Treatment for breast cancer in men might include:

These treatments may be given alone or in combination.

Treatment for primary breast cancer aims to remove the cancer and reduce the risk of it coming back or spreading to other parts of the body. If you have secondary breast cancer, see our information on how secondary breast cancer is treated.

Your doctors will consider the best treatment for you once they have the information they need from the tests. However, as more information about your cancer becomes available during the course of your treatment, the treatment plan may sometimes need to be adjusted.

Surgery

Surgery is the first treatment for most men. This aims to remove the cancer with a margin (border) of normal tissue around it. This is done to reduce the risk of the cancer coming back (known as recurrence) and to try to stop it spreading to other parts of the body (known as secondary breast cancer). The amount of tissue removed depends on the area affected and the size of the cancer.

Sometimes chemotherapy or hormone therapy may be given before surgery to reduce the size of the tumour.

There are two main types of operation.

Mastectomy

This is the most common treatment for men. It involves removing all the breast tissue including the nipple area. You will usually have some or all of the lymph nodes removed with the breast tissue.

Wide local excision (lumpectomy)

A wide local excision (also known as a lumpectomy) is where the cancer is removed with a margin (border) of normal breast tissue around it. In some situations you may have a quadrantectomy, where approximately a quarter of the breast area is removed (sometimes called a segmental excision). However, this is much less common and depends on the size of the tumour and the amount of breast tissue.

Most men will need a mastectomy.

Lymph node removal

If you have invasive breast cancer, your specialist team will want to check if any of the lymph nodes (glands) under the arm (the axilla) contain cancer cells. This, along with other information about your breast cancer, helps them decide whether you’ll benefit from any additional treatment after surgery.

To do this, your surgeon is likely to recommend an operation to remove either some of the lymph nodes (a lymph node sample or biopsy) or all of them (a lymph node clearance).

Find out more about surgery to the lymph nodes.

Your operation and recovery

Find out what happens at the hospital and what to expect after surgery (including possible side effects).

Changes to your body after surgery

If you have a mastectomy, all the breast tissue including the nipple and the darker area of skin around the nipple (areola) will be removed. This can mean losing the shape of your chest.

Reconstruction of the chest area after a mastectomy is not commonly carried out for men because available implants do not recreate the correct shape of a man’s chest. However, it may be worthwhile discussing this with your specialist as it’s sometimes possible to improve the appearance of the chest area with further surgery.

The first time you look at your body after the operation can be difficult. After surgery your chest area is likely to be bruised and swollen, but this will improve over time. The sooner you try to face the physical changes to your body, the easier you may find it to gain more confidence in the way you look.

For some people, surgery doesn’t affect how they feel about themselves, but many others find the changes more difficult to accept. Your confidence and self-esteem may be affected and you may feel unattractive. You might feel self-conscious about your chest area, for example if you’re in a communal changing room, particularly at first.

If you continue to feel uncomfortable about looking at your body, you may find it helpful to speak to a counsellor. Your GP or breast care nurse should be able to arrange this for you.

Lymphoedema

Lymphoedema is swelling of the arm, hand or chest area caused by a build-up of lymph fluid in the surface tissues of the body. It can occur as a result of damage to the lymphatic system because of surgery or radiotherapy to the lymph nodes under the arm (the axilla) and in the surrounding area. Sometimes it can be caused by cancer cells blocking the lymph system.

Having lymphoedema can affect you both physically and emotionally. It can make you feel differently about your body and mean that you have to adapt to yet another change in your body and appearance.

Find out more about living with lymphoedema.

Hormone (endocrine) therapy

The hormone oestrogen can stimulate some breast cancers to grow. A number of hormone therapies work in different ways to block the effect of oestrogen on cancer cells.

Although oestrogen is made in far greater quantities in women’s bodies, men also have small amounts of oestrogen.

Hormone therapy will only be prescribed if your breast cancer has receptors within the cell that bind to the hormone oestrogen, known as oestrogen receptor positive or ER+ breast cancer. All breast cancers are tested for oestrogen receptors, using tissue from a biopsy or after surgery. Most male breast cancers are oestrogen receptor positive.

Tamoxifen

The hormone therapy drug used in men is tamoxifen. It’s usually taken for five years.

Common side effects of tamoxifen include:

Less common or rare side effects include:

  • eyesight problems
  • hair thinning/hair loss
  • joint pains
  • tiredness
  • headaches.

Radiotherapy

Radiotherapy uses high-energy x-rays to destroy cancer cells.

If you have a wide local excision (lumpectomy), you will usually be offered radiotherapy to the chest area to reduce the risk of the cancer coming back (known as recurrence). Sometimes you may be offered radiotherapy to the nodes under your arm.

Radiotherapy may be given to the chest wall after a mastectomy in some circumstances, for example if some of the lymph nodes under the arm are affected.

Find out about radiotherapy and its side effects.

Chemotherapy

Chemotherapy destroys cancer cells using anti-cancer drugs, which are also called cytotoxic drugs.

Many different types of chemotherapy drugs are used to treat breast cancer. They can be given in different ways and in different combinations.

Chemotherapy is usually started a few weeks after surgery and before radiotherapy (if you're having it). This is known as adjuvant treatment.

Some people are offered chemotherapy before surgery. This is called neo-adjuvant or primary chemotherapy. It may be used to slow rapidly growing cancers or to shrink larger cancers.

Find out more information about chemotherapy.

Side effects of chemotherapy

Like any treatment, chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. Some people are able to carry on with their everyday activities such as work, while others may not be able to.

Common side effects of chemotherapy can include:

  • increased risk of infection
  • hair loss
  • nausea and vomiting
  • fatigue
  • effects on fertility.

Side effects can usually be controlled and those listed will not affect everyone. If you’re concerned about any side effects, talk to your chemotherapy nurse or cancer specialist (oncologist) as soon as possible.

You may find our information on the side effects of chemotherapy useful, as many of these side effects will be the same for women and men.

Effects of chemotherapy on fertility for men

Chemotherapy can affect sperm production, which can lead to temporary or permanent infertility in men. If you’re concerned about infertility, talk to your specialist before beginning treatment.

Sperm banking is a way of storing some of your sperm so that it can be used to artificially inseminate your partner at a later date. Artificial insemination involves putting the sperm directly into your partner’s womb. Sperm banking is best done before you start chemotherapy, although it may be possible up to four to six weeks after treatment has started.

Freezing and thawing sperm can reduce its quality and a pregnancy can’t be guaranteed with this process.

The usual storage period for sperm is 10 years. However, in certain circumstances sperm can be stored for a maximum of 55 years. Your clinician will be able to explain whether you can do this, and how long you may be able to store your sperm for. Therefore, you may wish to consider this even if you’re not yet ready to start a family or if you’re not currently in a relationship.

Sperm banking is not always free in the NHS and availability varies throughout the UK. You can find more information about sperm banking on the Cancer Research UK website.

Targeted therapies (also called biological therapies)

This is a group of drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that cause cancer to grow.

The most widely used targeted therapy for breast cancer is trastuzumab (Herceptin). Only people whose cancer has high levels of HER2 (HER2 positive breast cancer) will benefit from having trastuzumab. HER2 is a protein that makes cancer cells grow.

There are various tests to measure HER2 levels that are done on breast tissue removed during a biopsy or surgery. If your cancer is found to be HER2 negative, then trastuzumab will not help you. Men are less likely to be HER2 positive than women.

All the large-scale studies on trastuzumab have so far been on women, so the specific benefits of trastuzumab for men are not fully known.

Find out more about trastuzumab and its side effects.

Blood clots

People with breast cancer have a higher risk of blood clots. Their risk is higher because of the cancer itself and some treatments for breast cancer.

If the cancer has spread to other parts of the body (secondary breast cancer), this also increases the risk.

Blood clots can be harmful but are treatable so it’s important to report symptoms as soon as possible.

If you experience any of the following symptoms contact your local A&E department, GP or specialist team straight away:

  • pain, redness/discolouration, heat and swelling of the calf, leg or thigh
  • swelling, redness or tenderness where a central line is inserted to give chemotherapy, for example in the arm, chest area or up into the neck
  • shortness of breath
  • tightness in the chest
  • unexplained cough (you may cough up blood).

Find out more about blood clots.

What happens when treatment finishes

You will continue to be monitored after your hospital-based treatments (such as surgery, chemotherapy or radiotherapy) finish. This is known as follow-up. How you are followed up will depend on your individual needs and the arrangements at the hospital you’ve been treated in. Find out more about follow-up after treatment.

Worries about the cancer coming back

Most people worry about breast cancer coming back (recurrence). These worries are normal, and the fear and anxiety usually lessens with time.

The treatment you received will have been given to reduce the risk of the breast cancer coming back at its original site or elsewhere in the body.

While most people have no further problems, sometimes breast cancer can return after treatment.

Knowing how to continue to be body aware after treatment and the symptoms you should report can help manage your feelings of uncertainty. Find out about changes to be aware of after treatment, and tips for coping with worries about recurrence.

Moving Forward

Finishing active treatment for breast cancer can be an unexpectedly challenging time, bringing a mix of emotions. For some people, the last hospital-based treatment is the goal they focus on, and getting there can feel like a real achievement. But some people also feel isolated, low or anxious when their regular hospital appointments stop. You may be experiencing ongoing side effects of treatment, thinking about going back to work or worrying about the cancer coming back.

Our Moving Forward resource pack and course look at issues that you may face at this time, from the physical side effects of treatment like fatigue (extreme tiredness) to how you feel about your relationships and the future.

 

Last reviewed: June 2017
Next planned review begins 2019

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