Mastectomy in men with breast cancer

Men have a small amount of breast tissue behind the nipple, and breast cancer can develop there, although it is far less common than in women. Because there is so little tissue and the cancer usually sits directly behind the nipple, the most common operation for men is a mastectomy, which removes the breast tissue, the nipple and the areola, and some of the overlying skin. Removing only the lump is possible for some men, but it is used less often because there is rarely enough tissue to leave a good result. The lymph nodes under the arm are checked at the same time. If scans and needle tests show the nodes look normal, a sentinel lymph node biopsy removes just the first few nodes. If cancer is already known to be in the nodes, more of them may be removed. The operation is similar to that in women, usually takes one to two hours without extensive node surgery, and most men go home within a day or two. Recovery involves drain care, shoulder exercises and watching for arm swelling. Afterwards the chest on that side is flat with a scar and no nipple, which some men find easy to accept and others find difficult. Most male breast cancers are hormone-sensitive, so oestrogen-blocking tablets are commonly advised after surgery, and radiotherapy or chemotherapy may be recommended. Genetic testing is usually offered, because inherited gene changes are found more often in men with breast cancer.

Mastectomy is the usual operation

With little breast tissue, removing all of it with the nipple is often the most reliable approach.

Lymph nodes are checked too

Sentinel node biopsy is common when the armpit looks clear.

Genetic testing is offered

The result can matter for your own care and for relatives.

Men face the same medical treatment as women, with some extra challenges.

Diagnosis often comes later

Many men do not know they can get breast cancer and delay seeing a doctor, so cancers can be larger at diagnosis.

Less information is written for men

Leaflets, support groups and waiting rooms are often designed for women, which can feel isolating.

The scar is visible

Without a breast to hide it, the scar and missing nipple may show when shirtless, which matters to some men.

What this page cannot tell you

It cannot say which operation suits your cancer. Your surgeon will explain after reviewing your scans and biopsy.

Men with breast cancer can feel embarrassed or reluctant to talk. Support makes a real difference.

Talking about it

Telling close family or a friend can ease the burden. Some men prefer to describe it simply as chest cancer at first.

Relatives and genetics

If a gene change is found, daughters, sisters, brothers and sons may benefit from genetic counselling.

Getting help

Ask your team about counselling and whether any support networks for men with breast cancer are available.