Treatment for breast cancer in men

Treatment for breast cancer in men may include:

• Surgery
• Chemotherapy
• Radiotherapy
• Hormone (endocrine) therapy
• Targeted therapy

Your treatment team will explain the reasons for your particular treatment.

The treatment you’re offered will depend on a number of things including:

• The type of breast cancer you have: the most common type is called invasive ductal breast cancer
• The cancer stage: the size of the cancer and how far it has spread
• The cancer grade: how different the cancer cells are to normal cells and how quickly they are growing
• Whether the cancer is oestrogen receptor positive or negative 
• Whether the cancer is HER2-positive or negative 

The aim of treatment

If the cancer has not spread beyond the breast tissue or the lymph nodes under the arm (primary breast cancer), treatment aims to remove the cancer and reduce the risk of it coming back or spreading to other parts of the body. 

If the cancer has spread to another part of the body, known as secondary breast cancer, treatment can be given to control and slow the spread of the cancer, relieve symptoms and give you the best quality of life for as long as possible. 

Surgery to remove the cancer is the first treatment for most men. 

The amount of breast tissue removed depends on the area affected and the size of the cancer.

There are 2 main types of surgery:

• Mastectomy – removal of all the breast tissue including the nipple and areola (the area of darker skin around the nipple)
• Breast-conserving surgery (also known as wide local excision or lumpectomy) – removal of the cancer with a margin (border) of normal breast tissue around it

Most men do not have much breast tissue, so a mastectomy is the most common surgery for men with breast cancer.

Lymph node removal

If you have invasive breast cancer, your treatment team will check if any cancer cells have spread to the lymph nodes (glands) under your arm. 

Along with other information about your breast cancer, this helps them decide if you’ll benefit from any other treatment after surgery.

We've got more information on surgery to the lymph nodes. 

Breast reconstruction

Breast reconstruction is not usually offered to men but this may depend on your individual situation.

You can talk to your treatment team to find out what options are suitable to improve the appearance and evenness of your chest after surgery.

You may be able to have surgery to improve the symmetry of the chest. This can sometimes be done at the same time as surgery to remove the cancer or it may be offered at a later date.

Your breast care nurse or surgeon can explain which procedures may be suitable for you. They can also discuss options for nipple tattooing or nipple reconstruction with you.

Effects of surgery

Most people recover well after surgery. However, common after-effects can include pain and discomfort, swelling and wound infection. 

You can read more about the effects of surgery on our after surgery page. 

Changes to your body 

Your body will look different after surgery. For example, the shape of your chest may be different and your nipple may have been removed. Some men find this hard to come to terms with.

The first few times you look at your body after the operation may be difficult and you may feel unhappy or shocked. However, the initial intense feelings you may have should lessen over time as you get more used to how you look. 

You might feel self-conscious about your chest, and the changes to your body may affect your confidence and self-esteem.

If you continue to feel uncomfortable about looking at your body, you may find it helpful to speak to your breast care nurse, treatment team or GP. They may be able to refer you for further support or counselling. 

Lymphoedema

Lymphoedema is swelling of the arm, hand or chest area caused by a build-up of fluid in the surface tissues of the body. This can be caused by damage to the lymphatic system, for example because of surgery or radiotherapy to the lymph nodes under the arm and surrounding area. 

The lymphatic system is the drainage and filtering system of the body. It’s made up of lymph nodes, vessels and fluid. The lymph nodes under your arm filter lymph fluid from the breast and arm.

Chemotherapy destroys cancer cells by affecting their ability to divide and grow. 

You might have chemotherapy:

• After surgery to reduce the risk of cancer coming back (adjuvant chemotherapy)
• Before surgery to slow the growth of rapidly growing breast cancer, or to shrink a larger breast cancer (primary or neo-adjuvant chemotherapy)

If you have secondary breast cancer, chemotherapy aims to slow down and control the growth of the cancer and to relieve symptoms.

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

The benefit of chemotherapy might be clear for some people but less clear in other cases. Your treatment team may suggest a test to help decide whether you would benefit from chemotherapy.

Side effects of chemotherapy

Side effects of chemotherapy include:

• Increased risk of infections
• Hair loss
• Nausea and vomiting
• Fatigue 

Effects on fertility 

Chemotherapy can affect sperm production, which can lead to temporary or permanent infertility in men.

Your treatment team should tell you if the treatment they’re offering will affect your fertility.

If you’re concerned about infertility, talk to your breast care nurse or treatment team before beginning treatment.

Some men may want to bank their sperm before they start treatment. Sperm banking is a way of storing some of your sperm in a fertility preservation clinic. When you want to have a baby, it can then be used to fertilise your partner's or donor eggs.

You can find more information about sperm banking on the Cancer Research UK or HFEA websites.

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

If you have breast-conserving surgery, you will usually be offered radiotherapy to the remaining breast tissue to reduce the risk of the cancer coming back in the same breast.

You may also have radiotherapy to the lymph nodes under the arm or above the collarbone.

Radiotherapy is sometimes given to the chest wall after a mastectomy, for example if cancer cells have spread to the lymph nodes under the arm.

Side effects of radiotherapy

Side effects of radiotherapy include:

• Skin reactions
• Swelling 
• Hair loss in the area treated
• Tiredness and fatigue

Some breast cancers use oestrogen in the body to help them grow. These are known as oestrogen receptor positive or ER-positive breast cancers.

All men have small amounts of oestrogen. 

Most breast cancers in men are ER-positive.

Hormone therapies block or stop the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways.

Hormone therapy will only be prescribed if your breast cancer is ER-positive.

Tamoxifen

The most common hormone therapy drug used to treat breast cancer in men is tamoxifen. 

You usually take tamoxifen as a tablet every day for at least 5 years.

Some men may be unsure about taking tamoxifen because there are not many research studies about using this drug in men. This is because breast cancer in men is rare. But research shows tamoxifen is beneficial for men with ER-positive breast cancer. Speak to your treatment team if you’re unsure about taking tamoxifen.

Side effects of tamoxifen

Hot flushes

Hot flushes can range from a mild warming of the face to waves of heat throughout the body. 

How often you have them can vary from a few every hour to a couple a day.

Speak to your treatment team or GP if you’re struggling with hot flushes.

You can also try:

• Keeping a diary of when you have hot flushes to identify any patterns or if anything triggers them (some people find spicy foods, caffeine or alcohol are triggers)
• Losing weight if you’re overweight
• Doing regular exercise and stopping or cutting down on smoking 

Many people try complementary therapies, such as hypnosis, acupuncture or meditation. There’s not much evidence about how effective they are, but some people find them helpful.

Problems getting an erection

Some men may have loss of sex drive or difficulty getting an erection, and orgasms may feel different or less intense. This usually improves over time.

Treatment and support are available. It might help to:

• Speak to your breast care nurse, treatment team or GP about treatments that may help
• Try other ways of being intimate with a partner
• Talk openly with your partner
• Use aids like vacuum pumps to help get an erection
• Try sex or couples therapy

The NHS has more information on treating erection problems.

Prostate Cancer UK also has information on erection problems and other changes to your sex life caused by hormone therapy.

Other common side effects

Other common side effects include:

• Indigestion
• Headaches
• Change in mood

Less common side effects

There’s a small risk of changes in your vision. If you notice any changes in your vision tell your GP or treatment team.

There is also an increased risk of blood clots in people taking tamoxifen. 

If you have any new symptoms it’s important to discuss them with your GP, treatment team or breast care nurse.

Targeted therapy is the name given to a group of drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer grow. 

The most widely used targeted therapies are for HER2-positive breast cancer. HER2 is a protein that makes cancer cells grow. 

Breast cancer in men is less likely to be HER2-positive. However, if your cancer is found to be HER2-positive you may be offered drugs such as trastuzumab and pertuzumab.

Research on these drugs has so far only included women, so we don’t fully know all the individual benefits of targeted treatments for men. But your treatment team will make treatment decisions based on the data available and according to your individual situation.

People with breast cancer have a higher risk of blood clots such as a DVT (deep vein thrombosis).

If you have a DVT, there’s a risk part of the blood clot could break away and travel to the lung. This is known as a pulmonary embolism (PE).  

Blood clots can be life-threatening and should be treated quickly. 

At the end of your hospital-based treatment, you will continue to be monitored. This is called follow-up.

People are followed up in different ways. How you’re followed up after treatment will depend on:

• How likely you are to have side effects from treatment
• The risk of your cancer coming back
• Arrangements at the hospital where you’ve been treated

Some men may be advised to have regular mammograms, which are a type of x-ray that can look for breast changes. 

You should be given a name and contact number to call (usually the breast care nurse) if you have any questions or concerns between appointments. You can always talk to your GP about any concerns you have as well.

Worries about the cancer coming back

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

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

Knowing the symptoms you should report can help manage any feelings of uncertainty. 

Moving forward

Many people are surprised at how emotional they feel when they finish treatment. You might still need information and support to help you during this time.

Our Moving Forward course can help. Through supportive, open conversations in a safe, confidential space, you’ll connect with people who understand. And you’ll find the tools you need to feel more empowered, confident and in control.

You can attend Moving Forward either face-to-face or online.

And if you want more information or just want to talk things through, our nurses are ready to listen on our free helpline. See below for ways to get in touch.