Breast cancer in men - Treatment

Treatment-Breast cancer in men




The treatment for breast cancer in men largely depends on how far the cancer has spread. Possible treatments include surgery, radiotherapy and medication.

Your treatment plan

You'll be cared for by a team of specialists who will help you make decisions about your treatment.
Your recommended treatment plan will depend on how far the cancer has spread, but the final decision about going ahead with treatment is yours.
You may find it useful to write a list of questions you'd like to ask your team. For example, you could ask about the advantages and disadvantages of particular treatments.
If the cancer has not spread very far beyond your breast, a cure may be possible. This will usually involve surgery, possibly followed by radiotherapy or a course of medication.
If the cancer has spread into other parts of your body, a complete cure may not be possible. But treatment can help relieve symptoms and slow down the spread of the cancer.

Surgery

An operation called a mastectomy is the main treatment for breast cancer.
This involves removing all the breast tissue from the affected breast as well as the nipple, and possibly also the glands in your armpit and some of the muscle under your breast.
The operation is carried out under general anaesthetic(where you're asleep). You'll probably need to stay in hospital for a day or two.
It can take several months to fully recover. The Royal College of Surgeons of England has a leaflet for people recovering from a mastectomy with detailed information and advice.

Your body after surgery

After surgery, there'll be a straight scar across your chest where your nipple used to be and possibly a dent where the breast tissue was removed.
The scar will be raised and red at first, but it should flatten and fade with time. The area will also be bruised and swollen for the first few weeks.
It may be possible to have further surgery at some point to improve the appearance of your breast and create a replacement nipple. Other options include tattooing a new nipple on to your chest.
Talk to your care team about how your chest will look after surgery and what your options are for improving its appearance if necessary.

Possible complications

Side effects and risks of a mastectomy include:
  • pain and discomfort for a week or two – you'll be given painkillers to help with this
  • numbness or tingling around the scar and in your upper arm – this should pass within a few weeks or months, but can occasionally be permanent
  • a wound infection, causing redness, swelling, warmth or discharge from the wound – tell your nurse or doctor if you get any of these symptoms
  • painful swelling in the arm (lymphoedema) – this may be permanent, but can be treated (read more about treatments for lymphoedema)
Before having surgery, talk to your surgeon and breast care nurse about the possible risks.

Radiotherapy

Radiotherapy is a treatment where radiation is used to kill cancer cells. In breast cancer in men, it may be used to:
  • help stop the cancer coming back after surgery
  • slow down the spread of the cancer and relieve symptoms if a cure is not possible (palliative radiotherapy)
It involves several treatment sessions where a machine is used to carefully aim beams of radiation at the cancer. Each session usually only lasts for 10 to 15 minutes and you can go home afterwards.
A typical course of treatment involves 2 to 5 sessions a week over 3 to 6 weeks, although palliative radiotherapy may involve fewer sessions.

Side effects

Radiotherapy is not painful, although you'll probably get some side effects. Most of these should pass once treatment stops.
Common side effects of radiotherapy include:
  • sore, red skin (similar to sunburn) on your chest
  • feeling very tired
  • feeling sick
  • temporary hair loss in the area of your chest being treated
Read more about the side effects of radiotherapy.

Hormone therapy

Hormone therapy is a treatment that involves taking medication to block the effects of a hormone called oestrogen.
Around 9 in 10 breast cancers in men are "oestrogen receptor positive", which means the cancer cells need oestrogen to grow.
Hormone therapy can be used to:
  • help stop the cancer coming back after surgery
  • slow down the spread of the cancer and relieve symptoms if a cure is not possible
The most commonly used hormone medicine is tamoxifen. This is taken as a tablet or liquid every day, usually for 5 years.

Side effects

Tamoxifen can cause some unpleasant side effects, such as:
Tell your care team if you have any troublesome side effects. Other hormone medicines, such as a type called aromatase inhibitors, are available if needed.

Chemotherapy

Chemotherapy is a treatment where powerful medication is used to kill cancer cells. It may be used if hormone therapy is not suitable for you.
In breast cancer in men, chemotherapy may be used to:
  • help stop the cancer coming back after surgery
  • slow down the spread of the cancer and relieve symptoms if a cure is not possible
It involves several treatment sessions where medicine is given directly into a vein. Each session usually lasts a few hours and you can go home afterwards.
A typical course of treatment involves 6 sessions, with a break of a few weeks between each one to allow your body to recover.

Side effects

Chemotherapy can cause a range of unpleasant side effects, although most of these should pass once treatment stops.
Side effects of chemotherapy can include:
  • feeling very tired
  • feeling and being sick
  • temporary hair loss
  • being more vulnerable to infections – tell your care team if you feel unwell or develop symptoms such as a fever and chills
  • loss of appetite
  • diarrhoea
  • infertility
Read more about the side effects of chemotherapy.

Trastuzumab (Herceptin)

Trastuzumab (brand name Herceptin) is a medicine that blocks the effect of a substance called human epidermal growth factor receptor 2 (HER2).
In some breast cancers in men, HER2 contributes to the growth of the cancer cells.
Trastuzumab is usually used after radiotherapy or chemotherapy to help stop the cancer coming back.
It's given as a liquid directly into a vein or as an injection under the skin. You come into hospital for treatment and go home shortly afterwards.
A typical course of treatment involves a treatment session every 3 weeks for a year.

Side effects

Trastuzumab can cause some unpleasant side effects, such as:
  • a reaction to the medication – this can cause chills, a fever, swelling of the face and lips, headache, hot flushes, feeling sick, wheezing and breathlessness
  • tiredness and difficulty sleeping
  • diarrhoea or constipation
  • an increased risk of infections
  • loss of appetite and weight loss
  • pain in your muscles, joints, chest or tummy
  • heart problems
Read more about the side effects of trastuzumab.
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