Breast Cancer in men

Surgery

Surgery is usually the first form of treatment that a man 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 and the nipple on the affected side (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 this is less often possible for men. 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 the pre-operative scan shows the lymph gland appear normal, a technique called sentinel lymph node biopsy is used to take 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 this has been confirmed by a biopsy of a node in the armpit, then all of the nodes in that region will be removed - an axillary node or node sample or node clearance. This helps the doctors to decide whether any other treatment is needed after surgery. The size, grade and oestrogen receptor status of the tumour also help to determine what treatment should be offered. A sentinel node biopsy can reduce the chances of arm stiffness and swelling of the arm after surgery (see Lymphoedema). More information sources are available in our resources section.
 
Here men describe their experiences of having a mastectomy. Many men spoke of feeling nervous in the lead up to their surgery. Robert B said it was ‘probably the worst time knowing it was ahead of me and just wanting to get it over with’.  Steve said that, although he was a bit nervous before his operation, he knew he was in the hands of professionals and that the mastectomy was a fairly straightforward operation.
 
In preparation for their operation, men met the anaesthetist, they were x-rayed, they had their chest and armpit shaved, and their operation site drawn on their chest by their surgeon. Some men said that the use of humour had helped them to cope with feeling nervous in the lead up to their operation.
 
It is common to be asked to wear compressions socks during surgery to prevent complications.
 
Men stayed in a range of different types of wards (see ‘Experiences as a man in various breast cancer treatment settings’). Some were admitted to a general surgical ward, some to a specialist breast care ward (where they were often given a side room on their own), and some to other types of ward.
 
After their operation, several men said they were relieved that it was over and many were surprised at how well they felt. Some said they experienced no, or very little, pain immediately after their surgery and they were able to move their arms much more than they had expected they would be able to. Others spoke about their pain management. Tim talked about how his pain had been managed very well by a morphine pump which he controlled himself. Morphine can make some people feel sick but this can usually be controlled by anti-sickness medication. However, Bill decided to stop taking the morphine because he felt the pain was more manageable than the nausea.
Breast cancer surgery is now usually done as a day case or with just an overnight stay. The length of time that the men stayed in hospital following their surgery varied from as little as one night to seven nights. Most men described having drains attached to their bodies (chest and/or underarm) and a few said this had been the most uncomfortable aspect of their surgery. Several described not being allowed home from hospital until the fluid in their drain was clear. Some went home with their drains still attached and a few talked about it taking a long time for all the fluid to finally drain away.
For most men the operation and recovery were straight forward. However, a few did experience complications after their surgery. For example, one man who was diabetic had to have the clips on his wound redone because they were taken out too soon. Another, Steve, developed a post-operative infection.
All men had all breast tissue, the nipple and at least one lymph node removed during surgery, but a few men also had to have some of their chest muscle removed. Several men were surprised how long their scar was and, in some cases, how neat it was. Several talked about what it felt like to have their breast tissue and nipple removed (see also ‘Effect of breast cancer on men’s body image and ‘Reconstruction).
Most men made a complete recovery from their surgery. After surgery they were given exercises by the physiotherapist and most regained movement in their arm. However, some men were left with longer term symptoms such as stiffness, tenderness, aches, loss of strength and swelling (see ‘Lymphoedema).


Last reviewed October 2013.
Last updated October 2013.

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