Breast cancer in men

Breast cancer in men is rare. Each year, about 375 men are diagnosed with breast cancer in the UK. Breast cancer can develop in the small amount of breast tissue behind the nipples.

Clinical oncologist, Bernadette Lavery, talks you through what breast cancer is, the main types, risk factors, stages and common treatments available to you.

This content has been written for men, transgender (trans) women and people assigned male at birth.

The most common symptom is a painless lump under the nipple or areola. The areola is the darker area around the nipple.

Other symptoms may include:

• a nipple turning in (inverted nipple)
• changes in the size or shape of the breast
• an eczema-like rash on the nipple
• discharge or bleeding from the nipple
• a swelling or lump in either armpit
• an ulcer on the skin of the breast.

You will know how your chest area normally looks and feels. If you notice any change, you should visit your GP straight away. If breast cancer is diagnosed and treated early, the more successful treatment is likely to be.

In this video, Phil and Nellie share their unique experiences of being diagnosed with breast cancer and discuss some of the common misconceptions around breast cancer.

You usually start by seeing your GP. They will examine you and refer you to a breast clinic to see a specialist.

At the clinic, you will see a specialist breast doctor or nurse. You may also see a specialist breast nurse. They usually ask you if:

• you have had any other breast or health problems
• anyone in your family has had breast cancer or ovarian cancer.

The doctor or nurse will examine your chest area. They will also check the lymph nodes in your armpits and above your collarbone. After this, they will explain which tests you need.

After your examination, your doctor or nurse will tell you what tests you need. These may include:

You may have many of the tests on the same day. But you usually have to wait up to 2 weeks for some results. You may also need to come back to the hospital for further tests. We have more information on waiting for test results.

If the biopsy results show breast cancer cells, you will need more tests before you start treatment. You may have blood samples taken. This is to check your general health and to see how well your kidneys and liver are working. You may have an x-ray of your chest to check your lungs and heart.

You may also have other tests to:

• find out more about the size and position of the cancer
• see if it has spread to other parts of the body.

These tests may include:

The results will help you and your doctor decide on the best treatment. Waiting for test results can be a difficult time. We have We have more information on waiting for test results.

Breast cancer cells may have receptors on the outside of the cells. Hormones, such as oestrogen, can attach to the receptors and encourage the cells to grow.

Some breast cancer cells have too much of a protein called human epidermal growth factor receptor 2 (HER2) on their surface.

A doctor called a pathologist tests cancer cells taken during a biopsy or surgery for receptors.

The result help you and your doctor decide on the most effective treatment for you. 

You will usually be offered genetic testing even if you do not have a family history of breast cancer. This is because men with breast cancer have an increased risk of having a gene change. This is also called a mutation. A mutation is a change in a gene that can run in families (be inherited). In inherited breast cancer, BRCA1 and BRCA2 are the 2 genes usually found to have a change. Your cancer doctor or breast care nurse can explain more about this to you.

If you are worried about breast cancer in your family, talk to your GP or breast specialist. They can refer you to a family history clinic or a genetics clinic.

After treatment, you will have check-ups with your cancer doctor or regular contact with your nurse.

At first, your check-ups may be every few months. But eventually you may have them once a year. If you notice any new symptoms between appointments, it is important to contact your doctor or nurse for advice. They will give you contact numbers so you do not have to wait until your next appointment.

Instead of regular appointments, your nurse may give you information about what to look out for. They will give you contact numbers and ask you to contact them or your cancer doctor if there is anything you are worried about. You may have your follow-up appointments at a nurse-led clinic. This means you will only go to your cancer doctor if something needs to be checked further.

You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line for free on 0808 808 00 00. 
• Chat to our specialists online. 
• Visit our Online Community to talk with people who have been affected by cancer, share your experience, and ask an expert your questions. 

You may have regular check-ups, but it is still a good idea to know what is now normal for you. The treated side of your chest will look and feel different. This will depend on the treatment you have had.

Your breast care nurse or cancer doctor can tell you what to expect and what to look out for. It is also important to be aware of what to look out for in your untreated breast area.

If you notice anything unusual, contact your cancer doctor or breast care nurse straight away.

Lymphoedema is a swelling of the arm or hand on the side you had treatment. It sometimes happens after surgery or radiotherapy to the lymph nodes in the armpit. It usually develops slowly, months or years after treatment.

Lymphoedema is more likely to happen if all or many of your lymph nodes were removed. Having radiotherapy to the armpit as well as surgery increases the risk.

You may have had only 1 or 2 lymph nodes removed. This is called a sentinel lymph node biopsy. The risk of lymphoedema is low after this. If you are not sure what type of lymph node surgery you had, your breast care nurse can tell you.

If you notice any swelling in your arm, hand or chest, ask your doctor or nurse to check it. The earlier lymphoedema is diagnosed, the easier it is to manage and treat successfully.

Cancer and its treatments can sometimes affect your sex life or your ability to make someone pregnant (your fertility).

Sex

Breast cancer and its treatments and side effects may affect your sex life and your feelings about yourself. You may have:

• loss of sex drive (low libido)
• erection difficulties (erectile dysfunction or ED).

Difficulties often slowly improve after treatment, but it may take longer. Some people may continue to have difficulties. There are lots of different ways to help manage this. We have more information about sex and cancer. You can also talk to your doctor or nurse for further help and support.

Fertility

Some breast cancer treatments may affect your fertility.

Some chemotherapy drugs can make you unable to make someone pregnant (infertile). If you are taking hormonal therapy drugs, you may have trouble getting or keeping an erection. This is usually temporary, and you may still be able to make someone pregnant. But some hormonal therapy drugs can reduce the number of sperm you produce.

It is important to talk to your cancer doctor about your fertility before treatment starts. It may be possible to store sperm before treatment begins.

Becoming infertile can be very hard to cope with, whether or not you already have children. You may find it helpful to talk about your feelings with a trained counsellor. If you need more specialist help, ask your cancer doctor or breast care nurse to arrange this for you.

Your doctor will advise you not to make someone pregnant while having some types of breast cancer treatments and for some time afterwards. They will explain which drugs may affect sperm, which may harm a developing baby. It is important to use effective contraception. You can talk about this with your doctor or nurse.

Treatments for secondary breast cancer depend on where in the body the cancer has spread to.

The main treatments to control secondary breast cancer are:

• hormonal therapy for breast cancer that is ER positive
• chemotherapy
• targeted therapy
• radiotherapy to relieve pain from secondary breast cancer in the bone. Radiotherapy can also be used to shrink secondary cancer in the brain or lymph nodes.

You may have single or combined treatments one after the other to keep the cancer under control. This is called lines of treatment. You may have other treatments to control symptoms.

We have more information about treatments for secondary breast cancer.

You are likely to have different feelings to cope with during treatment. You may also be worried about practical issues such as work or finances. It is important to take care of yourself. This may include:

• getting enough rest
• trying to keep physically active
• eating healthily

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes to the way you live such as eating well and keeping active can improve your health and well-being and help your body recover.