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Surgery for breast cancer in men
Men with breast cancer almost always have a mastectomy, removing the tissue behind the nipple along with the nipple itself, plus a check of the lymph nodes in the armpit. Because men have little breast tissue, it is a smaller operation than in women. This page explains the pathway, and why genetic testing matters here.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
What surgery do men with breast cancer have?
Almost always a mastectomy, removing the breast tissue behind the nipple along with the nipple itself, plus a check of the lymph nodes in the armpit. Men have very little breast tissue, so there is rarely enough to remove a lump and leave a sensible breast behind.
Why the operation is usually straightforward
Because there is so little tissue, the operation is smaller than a mastectomy in a woman and recovery is usually quicker. The scar runs across the chest and most men are home within a day or two.
The armpit is checked the same way
A sentinel node procedure, where the first few nodes are removed and examined, is standard. If nodes are clearly involved, more may be removed. The principles are exactly the same as in women.
What usually follows
Most male breast cancers are hormone sensitive, so tablets afterwards are the mainstay and run for years. Radiotherapy and chemotherapy are used on the same grounds as in women, decided by the pathology report.
Ask for genetic testing. BRCA faults are found more often in men with breast cancer, and it matters for your family.What differs
How this differs from breast cancer in women
The biology is largely similar. The practical experience is not.
Diagnosis usually comes later
There is no screening programme for men, and most men do not expect breast cancer, so lumps are often ignored for months. That delay, not the biology, explains much of the difference in outcomes.
Keeping the breast is rarely an option
With so little tissue and the cancer usually sitting right behind the nipple, a mastectomy is almost always the sensible operation rather than a cautious one.
Genetic testing matters more
Inherited gene faults are found more often in men with breast cancer than in women. The result affects your own risk of other cancers and your children's risk.
Ask for a genetics referral, not just a test.Hormone treatment is chosen differently
Most male breast cancers are hormone sensitive, but the tablets used first in women after menopause do not work the same way in men. Your oncologist will explain which is right for you.
The pathway
From finding a lump to finishing treatment
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Getting it looked at
A firm lump behind the nipple, a pulled-in nipple, bleeding from it or a skin change all need checking. Most such lumps in men are not cancer, and that is a reason to get it checked rather than to wait.
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Triple assessment
Examination, imaging with a mammogram or ultrasound, and a needle biopsy. The same three steps used for women, at the same breast clinic.
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Surgery
Mastectomy with a sentinel node procedure, usually a short operation with a one or two day stay. A drain is sometimes left for a few days.
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The pathology report
Size, grade, margins, node status and receptor results. This is what decides whether radiotherapy or chemotherapy is added.
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Tablets for years
For hormone sensitive cancers, which is most, tablets continue for several years and do the long-term work. This is the part most often stopped early.
Not sure whether this applies to you?
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Words you will hear
The vocabulary, in plain language
- Mastectomy
- Removing the breast tissue and the nipple. In men this is a smaller operation than in women.
- Sentinel node procedure
- Removing the first few lymph nodes from the armpit to check whether cancer has reached them.
- Gynaecomastia
- Harmless enlargement of male breast tissue, often from medicines or hormone changes. Common, and not cancer, but it should be checked.
- Hormone receptor positive
- The cancer carries receptors that hormones attach to. Most male breast cancers are, which is good news for treatment.
- BRCA2
- An inherited gene fault found more often in men with breast cancer. It also raises prostate and other cancer risks.
- Adjuvant treatment
- Treatment given after surgery to lower the chance of the cancer returning.
Being straight with you
What is harder about this, and what is not
Stage for stage, outcomes for men are broadly comparable to those for women. Men often do worse overall, and the main reason is that they are diagnosed later, not that the disease behaves differently.
The isolation is real
Everything about breast cancer, from the clinic name to the leaflets to the waiting room, is addressed to women. Most men describe feeling out of place. Saying so to your team is worth doing, because they can often arrange appointments and information differently.
The evidence is thinner
Because male breast cancer is uncommon, much of the treatment is based on studies in women. That is a reasonable approach and it is honest to say it is an extrapolation. Ask your oncologist where the evidence for your plan comes from.
Telling people is often the hardest part
Many men delay telling family or employers because of embarrassment. That delay tends to cost more in support than it saves in awkwardness. Ask whether your hospital can put you in touch with another man treated for the same thing.
Commonly believed
What men are told about breast cancer
Men cannot get breast cancer.
Men have breast tissue and can develop breast cancer in it. It is uncommon, which is exactly why lumps get ignored. Any firm lump behind the nipple, nipple bleeding or a skin change should be checked without waiting.
A lump in a man is almost certainly something else.
Most are, usually harmless enlargement of breast tissue, and that is reassuring rather than a reason to delay. The checks are quick and the same as for women. Waiting to see whether it settles is what leads to late diagnosis.
It means something is wrong with my hormones or masculinity.
Breast cancer in men is a disease of breast tissue, which every man has. It says nothing about masculinity. Some men do have an underlying hormone or genetic factor, which is worth investigating because it is useful information, not because it is shameful.
There is no point having genetic testing at my age.
There is, because a gene fault affects your risk of other cancers including prostate, and your children's risk of breast and ovarian cancer. Testing you may be the most useful thing you can do for your family.
Questions we are asked
Common questions about breast cancer surgery in men
Will I need my whole chest operated on?
No. The operation removes the breast tissue behind the nipple along with the nipple, usually through a scar running across the chest. Because men have little breast tissue, it is a smaller operation than a mastectomy in a woman and recovery is generally quicker.
Can the lump be removed without losing the nipple?
Rarely, because male breast cancer usually sits directly behind the nipple and there is little tissue to spare. Removing the nipple is what allows a clear margin. Ask your surgeon whether anything else is possible in your case, but expect the answer to be no.
Will I need chemotherapy?
It depends on the same factors as in women: the size, the grade, the node result and the receptors. Many men have hormone sensitive cancers where tablets do the main work. Ask whether a gene test on the tumour would help decide.
How long do I take the tablets?
Usually several years, and they are the most important part of long-term treatment for hormone sensitive cancer. Side effects can include hot flushes and reduced sex drive, which men are often reluctant to mention. Say so, because the tablet can sometimes be changed.
Should my children be tested?
If a gene fault is found in you, yes, they should be offered testing and counselling, usually as adults. This is one of the strongest reasons to have testing yourself. A genetics team will explain what it means for each family member.
Will I have a noticeable scar or dent?
There will be a scar across the chest and often a flatter area where the nipple was. Most men find it becomes unremarkable over time. Nipple tattooing is available if it bothers you, and it is reasonable to ask about.
Do I need follow-up mammograms?
Not on the operated side, since the tissue has been removed. Follow-up is by examination. If you carry a gene fault, your team may recommend watching the other side, so ask what your own plan should include.
Is there support for men specifically?
Less than there should be, and most services are framed for women. Ask your breast care nurse whether they can connect you with another man who has been treated. Several charities also run groups specifically for men, including online.
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Sources
- Cancer Research UK — Breast cancer in men
- National Cancer Institute — Male breast cancer treatment (PDQ)
- Breast Cancer Now — Breast cancer in men
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.