Help And Support For Breast Cancer In Men

Overview

Breast cancer in men is a cancer that starts in the small amount of breast tissue that all men have behind and around the nipple. It happens when cells in that tissue grow out of control. Male breast cancer is treated in much the same way as breast cancer in women, and finding it early gives the best chance of a good outcome.

No, it is uncommon. Breast cancer is much rarer in men than in women, and many people do not realise men can get it at all. Because it is rare, men often delay asking for help — but a change in the chest is always worth checking.

It can affect men of any age, but it is most common in men over 60. It is extremely rare in children and teenagers. Some things raise the risk, such as a strong family history of breast or ovarian cancer, certain gene changes, previous chest radiotherapy, liver disease, heavy alcohol use, being very overweight, or conditions that affect male hormones.

Symptoms

Common symptoms

• A lump in the breast tissue, usually firm and often just behind or near the nipple
• The nipple turning inwards (inverted) or changing shape
• Fluid (discharge) coming from the nipple, sometimes blood-stained
• Crusting, scaly, red or sore skin on or around the nipple
• The skin of the chest looking dimpled, puckered or like the skin of an orange
• A change in the shape or outline of the chest, or one side looking different from the other
• A swelling or lump in the armpit, caused by enlarged lymph glands (small bean-shaped glands that help fight infection)
• Pain or tenderness in the breast area — although most male breast cancers are not painful

Symptoms in children

• Breast cancer is extremely rare in children and teenagers
• Many boys develop some temporary breast swelling or tenderness during puberty — this is common, harmless and usually settles within a year or two
• Any firm, one-sided lump that keeps growing, nipple discharge, or skin change in a child should still be checked by a doctor

Symptoms in older adults

• A lump may be easier to miss if there is already some chest tissue or the chest is larger
• Nipple changes or a rash that does not settle with simple creams
• Swelling in the armpit or arm
• Unexplained tiredness, weight loss or a general feeling of being unwell
• Older men may put symptoms down to ageing or an old injury — anything new and persistent deserves a check

Causes

Main causes

• Breast cancer happens when cells in the breast tissue develop changes in their DNA (the instructions inside cells) and start to grow in an uncontrolled way.
• In men, there is only a small amount of breast tissue, but it can still be affected by these cell changes.
• We do not know exactly why one man develops it and another does not. Usually it is not caused by anything a person did or did not do.

Risk factors

• Getting older — most cases are in men over 60
• A close family history of breast, ovarian or prostate cancer
• Inherited gene changes, such as BRCA1, BRCA2, CHEK2 or PALB2 — these genes can be passed down in families
• Previous radiotherapy to the chest, for example treatment for another cancer years earlier
• Conditions that change the balance of male hormones, such as Klinefelter syndrome (a genetic condition where a boy is born with an extra X chromosome), undescended testicles, or having had the testicles removed
• Liver disease, which can change hormone levels
• Drinking a lot of alcohol over many years
• Being very overweight, especially around the middle
• Past treatment with oestrogen (a female hormone) — for example some treatments for prostate cancer
• Smoking may also play a part

When to see a doctor

See a doctor urgently if:

• You have a new lump in your chest or armpit
• You have nipple discharge, especially if it is blood-stained
• Your nipple has turned inwards or the skin around it is crusty, scaly or sore
• The skin of your chest is dimpled or puckered
• A lump is growing quickly or feels hard and fixed in place
• You have a red, hot, painful chest with a fever

Book a routine appointment if:

• You have chest tenderness or swelling that has not settled after a few weeks
• You have a family history of breast, ovarian or prostate cancer and want to talk about your own risk
• You are worried about a change in your chest, even if you are not sure it is anything serious
• You are a man who has had chest radiotherapy in the past and want advice on watching for changes

Diagnosis

Your doctor will start by asking about your symptoms and your family history, then feel (examine) your chest and armpits. If anything looks or feels unusual, you will usually be referred to a breast clinic — in the UK this is often within two weeks on an urgent suspected cancer pathway. At the clinic, a specialist team will do a set of tests called a triple assessment: an examination, a scan, and usually a small tissue sample.

Tests that may be done

• Clinical examination — the doctor carefully feels your chest, nipples and armpits
• Mammogram — a low-dose X-ray of the chest area, which can show changes inside the breast tissue
• Ultrasound scan — sound waves used to look at the lump and nearby lymph glands in the armpit
• Core biopsy — a small sample of tissue taken with a fine needle, using local anaesthetic, and checked in a laboratory
• Sometimes a fine needle aspiration — using a thin needle to draw off fluid or cells from a lump
• Blood tests to check your general health
• Tests on the cancer cells to see which treatments are likely to work best, such as checking for hormone receptors and HER2 (a protein that can make some cancers grow faster)
• If cancer is found, scans such as a CT or bone scan may be done to check whether it has spread

What to expect at your appointment

Being referred to a breast clinic can feel frightening, and waiting for results is often the hardest part. The tests are usually quick, and a biopsy may sting briefly but is done with local numbing medicine. You can normally go home the same day. Results often take one to two weeks. It can help to bring someone with you, write down your questions, and ask the team to explain anything you do not understand.

Treatment

Treatment for breast cancer in men is very similar to treatment for women and is planned by a specialist team. The plan depends on the size of the cancer, whether it has spread, and the type of cells involved. Most men have surgery, and some also need radiotherapy, chemotherapy, hormone treatment or targeted treatment. Your team will explain the aims of each treatment, including the possible benefits and side effects, so you can decide together.

Self-care at home

• Keep the skin around your wound clean and dry, and follow the care advice your team gives you
• Do the arm and shoulder exercises your team recommends after surgery to help prevent stiffness
• Rest when you need to, and build activity back up slowly
• Eat regular, balanced meals to help your body cope with treatment
• Tell your team about any side effects early — there is often something that can help
• Keep a notebook of appointments, medicines and questions
• Avoid smoking and keep alcohol within low-risk levels; ask for help if you want to cut down

Medical treatments

Surgery is the most common first treatment and usually means removing the breast tissue and often some lymph glands from the armpit. After surgery, some men have radiotherapy — a course of targeted X-rays that helps stop the cancer coming back. Chemotherapy uses medicines that kill fast-growing cancer cells and is given as a course over several months. Hormone treatment blocks or lowers the hormones that some breast cancers need to grow; it is usually taken as a tablet for several years. Targeted treatments are medicines that focus on specific features of the cancer cells. Your specialist team will recommend which of these apply to you and explain the possible side effects.

When is surgery considered?

Surgery is usually the main treatment and is often done soon after diagnosis. Most men have the breast tissue and nipple removed (a mastectomy), because male breast tissue is small. Lymph glands under the arm may also be checked or removed. Some men have chemotherapy or hormone treatment before surgery to shrink the cancer first. Your team will explain the options and what to expect for recovery, scarring and follow-up.

Living with this condition

Life during and after treatment often settles into a new rhythm of appointments, rest and gradual return to normal activities. Many men find it helps to plan a little at a time, accept offers of practical help, and be honest with family and employers about what feels manageable. Side effects such as tiredness, sore skin or a stiff shoulder usually improve with time and with the exercises and advice from your team.

Lifestyle tips

• Stay as active as feels comfortable — short walks count
• Keep to a healthy weight, with steady changes rather than strict diets
• Limit alcohol and avoid smoking; ask your GP or pharmacist for support to stop
• Get plenty of sleep and rest when your body asks for it
• Protect your skin from sun, and look after the skin on your chest and arm
• Keep up with follow-up appointments and any checks your team recommends
• Notice how you feel and tell your team about new symptoms, rather than waiting for the next appointment

Diet and exercise

There is no special diet that cures or prevents cancer coming back, but eating well helps you feel stronger and recover better. Aim for plenty of vegetables, fruit, whole grains, beans and lean protein, and drink enough water. Gentle, regular movement — walking, gardening, swimming, or the arm exercises your team gives you — helps with tiredness, mood, and shoulder stiffness after surgery. Ask your team before starting anything strenuous, and build up slowly.

Mental health and emotional wellbeing

Being diagnosed with breast cancer as a man can feel isolating, because most information and support is written for women. It is very common to feel shocked, anxious, angry or low, and to worry about body image, work, money and relationships. These feelings are normal and they usually ease with time and support. Talking to someone — a partner, a friend, your GP, a specialist nurse or a counsellor — really does help. If you ever have thoughts of harming yourself, please contact your local emergency number or a crisis line straight away, or speak to your GP urgently. You do not have to cope alone.

Prevention

There is no sure way to prevent breast cancer in men, and most cases happen without any clear cause. You can lower your risk in general ways: keep to a healthy weight, limit alcohol, avoid smoking, and be aware of your family history. The most useful thing you can do is know what your chest normally looks and feels like, and get any new lump, nipple change or skin change checked promptly.

Vaccines

There is no vaccine that prevents breast cancer.

Screening programmes

There is no routine breast screening programme for men. If you have a strong family history of breast, ovarian or prostate cancer, or you know you carry a gene change such as BRCA1 or BRCA2, talk to your GP. You may be referred for genetic counselling and, if your risk is higher, offered regular check-ups or scans.

Complications

If left untreated

• The cancer can grow larger and spread into nearby lymph glands in the armpit
• It can spread to other parts of the body, such as the bones, lungs or liver, which is harder to treat
• Skin changes, sores or discharge from the nipple can develop
• Treatment is generally more effective the earlier the cancer is found

Long-term outlook

The outlook for men with breast cancer is generally good, especially when it is found early. Outcomes for men treated at the same stage are broadly similar to those for women. Many men are successfully treated and get back to their normal lives. There is strong support available, and your specialist team can talk honestly with you about what to expect for your own situation.

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