

They done that, the whole works in one day. I couldn’t have this steriotactic biopsy on this side that same day, I had to go back for that – but they done a biopsy on this side, and you know, and then they, the table top thing – and I was watching it all on camera, you know? And the little thing goes in and grabs bits and comes out.

Amazing.

Yeah, it really is amazing, yeah. But what it is, you lay on a bench, right, I don’t know if you know?

No, I don’t – please tell me about it, coz I don’t?

You lay on a bench, and you put your boob in the bit, there’s a hole in it.

This is for the table top, yeah.

For this table top, yeah, steriotactic biopsy or something – and you put your thing in, and they try and pull a bit, you know, yank it about a bit again. Then this little machine comes, they get this little machine and it’s like a little snake, really – then you can see it on the screen, on the big screen, and the chap’s looking at the screen, and this thing’s going round, and it’s…

So is he operating it, or is it…

No, it does it on its own.

Oh, it does it on its own, amazing.

Yeah, and it’s going round, and all of a sudden, they see a little bit what it wants, and out it comes, and then back in again.

So it comes, so it kind of comes out of the tissue, and then deposits that?

Yeah, deposits it in a little tub of stuff, or whatever, and then, in it goes again, and you see it searching around, and out it comes again. But it’s amazing, yeah.

That’s amazing – and is that uncomfortable?

No. No, it bruises you an awful lot, but I had, they give you an anaesthetic anyway, an injection, you know?

Yeah – so you had that after you’d had the ordinary biopsy, obviously before you’d had the mastectomy?

Yeah, I had that the same, the next day. I had the ordinary biopsy done both sides, one day, and then they – coz they was a bit worried, coz the bruise, the ordinary biopsy bruises you terribly, you know, you go all black – and they said, “oh, will you be alright having this done today, coz of your bruises?” I said, “yeah, just do it, you know?” So they just done it, you know? They said, “you can leave it for a couple of weeks.” I thought no, get it over and done with.

And so was it quite a nice distraction, being able to watch it on the screen?

Yeah – I never felt it, really, you know? Once they sort of deadened it, I never felt it until it was all over, and then it’s quite – it’s a bit uncomfortable for a couple of days. But yeah, it wasn’t any great drama, really. Obviously, when they said I’d got it both sides, obviously it spread, you know?

And so were they able to detect that from this steri…eh this table top test, rather than from the mammogram?

They couldn’t do it from the normal mammogram, or the normal biopsy.

That’s coz it was kind of early crystals, yeah.

Yeah, it was very early stages in the, but he seemed to think, because of the grade of cancer, that it should all come off anyway. He said it was the best option, with the grade of the cancer. He said, “if we do a lumpectomy,” he said, “I would give it a ninety percent chance it’s going to come back within a couple of years.”

Right.

You know, so he said, “you’re just wasting your time, really,” you know? But a lot of women choose that option, because they don’t wanna lose their breast, you know what I mean?

Yeah. And you just felt like you didn’t…

Oh, I said, “no, no” I said, “they ain’t no good to me anyway.” What good are man’s nipples anyway? You know? Always been a waste of time, haven’t they, really? I said “no”.

If men were not able to get a definite diagnosis on the same day as their tests, they could have a difficult and worrying time whilst they were waiting for their results, especially if they were called back for further tests.

Michael found the week between having his tests and getting definite results really difficult

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Age at interview: 67

Sex: Male

Age at diagnosis: 57

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You said you had to wait between getting the results. Did you have a second biopsy on the first lump or did you just have to wait to have somebody else…

No, I had to wait…

… interpreted the same biopsy?

Yes, I think… he said, I’m sorry the histology is not conclusive and we want Mr so and so who was on leave at that time to look at it, and they did and a week later they confirmed that it was in fact an aggressive cancer but quite small.

Yeah, so that must’ve been a horrible week. You said it was?

Yes, it was, it was a really… it was actually a very, a very unpleasant week but…

Can you say why that was? Was that just… the immense uncertainty?

It’s just not knowing. It’s not knowing, it’s the uncertainty, yeah you know. And so that’s why you know, it was unpleasant. And I think that would probably be the same for most people…not knowing. And I think also, I was very pleased because I felt that they took my hand and lead me through the process in a very sensitive way, the team and I think that’s very, very important, that they should do that.

So did you have the help and support of the breast care nurse as well?

I did, yes. I had my own personal breast care nurse.

HGV King felt anxious when he was waiting for the results of his test, especially when he was...

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Age at interview: 51

Sex: Male

Age at diagnosis: 50

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Right, and then they done all the tests in the one day and you were called back in?

They done all the tests for this, yeah, to find out if I had got cancer. I can’t remember now if they did the… all the scans as well on the same day. I can’t remember if they did that or if they called me back, but you have to wait a week for your results. I think the first… I went in very quick for this, for the biopsy and then I think you go in and have your bone scan and all this business, or the scan the whole body, but they… that was it, that week… because I was worried about the person, the receptionist. The receptionist rang me and I wasn’t even told that I had cancer. I was just told I may have cancer so the receptionist rang me in the week and said to me, “Would you be able to come in on Friday?” And I said, “Well what for?” And she said, “Because we’d like to do a bone scan”, and that was it. I wasn’t even told that I’d got cancer, so my immediate thought was, I’ve got bone cancer. That worried me… because I didn’t know the procedure of all the scans that they had to do. So I was scared stiff then and I told my Macmillan nurse about it and she said, “Oh, I’ll find out who’s done it”. I said, “No, I don’t want to get anybody into trouble”. So, she said, “No, you won’t get them in trouble” she said, “but this sort of thing has got to be resolved”, you know? “They can’t… they’ve got to know that you don’t know if you’ve got cancer or not. They’ve got to know, that when they inform you of this, it’s just procedure”, so I felt really sorry for the receptionist. But no, nothing came of it but I was just lucky it wasn’t in the rest of me body it was just restricted to that area.

It is often recommended that people should take someone with them when they are getting results from their tests. However, if people are not expecting to get bad news they sometimes choose to go on their own. David, who had had various lumps and bumps on his body before which had all been benign, was not expecting to receive bad news about his breast lump and so went to the clinic on his own.

David W went on his own to get his results, not expecting to hear he had breast cancer. He...

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Age at interview: 57

Sex: Male

Age at diagnosis: 52

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So I turns up, obviously [wife] said, “Do you want…?” I said, “No, I’ll be fine”. I said, “It’s just a result from this stupid lump, whatever it is”. Turned up for the clinic and I’m sat there and… there’s all women and only men that were there were supporting and whatever. Anyway, it came my turn and people were… “What’s he going in there for? You know, breast clinic and sorta thing”. Anyway, went in and the… [consultant], the specialist, was sort of sat at her desk and sat down by the side. “Right, mister, how are you doing?” “I’m fine, yeah.” We just had a chat and I noticed out the corner of my eye these people coming in from all directions, you know, until there were about five people stood around me and then she got down, she says, “Yeah, you know, you found this lump, we did a… ultrasound, a mammogram, fine needle core biopsy”, you know, “We’re sad to tell you you’ve got breast cancer.” I’m just… what? “Men don’t get…” “Oh yes, you do, and you’ve got it”. So you’re just thinking… all you’re hearing is the cancer. I mean, all the people I’ve ever known had cancer, they died within a short period, and that’s all you’re thinking, not knowing how bad it is and not knowing that, as I said, men could get breast cancer.

One or two of the men had a recurrence of their breast cancer and they were able to compare their experiences of the first and second time they went through tests and treatment. Michael commented on how much things had moved forward in the eight years between his first and second diagnoses.

Michael found that things had moved on between his first diagnosis with breast cancer and his...

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Age at interview: 67

Sex: Male

Age at diagnosis: 57

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So, 2006 I think it was, I got a piece of paper that really meant it said ‘discharged’ on it, so I had to continue to take the tamoxifen for a little longer and that as far as I was concerned, was it, until 2008. I was… I discovered a lump in my other breast actually. This time I was… I found it, I have to admit, I was not good about checking my breast regularly and I’d actually been doing the decking with paint and I thought, my arm feels tired. And I felt… and I thought, ‘Oh bother, there’s a lump there’. So again I went to the doctor. He said, “Yes, you’ve got a lump”. Went through a similar procedure but I’d noticed that in the eight years that things advanced. There was… all the paperwork was a lot less gender-specific and some of that was due to my comments, and this time they had developed a new way of checking the lymph nodes which… well they do, they look at the sentinel lymph node and they put a wire… they dye, they put some dye into your breast. It goes to the first lymph node and they check it on the ultrasound and they put a wire in there to mark it, and this is the day before you have the operation. You go in and they removed this time just a lump from my breast and the first two lymph nodes which was comparatively minor to having sort of most of them removed. And I recovered even… by then I had retired so it was a lot easier and because it seemed like this, well… a piece of cake, really.

In comparison…?

I’ve been there before you know, and I’d survived for eight years so this time they put me on a different drug, Arimidex, which I’m still on at the moment because it’s only just a couple of years and I did actually with tamoxifen, have hot flushes which was, which some of my lady, our friends, found quite amusing. I then was sent to… a letter, suggesting I should have a DNA check because I’d had it twice and they were again… this was slightly different cancer so it showed more…. They said a predisposition towards cancer than just breast cancer so I did, I went to a [name of city] hospital and they took a sample and it came back that BRCA2 which is one of the genes apparently that protects you from cancer, was altered which put me a greater risk of breast cancer and prostate cancer.

Last reviewed June 2017.