Breast Cancer in men

Reconstruction for breast cancer in men

Most men who develop breast cancer have surgery to remove their tumour. Because in general men have much less breast tissue than women, it is usually necessary to remove all of the breast tissue and the nipple on the affected side (a mastectomy) when their breast cancer is detected. Sometimes it is necessary to remove muscle as well. Men who have had a mastectomy or who have had a nipple removed may be offered or may want some form of reconstruction after their operation.

Not all of the men had been offered reconstruction. One man who hadn’t been given the option of reconstruction said it would have been nice to have had the choice. In many cases it seemed that discussion of whether the men might want reconstruction had been completely overlooked.
The men who had been offered some form of cosmetic procedure (either a tattooed nipple or more extensive reconstructive surgery) were glad they had been given the choice but all of these men had chosen not to have it for various reasons.
Some men chose not to have reconstruction because they didn’t want to have more surgery.

Robert had been offered reconstruction but didn’t want another operation. He was careful about...

View full profile
Age at interview: 58
Sex: Male
Age at diagnosis: 54

I was offered reconstructive surgery if I’d particularly wanted it, but I didn’t, I didn’t want another operation.

No, and so were you offered that at the, at the time of your mastectomy?
Yes I was.
Yeah, yeah, so you could have had it at the same time, or you could have come back for it?
It would probably have been later.
‘Cos I didn’t want another, another operation, I thought one was enough.
Didn’t matter for me, as a man, I felt it didn’t matter to me, but obviously for women it’s a different thing.
And so you know just talking about your body, you say, you know, you feel like it doesn’t matter for you, I mean are you comfortable about this time of year you wouldn’t be taking your shirt off much anyway! (laugh)
Well it wouldn’t bother me if we went, if we we’re abroad, the only thing is, I’d have to be very careful about going in the sun anyway now, because it, because I’m fair skinned anyway, I think after the radiotherapy treatment and everything else – so I wouldn’t want to get it burnt, I wouldn’t want to get the area burnt.
Yeah, but you haven’t felt like you’ve had to change
aspects of your life because of feeling
differently about your, about your body at all?
No. No. It wouldn’t stop me going swimming if we were abroad at all. 

Stuart had options for reconstruction explained to him but he didn’t want a longer operation or...

View full profile
Age at interview: 40
Sex: Male
Age at diagnosis: 36

 She also discussed the option of… what’s it called again?

The chemo?
No. About where they take the flap of muscle from round the back…
An LD flap?
… which was good because, you know, normally it would be just women she was talking to and she’d discuss that with me as well and whether I’d want to do that and if I did decide on that then it would be a longer operation and slightly longer recovery, cos obviously have to take the flap and put it round the front and this sort of thing. And then talked about the nipple and I said, well, after we’d thought about it, I said, well, no, I don’t… it doesn’t really affect me as much as it would a woman, because, you know, I haven’t got a big chest and there’s not a lot up top for me, so personally it wouldn’t really sort of… when I’ve got clothes on, you wouldn’t really notice as much as a woman, so it was good that they offered that to me and I thought about it and I thought well, I don’t really want to go through a longer operation, for one, and longer recovery so I decided upon just a mastectomy.
So yeah, they did give you the various options, which was good, and it was all explained.
Have you ever had, since then have you had the offer to reconstruct since?
I haven’t since, but after the… sorry, when she was discussing this, about the reconstruction, he said, “You can have it now or at a later stage.” But… sort of since I had the operation and going through my treatments, I hadn’t sort of discussed that further with her or with [name of Dr] about doing it, and… and as it happens, the actual… I mean, it’s not a lot of difference, really, either side. So… you know, hasn’t really affected me too much.
OK. Do you think you’d ever get a nipple reconstructed?
No. No. I mean, for some people it may affect them differently in that they probably wouldn’t want to be seen with a bare chest with no nipple on one side and, yeah, not exactly the same size and shape as the other, but to me it didn’t matter at all. You know, and I’ve been swimming and this sort of thing and it doesn’t bother me.
Several of the older men said that the loss of their nipple and breast tissue didn’t bother them at their age, although they recognised that it might matter more to a younger man.

Robert was offered cosmetic surgery. He said he wasn’t bothered about having another scar at his...

View full profile
Age at interview: 70
Sex: Male
Age at diagnosis: 70

 So when you came out of surgery and you’d had the mastectomy…

Had the surgery, oh aye, that’s right, of course.
(overtalk) had the mastectomy, I mean, how do you think it looks? Have they done a good job with the scar?
Yeah, it’s fine – I mean, ok, my nipple’s away and everything, and the consultant said, you know, “you can have cosmetic surgery,” and I went, “at my age? Forget that,” you know?
So you were offered that?
Yeah, I was offered that.
At the time, just before they were going to do the…
Before… When I went initially, you know, they were discussing the surgery and said, you know, “you can have cosmetic surgery.” I says, “…don’t need cosmetic surgery at my age,” you know? If I was a young guy or something, uh uh, but I didn’t worry too much about that. But anyway, they made a very neat job of it.
And how do you feel about your body now?
Well it’s, I mean, I’ve got enough scars as well, you know? But the fact that the age I am, it doesn’t bother me at all. The thing is I feel ok – that’s the main thing, you know?

After his bilateral mastectomy Roy didn’t feel a need to have tattooed nipples, although he...

View full profile
Age at interview: 67
Sex: Male
Age at diagnosis: 65

I wouldn’t fancy being tattooed, really. It might hurt (laughing).

Well, you’ve had a couple of…
I’ve had tattoos, yeah. Yeah, no, I, I, no, I wouldn’t do that. I wouldn’t do that, coz a lot of women have it done, as well, tattooed back on, don’t they?
I don’t know, actually, coz I don’t know the different techniques that they use.
My cousin’s wife, she had it done on one side, and she had a nipple tattooed back on there.
Coz I think sometimes, they can save the nipple in the surgery?
Yeah, they can do.
As I say, a long way out of my expertise, but…
I mean, probably, if I sort of said well, “I don’t want to…” They could have probably saved this one, but I think this one had to go anyway coz the tumour was right in the nipple, sort of thing.
So close by, yeah.
Yeah – I think that one would have had to have gone anyway, but like I say, you know – especially at my, I mean, it might have been different if I’d been twenty years old, you know?
So you think a younger guy might find it…
Yeah – coz I mean, you know, I mean, all of us, when we’re young, are vain, aren’t we?
You know, whether you’re man, woman, or whatever you are – there’s always a bit of vainness about you, you know? But I think a younger fella might, I don’t know if I would have done when I was young – I don’t know if I would have worried then, or not, I really don’t. Might have done, I don’t know – but then again, we never had time for sunbathing, we had to go to work and earn, you know, and just work. That was your life, you know, just going to work, sort of thing. 
Others explained that they no longer took their shirt off in public places very often so exposing their scar was not a concern for them. However, a few men said there were some situations where they did feel uncomfortable about having their bare chest on view to other people, such as swimming (see also ‘Effect of breast cancer on men’s body image’).

Tom was seldom bare-chested in public, but he did worry that he might embarrass the younger women...

View full profile
Age at interview: 71
Sex: Male
Age at diagnosis: 70

So, you were offered reconstruction?

Yes, they said they could tattoo them if I wanted in that area. I said, “Well I ain’t really bothered”. I said, the only time I’m stripped to the waist is usually I sit in here at nights with nothing on because I put the cream on and all that, and I’d rather it soak into me than into me clothing, and of course, weather like this, down on the allotment, I strip to the waist. A little bit, just because there’s three or four young… well, I say young lassies, I mean you know, forty-odd downwards, and it curtails it a bit because I don’t want to embarrass them or myself for that matter.
What now?
Well, I mean, they’re young lassies compared to me, I mean you know, probably between thirty and forty.
Several men thought that they didn’t need reconstruction because the loss of breast tissue was less noticeable for them than it would be for a woman.

Tom wasn’t offered reconstruction but wouldn’t have wanted it because there wasn’t much...

View full profile
Age at interview: 65
Sex: Male
Age at diagnosis: 60

Did they offer you reconstruction?

No, no.
Or a tattoo for a nipple or…?
No. I didn’t know you could get it. Well they never asked, I never asked them, fair enough, if a woman might get a nipple, but my wife aint got nowt, you know what I mean? If a woman, fair enough, she get it done but never... I was never asked about it and I never asked them.
It’s not something you’d have gone for if they’d offered it to you?
No... It’s different for a woman.
Why’s that?
Coz she’s got bigguns – mine aren’t big. Mine’s flat, aren’t they? You can see where it delves in there, that’s all so you know what I mean, whereas the other one sticks out a bit here – but it’s only muscle, isn’t it, really when you look at it? No, it doesn’t embarrass me. I’d never shout for it, they never offered, so I don’t think they could help you out – I didn’t know they could offer men owt. What can they offer a man?
Well sometimes they can either, it’s like you say, sometimes if the breast on the other side, if it’s uneven, sometimes they might do some liposuction (ah) to flatten it down or else they might offer you the chance to tattoo on a nipple, just so that, you know?
Even it up, yeah – well no, I never even was offered that and I ain’t asked about it. Well, it don’t bother me now.
There’s some men get a reconstructed breast like a woman, obviously not the same size as a woman, but they can do that.
I know what you’re saying, yeah, yeah – build it up a bit, yeah. Coz that does sink in, know what I mean? It’s flat as a pancake now, where that one stands out a bit but it doesn’t bother me – it doesn’t bother me one bit.
Some of the men had shown their scar to others to prove that they had breast cancer and had had a mastectomy. Ben said, “I haven’t had [reconstruction], but it’s alright with a bloke. It’s a bit of war damage if you like’. Alan called it his ‘Vietnam war wound’, and another commented that men could always say, ‘look at my scar’.

Steve hadn’t wanted a nipple tattoo. He didn’t want the pain and he didn’t mind his scar being...

View full profile
Age at interview: 58
Sex: Male
Age at diagnosis: 58

And did he discuss options afterwards? Was there any talk of any reconstruction, or have you ever felt any need for that?

I was offered a tattooed nipple, which I thought hilarious – I thought that was really great. I could have any colour I liked, I presume! But from my point of view, the breast care nurse talked to me about that, and said, you know, did I want to go down any of those avenues, and I said, “No,” I think because I’m – even though I’m 58, and my breasts have grown a little bit, I didn’t have huge man boobs. I didn’t think there was a need for me to have any reconstructive surgery. The actual – I’m a hairy person as well, so a tattooed nipple would have been a total waste of time in a couple of weeks, because the hair would have grown over it. I didn’t fancy the pain of having a tattoo – which is funny when you have full surgery, and you worry about the pain of a tattoo! But, literally, no other issues. I’ve been swimming in a public pool since, I’ve got no qualms about my scar being on view. I know it’s different for a woman, obviously, but from a man’s point of view, you can always say you know, “Look at my scar!” I think, you know, it’s one of these things, isn’t it?
Men like showing off their scars?
Yeah, showing off, yeah, “Look at this scar!” You know. So there’s no...
So you haven’t felt at all self conscious, or any need to feel self conscious?
No, not at all. Literally. I mean, from the point, when I said earlier, about showing my, you know, I took my, opened my shirt on the bus. And people are looking on the bus, and quite interested.
So you educated a few people!
So I educated quite a few people, yeah, late at night, yeah. Quite funny! But – no, I’ve got no qualms about it. But I can appreciate that there will be people, men who don’t want to bare their chests, but what I say is, you don’t look that different, because you haven’t got big breasts in the first place. It’s just a flat version of the other side, literally. 
Bill was the only man who had reconstruction. When it wasn’t offered to him he asked if he could have cosmetic surgery. He said he felt like ‘Oliver Twist’ asking for more and he was angry that it was not routinely offered to him as it would be to a woman. When he phoned to make an appointment with the plastic surgeon, the secretary assumed that he wanted to make an appointment for his wife. Bill eventually had two new nipples tattooed onto his chest and he was very pleased with the result.

After Bill had a second mastectomy he insisted that he see a plastic surgeon. After the wounds...

View full profile
Age at interview: 54
Sex: Male
Age at diagnosis: 46

Why did they recommend that you went to a plastic surgeon then, this second time? Did they offer you some kind of reconstruction, on the second occasion but not the first, or-?

They had never talked about reconstruction the first time, and I had insisted on being referred to a plastic surgeon. After the first time, to see what could be done. And that was greeted with some astonishment, I remember. And-
Again because you were a man asking about it?
Because I was a man, and I was aware that women were offered reconstructive surgery at the point of initial surgery or they could delay it. But they were offered reconstructive surgery. So I felt like Oliver Twist almost, asking for more. But I was determined then that men should be treated absolutely the same as women. And they referred me to- no, they didn’t refer me to a plastic surgeon, they gave me the telephone number of the plastic surgeon, to make an appointment.
So you had to do that yourself?
I did.
I phoned the number and the person said, “Oh, you’ll have to hang on until I get my diary, [name]”. I said, “Okay”. So, she came back. “Okay, mister…” I remember exactly, she said, “Okay [name] I’ve got the diary now. What’s your wife’s name?” And… that was obviously as bad as the pharmacist.
Yeah, it must…
And anyway it was this assumption that men first of all didn’t get breast cancer, and secondly they wouldn’t bother at all with the reconstruction and…
So, there was just no thought at all that you might be phoning on your own behalf?
Just no thought that I might be the person looking for treatment. Anyway, I made the lady aware that it wasn’t my wife I was talking about, it was me and I was the very first man… the very first man, that had been referred, or asked to be referred to a plastic surgeon after breast cancer treatment and this is of course before I found out the symptoms returning to the other side and by that time, they had decided a second mastectomy was best and because I had spoken to the plastic surgeon, she said she would do it…
… and that’s, that’s how it came about.
So, after the second mastectomy of course I was… didn’t have anything, no nipples so there was a serious lack…
That must feel very strange?
Well, it does and it kind of looked very neat but there is definitely something missing and I did miss them and I do. Anyway, after that treatment, after that surgery, the plastic surgeon said that she would do something for me but not until the wound had healed and calmed down, and then she would see what she would do and I said, that’s fine, but in the interim, before she did anything, I became very depressed.

Last reviewed June 2017.
Last updated October 2013. Donate to healthtalk.org
Previous Page
Next Page