Breast Cancer in men

Effect of mastectomy on men's body image

Most men who develop breast cancer need to have a mastectomy to remove their tumour, and it is less common for them to have reconstructive surgery or other cosmetic procedures afterwards than it is for women. (see ‘Reconstruction’). Some men will also need either radiotherapy or chemotherapy which can also alter their appearance, even if only for a short time (e.g. through the loss of head, facial, chest or other body hair) (see ‘Radiotherapy’ and ‘Chemotherapy).

Any major surgery can leave scars or other changes to the body (see pre and post operation male mastectomy photos), and people react to, and cope differently with, their changed bodies. Here men discuss the feelings they had about their body image after their breast cancer treatment.
Some men felt very self-conscious about their body following surgery which usually removed their breast tissue and nipple, whilst others said that they were not at all bothered by the change to their body.

BT has a big scar but is still happy to do sport and strip off. Rugby people are used to scars....

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Age at interview: 65
Sex: Male
Age at diagnosis: 64

 Has it stopped you doing anything I mean would you…?

No. No, no it hasn’t stopped me doing owt.
I don’t know whether you went swimming anyway, but do you still go and take your top off or- when you’re at the beach do you?
Oh aye, I strip off. If I go anywhere I strip off. Oh yeah. And when I were running touch, after a match, obviously it’s a community shower room, so everybody’s in there, and everybody’s buff naked. So you know, it’s just part of it. If anybody asks you just tell them.
Right. And did people ask?
Well. Yeah, you just got a- “oh what’s that then?” “That’s a good scar” or- “that looks neat”, or something like that. I mean basically, we- rugby people, they’re that used to knocks and bumps and cuts and bruises and broken legs and that, all it is virtually, “that looks nasty” or that- you know, “that looks as though it were painful” and things like that, but they don’t- basically they don’t go into it. It’s just- they just accept that that’s a thing that’s happened and off you go. 

David found no-one seemed to notice his scar when he took his shirt off at the beach. He had...

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Age at interview: 60
Sex: Male
Age at diagnosis: 51
Has having a mastectomy stopped you doing anything?
No? Do you swim? Yeah?
I took a big shirt off at the beach.
You keep a shirt on?
Take it off.
Take it off, OK.
Just to see if I could do it. Nobody seemed to notice.
Right, OK.
I’ve been on television. Showed the scar.
You have?
Yeah, a deaf programme.
Uhuh, yeah. So you wouldn’t mind if people noticed and even asked you questions on it? Would you mind?
Not mind.
You wouldn’t mind?
Not mind, no.



Bernard didn’t like to take his top off. He didn’t want to cause any embarrassment or make people...

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Age at interview: 59
Sex: Male
Age at diagnosis: 56

How, how do you feel having your mastectomy? You’ve got a bit of your chest away.

Well, the likes of on holiday and that, I’ll no take my top off or that. Right. And I don’t know if it’s embarrassment or no, but in the work, we’ve got a hydro pool. And when I say it’s a hydra pool it holds fifteen thousand gallons of water so it’s like a swimming pool. It’s a big hydro pool. And we take our customers, or service users, whatever you want to call them, I take some of them in you know. And it’s just recently I started wearing a top. I used to go in without, you know just show the scar and that, you know. Even if there was-. But there’s strangers in now, it’s- I’m no wanting them to feel embarrassed. It’s no me, I don’t feel embarrassed about it now you know. But I don’t want them to be going, ‘oh that poor guy what’s wrong with him’ or something like that you know. But it’s fine you know, I’m fine with it. But on holiday, even before I had that I never took ma top off anyway, because I burn too easily. You know. So I’m telling lies there, I don’t- I never ever took my top off anyway.
Before I had this you know.
But you are aware of the scar being there, it’s not like-
Aye because it’s always itchy, I’m always scratching it.
Does it look any different because of the radiotherapy? You know, it can sometimes sort of tan the skin. Does it?
Sometimes men’s feelings were affected by the appearance of the scar, and sometimes they were self-conscious about the absence of a nipple or an imbalance in the two sides of their chest. Feeling self-conscious stopped some men from going swimming. Some no longer wanted to expose their chests on holiday, although several said that they needed to be careful anyway about exposing themselves to the sun after having radiotherapy on their chest or because they were fair-skinned. John’s granddaughter helped him to overcome his self-consciousness by encouraging him to go in to the water whilst on holiday.

Bob thinks his scar is not very nice to look at. It needed to be restitched after the first set...

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Age at interview: 67
Sex: Male
Age at diagnosis: 63

How does it feel, having had the mastectomy? I mean, you said that you didn’t like to take your top off. How do you feel as a man, having had that?

Well, I feel… well, it’s like owt else. If it’s a warm day or we’ve been somewhere, I like to keep me shirt on, because I don’t like anybody to look. I mean, it’s like owt else. They’re like that, you know? “What’s up, what’s up, what’s up, what’s up wi’ ye?” And I just don’t like it. I don’t know, it’s… I think it’s a stigma sometimes. I… just don’t like it at all.
When you take your top off, the rare times you do, do people ask you or do you just see them looking?
I see them looking, cos when I were younger, 19, you know when you’re 19, sssh, when I were in quarry it were shorts and nothing. Now I can’t do that.
And do you miss taking off your top?
Oh, sometimes, yeah, yeah, yeah. I try to keep a t-shirt or a shirt on. If I’m doing anything, I like to keep covered up.
And what about with your wife? Do you feel that you still need to be covered up with her?
No, not really. No, she understands. She understands what’s… she’ll say sometimes “are you alright with it? It don’t hurt, nowt’s wrong with it, is it?” I’ll say “no, everything’s alright, you know? Everything’s quite alright”. No, no, no, because the point is, she knows what I’ve gone through. She knows exactly. Every doctor’s been and they’ve done what they could. 
I’m gonna get no help from anywhere else. It’s healed up and… I know it’s not very nice to look at, cos they’ve, like I say, the operation didn’t sew up… and with being diabetic, it just bursts. I think it were the doctor’s fault for taking the stitches too early out. 
And I had to get it all stitched up, they had to whip me out and get it all stitched up again. 

RG thinks that he looks ‘lop-sided’ and wouldn’t want to bare his chest at the gym or swimming...

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Age at interview: 64
Sex: Male
Age at diagnosis: 62

 I’m very aware of this side. And I don’t feel, you know I used to go the gym, but I- well I’d stopped going to the gym before all this happened, but you know, I wouldn’t want to go back to the gym cause I’d feel- you know say you’re going for a swim, I wouldn’t feel that I could strip off, and you know sort of just be natural about it. So, you know, you know that’s- you see I think that, from what I understand, women are possibly supported better than men, in this whole, in this whole thing.

Can you talk a wee bit more about how you feel about your mastectomy scar? You said it stopped you going to the gym and things. Is there any other aspect of your life, I mean can you look at it okay in the mirror, does it-?
That doesn’t- yeah, when you look down and you’re lopsided you know. Well I mean I think I just feel self-conscious about it really I suppose, you know, going for a swim or something like that. That’s why I wouldn’t go, you know. Tend to go walking and such like now. 

Eric feels self-conscious about his scar and wouldn’t want to walk around with nothing on. It...

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Age at interview: 78
Sex: Male
Age at diagnosis: 70

 And… in Fiji, I mean, it’s nice and warm and there are nice pools. I wouldn’t take me shirt, I don’t take me shirt off anyway, being fair-skinned, I get burnt very easily. But I wouldn’t go in the pool. My wife swims now, although she’s a bit older than I am, she swims twice a week. She said “oh, come with me, good exercise.” I’m like this, “I don’t know whether I want to go”. Sometimes I want to go swimming, but I don’t want to walk about with nothing on. I’m self-conscious about it. I’ll have to finish, I think we shall have to make a go, cos I go to the gym now once a week. My wife comes to the gym and she goes swimming twice a week, and she says “oh, come swimming with me, that’s the best exercise out.” But I haven’t got round to it yet. Yes, I am self-conscious about it.

Has anyone ever seen it, the scar, apart from medical staff and your wife?
No, I don’t think they have. Don’t think they have.
What do you think other people’s reactions are going to be?
What have you been up to? I don’t know. Perhaps it’s… perhaps I think entirely different I suppose if it was a woman had been there, she’d know what it was. But when he said there’d be no scar, it’ll just be a fold there’ll be no scar, but it is a scar about that long [mutters] here down underneath, it’s all wrinkly all along it. Because of this infection, I think I had but that didn’t cause me any problem. Didn’t cause me any problem having a shower or anything, just the problem of exposing your body. I think I ought to go, I’m sure I ought to go, but I can’t… get to it yet.
Quite a few men had felt self-conscious when they were first recovering from their surgery, or when they went on holiday or swimming for the first time, but they were gradually getting over it or had already got used to their changed body. Eddie said he still felt somewhat self-conscious about having to wear a compression sleeve to help prevent problems with his lymphoedema whilst on holiday in a warm climate.

Mike still feels a bit self-conscious about his scar but is getting over it. It is red and not...

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Age at interview: 59
Sex: Male
Age at diagnosis: 59

 Obviously a mastectomy in a woman is far greater than a mastectomy in a man. It’s much more traumatic. I mean, I am a bit self-conscious when I have a shower… and I said to my wife, “I don’t know whether I want to go swimming anymore.” “Oh, you can wear a vest.” I said, “Look, a grown man, you know, 59, 60, going in the swimming pool wearing a vest?” You know… “Well, you can wear a wet suit.” Where am I gonna buy a wet suit, you know? Don’t be silly, you know? So… I am a little bit self-conscious of that, I think that’s the only thing I’m a little bit self-conscious cos I’ve got quite a big scar across, across my chest there and it does look… and sometimes it’ll just remind me of somebody who’s had a stroke because it’s not quite a straight one, it just gives you that kind of impression, but… I’m slowly getting over that. I’m slowly trying to, you know… but whether I, you know, if I ever go sunbathing but I shouldn't think I’ll ever take my top off. I don’t know why, maybe.

I was interested by your comment, you said that for a woman a mastectomy would be so much worse, but it seems to have affected you as well.
Yeah, I… it’s affected me, I suppose because the scar is quite prominent still, it’s sort of sore at the moment to touch. It’s also, underneath my arm it’s still very numb and I suppose once the numbness and soreness has disappeared, so will it disappear in my mind and my thinkings about it. I think because at the moment I can’t put my arm down properly because it just feels like I’ve got a golf ball under my arm. There’s nothing there. I mean, it’s the way, I suppose it’s been cut the nerve endings that the surgeon said it could take up to a year to repair itself. It is a little bit unsightly. It’s not, you know, it’s quite red. In fact it’s a bit more redder now because of the radiotherapy treatment. And I suppose it makes me just self-conscious a little bit. But… actually sort of… I think it’s also the same thing if you go out, you go out in the street and somebody sees… sees you, there are certain people that you know, oh, I know that fellow’s got cancer, by just looking at the face. I do this, and sometimes when I’m sitting waiting to see my oncologist and he’s got patients prior to me, and all the same thing, bald, you know, I mean, fortunately I didn’t lose my eyebrows. But they all have a… as I said before, a typical look, and you sort of, some people say to you, you know… yeah, sometimes I think… they’re talking about me. That’s how I think somebody would perceive, you know, if they saw me lying out on a deckchair doing the same thing, it’s… I’ll probably get over it. And I mean, I’m not that self-conscious of it. I mean, I’m self-conscious when I see myself in the bathroom sometimes because I think it’s… it isn’t a particularly nice thing, so when you have a friend who’s actually a doctor, a retired doctor, and when he speaks, his face tends to go [gives example of the way in which the retired doctor speaks] he’s very well-spoken, his face sort of goes slightly upwards and that just reminds me of the scar, and I don’t know why. My wife finds it very funny, and so do I find it funny. And I suppose that’s how I perceive it at the moment. Yes, a little bit self-conscious of it, yeah, but I think in time, I’m not-self-conscious that I’m vastly depressed about it… had you not brought up the subject I wouldn’t have thought about it, but no, I suppose going away, going away on holiday obviously I can’t expose myself to the sun anyway. Yes, I would like to go swimming but I can’t see myself going swimming wearing, you know, a top.

Do you, does your wife see it all the time? You don’t hide it from her?

No, no, I never hide it. If I’m in the bathroom when I wash in the evening I’m always stripped to the waist. No, she often looks at it, sometimes looks at… hmm, seems a bit more redder today. I thought well, I’ve had radiotherapy, I mean, you know… you’re lying sitting underneath the sun for 24 hours, you know? 

Eddie used to be self-conscious about his scar but now thinks that no-one seems bothered by it....

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Age at interview: 70
Sex: Male
Age at diagnosis: 69

So, just before I went- we went on holiday, they fitted me up with a compression sleeve.

And that had to be worn all day, but could be taken off in the evening, you know socialising and things like that and what have you. Cause you got very sort of self-conscious about it. Also I was extremely self-conscious about my scar on my chest, where they’d taken my left breast off. And, wouldn’t go into the pool and all sorts of things. But of course the most uncomfortable thing is this sleeve, of course, because it was so hot out there.
I was going to say, it must’ve been very hard to wear?
It was very uncomfortable, and it was very difficult to wear. But, we got through it okay. And-
And how much of your arm does the sleeve cover?
It covers from the wrist to the bicep.
The only time as I said I felt self conscious was on holiday, you know, because there’s a scar and...
And do you still have that feeling- I don’t know if you’ve had a chance to go away on holiday since then?
No we’ve been away on holiday since then and it hasn’t bothered me.
So you’ll just be able to go around, you know with your chest exposed as you normally would have done in the past?
Yeah, yeah, yeah.
You don’t feel like you’re getting any reactions from other people?
You might get the odd glance, I mean, I’m sure you- I think they glance more at the- the sleeve than anything else. It’s not exactly- what’s happened was is that I’ve used bio-oil ever since I’ve had the operation. .And the scar is virtually- you wouldn’t even notice it. What you may notice is that I haven’t got a breast. But that doesn’t- no-one seems to be bothered with that. They’re not going, “Oooh look he hasn’t got a breast”, you know, it doesn’t happen. You know. 

John no longer worries about showing his body on holiday, but he had had to get his confidence back.

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Age at interview: 61
Sex: Male
Age at diagnosis: 57

But it must be horrific for a woman to have breast cancer, it must be terrible. I don't think it's as bad for a man, you can cope with it. As I said I went on holiday last year and that's the first time I've actually shown my body walking along kind of thing you know because it was a nice hot day but that's the first, I've had to get my confidence back in that respect. But I don't worry now.

How did you feel after the operation, did it take a while before you could look at the scar?
Yeah well it was covered up, it was plastered up kind of thing but I did look at it yeah and there was lots of metal clips about you know, half way across my body but they were fine.
But you've got the confidence now to, on a beach for example to take off your...?
Yeah I've a lot more confidence in life in general now yeah because if that can't hurt me then nothing can you know, that's how I look at it anyway. 
Several of the men made comparisons between how they felt and how they imagined women would feel after a mastectomy. Mostly they suggested that it would be worse for a woman, but one or two did point out that it was easier for women to cover their changed body with specially-made clothes.

John had a shock when he first saw his scar and still feels a bit different at times because he...

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Age at interview: 65
Sex: Male
Age at diagnosis: 63

We touched on the subject once about reconstruction and I think the nurse said, “I’m not sure whether they do much for men John anyway” she said, “I’m sure if you ask they probably could”. But I wouldn’t bother Kate. To me that’s more surgery. And it’s not as though I’m a young fella you know, I’m not running round on a beach six months out of the year, you know. I certainly wouldn’t bother with that you know.

So you’ve not got plans to work as an Australian lifeguard or… (laugh)?
(laugh) No, no. So no that wouldn’t bother me. No, I was a little bit, the first time I sort of stripped off on holiday, yeah I felt a little bit awkward you could, like everything else, you feel people are looking, you know. I’m sure they wasn’t. But after a while my grand-daughter God bless her, “come on Grand-dad, come in the water… lying there” after a while I looked around and no, I just accept it now. I mean I’ve still got what I call a good tan in that area from the radiotherapy. So it does stand out a little bit, but they assure me that, well it is, it’s going quite quickly now. But apart from that you know, the scar is almost non-existent. Until you actually realise that I’ve only got one nipple you’d, probably have a job, you know, you wouldn’t notice it type of thing.
And you know, you don’t feel differently about yourself as a man having you know, had, I mean did that, obviously it must have provoked a few thoughts when it first happened, but, …?
Well… I don’t, I don’t think so, I, you know, It’s been said, well I’ve told you – that stripping off on holiday and that. At times I still feel different, from the next chap purely because as far as I know he’s got two nipples and I’ve only got one, which brings me back to what I said to you about the ladies, it must be devastating for, you know, two women to be sitting, she’s got two boobs – you’ve only got one, you know, fortunately you don’t know, but I’m still stripping off. It’s unbelievable, don’t know how they cope with it to tell you the truth.
‘Cos you said yourself before, that you know when you’d first seen your scar that that gave you quite a shock?
Yeah, I would, as I say, I was a little bit annoyed and ungrateful, I had very mixed feelings, because like I said to you, I thought well, bloody hell, a couple of weeks ago the only thing I’d got was a flat nipple. And now look at me, you know. All round (inaudible) tubes coming out of it and – but, you know that passes and the ungratefulness passes and you know. So…
You felt like...?
But at times occasionally you do feel a little bit different, but I think it’s, you know, probably psychological or more than actual you know physical side of it. I mean, when you do strip off on holiday, I’m sure people, they don’t have the time, they don’t notice I shouldn’t think, but, to you, you know, you wouldn’t think people, whereas a lady, you would obviously if she was walking round topless, with one boob and not the other one, I mean it would stand out like a sore thumb type of thing. But no, no, apart from, as I say, just occasionally I just feel slightly different, than you know that passes- you put your shirt back on…it passes (Laughs).

David no longer takes his shirt off because he is conscious of the sun, but he does think that it...

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Age at interview: 57
Sex: Male
Age at diagnosis: 52

 I’m not bothered now. Maybe at the time or maybe if I were younger, I don’t take me shirt off or owt like that, you know, cos you realise what that big sun can do to you. So I’m just very aware now. You know, so no, I’m not that bothered, no.

Do you go swimming and…
I have done swimming, yeah, but I think you’re self-conscious at first cos you think everybody’s looking at you, but… I wouldn’t be bothered, no, you know? I’d go swimming if I needed to go swimming.
You would take your top off if you wanted to?
Yeah, yeah, I would, but I don’t take it off, but it wouldn’t stop me taking it off.
That’s again where the women differ from the men cos women can have clothes made. You know, men, there’s nothing for men it’s just... If I put a tight t-shirt on, not that I would, but I would be lopsided, you know? Simple as.
And would that bother you?
Not now. It might have done right at the beginning, but as I say I’m mature and it’s sort of, you know, I’m not on this earth to be looked at or whatever else. I’m just a normal guy trying to get round his normal day of work, so yeah. I were very self-conscious at the beginning, very self-conscious, but as I say, not now. So… 
Several of the men, like Derek, suggested that their feelings about having a mastectomy might have been different if they had been a younger man.

Derek feels he would be far more self-conscious of his changed body image if he was a younger man.

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Age at interview: 69
Sex: Male
Age at diagnosis: 68

And to a certain extent, I mean I know it’s totally different for a woman, but my next door neighbour actually had it five years ago, so, you know I can sort of relate and talk to her about it you know, and she doesn’t mind talking about it. She’s just going through reconstruction, and I made the comment with the surgeon and said, I said about you know, “It looks odd”. So he said “We don’t do reconstruction for men” (laugh). So I said, “No, I’m sure you don’t, but I said, it would be nice to lose enough weight so that it wasn’t obvious”, but, when, when you are on the big side, then, you know, as a man you’ve still got a bit of a bust, so (laugh). But yeah that’s just one of these things and it’s a bit of vanity I suppose really.

We’re all entitled to a bit of vanity! (laugh) Yeah so you were saying before that you felt fairly self conscious with, you know, say going swimming or …?
Yeah, if I do go swimming because I’m supposed to belong to a health club but I haven’t been for a long time, but when I go there, they’ve got a pool and I did go in after it, but it, it’s fortunate in that it’s not a very busy pool, so, I you know, I didn’t worry about it too much. And I mean even from the point of view of changing rooms and that, it doesn’t worry me that much.
Do you feel as if people are looking at you or staring it at?
No, not really I don’t think, I can’t honestly say that you know I’ve ever been conscious of anybody sort of staring or, or anyone sort of saying “ooh what did you do?” or you know, ‘cos most people they’re a bit conscious about asking questions like that anyway.
And has the whole experience you know, having the surgery and I suppose being more conscious of your chest or, you know your bust as you called it, has, has that changed how you feel as a man at all over…?
I don’t think so, you know, and as I, I’ve said to you, I mean basically I’ve never been a very physical person so, you know, it, it, it hasn’t had that much affect on me at all. And I mean at my time of life, it’s even less really. I mean probably if I’d been much younger it might have been a bit different but I mean, at my age I don’t think it makes that much difference at all.
So how do you, how do you think a younger man may respond or…?
Well I think they might be far more conscious about, you know appearances and all the rest of it. But I mean that, that’s just me I, that’s what I feel if it had been sort of 20 years ago that it happened, then I, I feel that I might have been more sensitive about it, whereas now, it isn’t. I mean it’s not, but I think if it had been sort of 20 or so years ago, then I might have been a bit more conscious and, you know, about it.

Only one of the men had had any cosmetic surgery (see also ‘Reconstruction’). Having new nipples tattooed onto his chest had made a real difference to how he felt about himself. He now felt reborn as a man because he now looked the same as he used to before he was diagnosed with breast cancer.

Last reviewed June 2017.
Last updated October 2013.

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