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Breast Cancer in Men - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Breast Cancer in Men. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Breast cancer in men is rare, accounting for less than 1% of all breast cancers. Although breast cancer in men occurs much less often than breast cancer in women, the diseases are similar in many ways.

About the breast

The breast is mostly made up of fatty tissue. Within this tissue is a network of lobes, which are made up of tiny, tube-like structures called lobules that contain milk glands. Tiny ducts connect the glands, lobules, and lobes to the nipple, located in the middle of the areola, which is the darker area that surrounds the nipple. Blood and lymph vessels also run throughout the breast; blood nourishes the cells, and the lymph system drains bodily waste products. The lymph vessels connect to lymph nodes, the tiny, bean-shaped organs that help fight infection.

About breast cancer

Cancer begins when healthy cells in the breast change and grow uncontrollably, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Breast cancer spreads when the cancer grows into other parts of the body or when breast cancer cells move to other parts of the body through the blood vessels and/or lymph vessels. This is called metastasis. Breast cancer most commonly spreads to the regional lymph nodes. The regional lymph nodes are located under the arm, in the neck, under the chest bone, or just above the collarbone. When the cancer spreads further through the body, it most commonly spreads to the bones, lungs, and liver. Less often, breast cancer may spread to the brain. If cancer comes back after initial treatment, it can recur locally, meaning in the breast and/or regional lymph nodes. It can also recur elsewhere in the body, called distant metastases.

Types of breast cancer

The main types of breast cancer are the same for men and women. Most breast cancers start in the ducts or lobes and are called ductal carcinomas or lobular carcinomas:

  • Ductal carcinoma. These cancers starts in the cells lining the milk ducts and make up the majority of breast cancers.

    • Ductal carcinoma in situ (DCIS). This is cancer that is located only in the duct. It is uncommon in men.

    • Invasive or infiltrating ductal carcinoma (IDC). This is cancer that has spread outside of the duct. Most men with breast cancer have invasive ductal carcinomas.

  • Lobular carcinoma.This starts in the lobules.

    • Lobular carcinoma in situ (LCIS). LCIS is located only in the lobules. LCIS is not considered cancer. However, LCIS in one breast is a risk factor for developing invasive breast cancer in both breasts (see the Risk Factors section for more information.)

    • Invasive lobular carcinoma (ILC). This is cancer that has spread outside the lobule.

Other, less common types of breast cancer include:

  • Medullary

  • Mucinous

  • Tubular

  • Metaplastic

  • Papillary breast cancer

  • Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers. However, it is uncommon in men.

  • Paget’s disease is a type of cancer that begins in the ducts of the nipple. Although it is usually in situ, it can also be an invasive cancer. It is more common in men than in women.

Breast cancer subtypes

Breast cancer is not all one disease, even among the same type of breast cancer. Often, the disease is made up of three main subtypes. Special receptors on the outside of the cancer cell help determine the subtype of breast cancer:

  • Hormone receptor positive. Breast cancers expressing estrogen receptors (ER) and progesterone receptors (PR) are called hormone receptor positive. These cancers may depend on the hormones estrogen and/or progesterone to grow. Breast cancer in men is more likely to have receptors for estrogen and progesterone, which means that hormonal therapy is an option for these cancers.

  • HER2 positive. About 20% to 25% of breast cancers depend on the gene called human epidermal growth factor receptor 2 (HER2) to grow. These cancers are called HER2 positive and have excessive numbers of HER2 receptors or copies of the HER2 gene. The HER2 gene makes a protein that is found on the cancer cell and is important for tumor cell growth. This type of cancer may grow more quickly.

  • Triple negative. If a person’s tumor does not express ER, PR, and/or HER2, the tumor is called triple-negative. Triple negative cancers tend to be faster growing cancers. This category of breast cancer may be more common in younger men diagnosed with breast cancer.

Looking for More of an Overview?

If you would like additional introductory information, explore these related items. Please note these links will take you to other sections on Cancer.Net:

  • ASCO Answers Fact Sheet: Read a one-page fact sheet (available as a PDF) that offers an easy-to-print introduction to breast cancer.

  • ASCO Answers Guide: This 52-page booklet (available as a PDF) helps newly diagnosed patients better understand their disease and treatment options, as well as keep track of the specifics of their individual cancer care plan.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert in breast cancer that provides basic information and areas of research.

The next section in this guide is Statistics and it helps explain how many men are diagnosed with this disease and general survival rates. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find information about how many men are diagnosed with this type of cancer each year. You will also learn some general information on surviving the disease. Remember, survival rates depend on many factors. To see other pages, use the menu on the side of your screen.

This year, an estimated 2,600 men in the United States will be diagnosed with breast cancer. It is estimated 440 men will die from breast cancer this year.

Men and women with breast cancer have similar survival rates. The 5-year survival rate tells you what percent of men live at least 5 years after the breast cancer is found. Percent means how many out of 100. For the earliest stages of breast cancer in men, stages 0 and I (zero and one), the 5-year survival rate is 100%. The 5-year survival rate for men with stage II (two) disease is 91% and stage III (three) disease is 72%.

When the disease has spread to other parts of the body, the stage is called stage IV (four). The 5-year survival rate for men with Stage IV breast cancer is 20%. Even if the cancer is found at a more advanced stage, new treatments help many people with breast cancer maintain a good quality of life, at least for some time.

It is important to remember that statistics on how many men survive this type of cancer are an estimate. The estimate comes from data based on the men with this cancer in the United States each year. So, your own risk may be different. Doctors cannot say for sure how long any man will live with breast cancer. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society.

The next section in this guide is Risk Factors. It explains what factors may increase the chance of developing this disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Breast Cancer in Men - Risk Factors and Prevention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the risk of developing of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

A man’s average risk for breast cancer is very low – 1 out of every 1,000 men with an average risk of the disease will develop breast cancer. Generally, most breast cancers are sporadic, meaning they develop from damage to a person’s genes that occurs by chance after they are born. There is no risk of passing this gene on to a person's children. Inherited breast cancers are less common, making up 5% to 10% of all breast cancers, and occur when gene changes called mutations are passed down within a family from one generation to the next (see below). The following factors can raise a man’s risk of breast cancer:

  • Family history of breast disease or presence of a genetic mutation. About 1 out of 5 men who develop breast cancer has a family history of the disease. Men with breast cancer gene (BRCA1 or BRCA2) gene mutations may be at increased risk for breast cancer and prostate cancer. Men with BRCA2 gene mutations have a 6 in 100 chance of developing breast cancer, whereas men with BRCA1 gene mutations have a 1 in 100 chance of developing breast cancer. Men with breast cancer are often referred to a genetic counselor to discuss genetic testing for BRCA1 and BRCA2 and other inherited cancer risk genes. Learn more about BRCA gene mutations and hereditary breast cancer risk in a separate article on this website.

  • Age. The average age for men to be diagnosed with breast cancer is 65.

  • Elevated estrogen levels. Certain diseases, conditions, or treatments can increase the levels of female hormones such as estrogen, which contributes to the development of breast cancer.

    • Klinefelter’s syndrome is a rare genetic condition in which men are born with an extra X chromosome. Men with this syndrome may have an increased risk of breast cancer because they have higher levels of estrogen and lower levels of male hormones called androgens.

    • Liver disease, such as cirrhosis, can change hormone levels and cause low levels of androgens and higher levels of estrogens.

    • Low doses of estrogen-related drugs that are given for the treatment of prostate cancer may slightly increase the risk of breast cancer.

  • Lifestyle factors. As with other types of cancer, studies continue to show that various lifestyle factors may contribute to the development of breast cancer.

    • Being obese or even overweight increases the risk of breast cancer.

    • Lack of exercise may increase the risk of breast cancer because exercise lowers hormone levels, alters metabolism, and boosts the immune system. Increased physical activity is associated with a decreased risk of developing breast cancer.

    • Drinking 2 or more alcoholic drinks per day may raise the risk of breast cancer. However, this risk factor has not been studied in men.

The next section in this guide is Screening and it explains how tests may find cancer before signs or symptoms appear. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Breast Cancer in Men - Screening

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find out more about how men may be screened for this type of cancer, including risks and benefits of screening. To see other pages, use the menu on the side of your screen.

Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer before signs or symptoms appear. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for men with breast cancer

Men should be familiar with the feel of their breast and chest wall tissue, so they can talk with their doctor if they notice any lump or change. Mammograms are not routinely offered to men and may be difficult to perform because of the small amount of breast tissue. A doctor may recommend screening mammography for men with a genetic mutation (see Risk Factors) that increases the risk of developing the disease.

The next section in this guide is Symptoms and Signs and it explains what body changes or medical problems this disease can cause. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

Men with breast cancer may experience the following symptoms. Sometimes, men with breast cancer do not show any of these signs or symptoms when diagnosed. Many times, breast signs or symptoms can be caused by a medical condition that is not cancer.

The signs and symptoms that should be discussed with a doctor include:

  • A lump that feels like a hard knot or a thickening in the breast or under the arm. Because men generally have small amounts of breast tissue, it is easier to feel small lumps.

  • Any new irregularity on the skin or nipple, such as redness, scaliness, puckering, or a discharge from the nipple

If you are concerned about one or more symptoms or signs on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms is an important part of cancer care and treatment. This may also be called symptom management, supportive care, or palliative care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis and it explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose cancer and find out if the cancer has spread or metastasized to other parts of the body beyond the breast and the lymph nodes under the arm. Some tests may also help the doctor decide which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread.

This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition

  • Type of cancer suspected

  • Signs and symptoms

  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose breast cancer in men:

  • Clinical breast examination. During this procedure, the doctor will feel for lumps in the breast tissue and under the arm.

  • Diagnostic mammography. If a lump or suspicious area is found, the doctor will recommend a diagnostic mammogram.

  • Ultrasound. An ultrasound uses high-frequency sound waves to create an image of the breast tissue. An ultrasound can distinguish between a solid mass, which may be cancer, and a fluid-filled cyst, which is usually not cancer.

  • Nipple discharge examination. Fluid from the nipple can be examined under a microscope to look for cancer cells.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. There are different types of biopsies, classified by the technique and/or size of needle used to collect the tissue sample.

    • A fine needle aspiration biopsy uses a thin needle to remove a small sample of cells.

    • A core needle biopsy uses a wider needle to remove a larger sample of tissue. This is usually the preferred biopsy technique for finding out whether an abnormality on a physical examination or an imaging test is cancer. A vacuum-assisted biopsy removes several large cores of tissue. Local anesthesia, which is medication to block pain, is used to lessen a patient’s discomfort during the procedure.

    • A surgical biopsy removes the largest amount of tissue. This biopsy may be incisional, which is the removal of part of the lump, or excisional, which is the removal of the entire lump. Because surgery is best done after a cancer diagnosis has been made, a surgical biopsy is usually not the recommended way to diagnose breast cancer. Most often, non-surgical core needle biopsies are recommended to diagnose breast cancer. This means that only one surgical procedure is needed to remove the tumor and to take samples of the lymph nodes.

    • Image-guided biopsy is used when a distinct lump cannot be felt, but an abnormality is seen with an imaging test, such as a mammogram. During this procedure, a needle is guided to the location with the help of an imaging technique, such as mammography, ultrasound, or magnetic resonance imaging (MRI). A stereotactic biopsy is done using mammography to help guide the needle. A small metal clip may be put into the breast to mark where the biopsy sample was taken, in case the tissue is cancerous and more surgery is needed. This clip is usually titanium so it will not cause problems with future imaging tests, but check with your doctor before you have additional imaging tests. An image-guided biopsy can be done using a fine needle, core, or vacuum-assisted biopsy (see above), depending on the amount of tissue being removed. Imaging tests may also be used to help do a biopsy on a lump that can be felt, in order to help find the best location.

    • Sentinel lymph node biopsy is a way to find out if there is cancer in the lymph nodes near the breast. Learn more about sentinel lymph node biopsy in the Treatment Options section.

Analyzing the biopsy sample

Analyzing the sample(s) removed during the biopsy can help your doctor learn about specific features of a cancer that help determine treatment options.

  • Tumor features. Examination of the tumor under the microscope is used to determine if it is invasive or in situ, ductal or lobular, and whether the cancer has spread to the lymph nodes. The margins or edges of the tumor are also examined and their distance from the tumor is measured, which is called margin width.

  • ER and PR. Testing for ER and PR (see Overview) helps determine both the patient’s risk of recurrence and the type of treatment that is most likely to lower the risk of recurrence. ER and PR are often measured for DCIS as well. Generally, hormonal therapy (see Treatment Options) is an option for ER-positive and/or PR-positive cancers. Learn about ER and PR testing recommendations from ASCO and the College of American Pathologists (CAP).

  • HER2. The HER2 status (see Overview) helps determine whether drugs that target the HER2 receptor, for example the antibody treatment trastuzumab (Herceptin), might help treat the cancer. In addition, about 50% of HER2-positive tumors also have hormone receptors and can benefit from both hormone and HER2 directed therapy. Read ASCO’s and CAP's recommendations for HER2 testing for breast cancer

  • Grade. The tumor grade is also determined from a biopsy. Grade refers to how different the cancer cells look from healthy cells, and whether they appear slower growing or faster growing. There are three grades: grade 1 (well differentiated), grade 2 (moderately differentiated), and grade 3 (poorly differentiated).

Your doctor may recommend additional laboratory tests on your tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This helps your doctor find out the subtype of cancer.

Genomic tests to predict recurrence risk

Tests that take an even closer look at the biology of the tumor are commonly used to understand more about a breast cancer, particularly for a cancer that has not spread to other organs. These tests can help estimate the risk of cancer recurrence in the years after diagnosis. They can also predict whether a treatment will be helpful to reduce the risk of cancer recurrence. This helps some patients avoid the possible side effects of a treatment that is not likely to work well.

The tests described below are typically done on tissue removed during surgery. Most patients will not need an extra biopsy or more surgery. For more information about genomic tests, what they mean, and how the results might affect your treatment plan, talk with your doctor.

  • Oncotype Dx™. This test evaluates 16 cancer-related genes and 5 reference genes to estimate the risk of the cancer coming back in a place other than the breast and nearby lymph nodes within 10 years after diagnosis of stage I or stage II (see Stages) ER-positive breast cancer treated with hormonal therapy alone. Results are mainly used to help make decisions about whether chemotherapy should be added to a person’s treatment with hormonal therapy. Although this test is typically used for patients with breast cancer that has not spread to the lymph nodes, recent research suggests that this test may be useful for some patients with cancer that has spread to the lymph nodes. Additionally, this test appears to provide equally helpful information for men with as it does for women.

  • Mammaprint™. This test uses information from 70 genes to predict the risk of the cancer coming back for early-stage, low-risk breast cancer. It is approved by the FDA for estimating the risk of recurrence in early-stage breast cancer, but it is not yet known if this test can predict whether chemotherapy will work. This test is more common in Europe than in the United States.

  • Additional tests. Other tests are being researched and may become additional tools to guide treatment options in the future. These tests include the following, among others:

    • Breast cancer index (BCI)

    • Prosigna™ (PAM50)

Blood tests

The doctor may also need to do several types of blood tests to learn more about the cancer:

  • Complete blood count. A complete blood count (CBC) is used to measure the number of different types of cells, such as red blood cells and white blood cells, in a sample of a person’s blood. It is done to make sure that your bone marrow is functioning well.

  • Serum chemistry. These tests are often done to look at minerals in your blood, such as potassium and calcium, called electrolytes and specialized proteins called enzymes that can be abnormal if cancer has spread. However, many noncancerous conditions can cause changes in these tests, and they are not specific to cancer.

    • Alkaline phosphatase is an enzyme that can be associated with disease that has spread to the liver, bone, or bile ducts.

    • Blood calcium levels can be high if cancer has spread to the bone.

    • Total bilirubin count and the enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) evaluate liver function. High levels of any of these substances can indicate liver damage, a sign that the cancer may have spread to that organ.

  • Hepatitis tests. These may be used to check for evidence of prior exposure to hepatitis B and/or hepatitis C. If you have evidence of an active hepatitis B infection, you may need to take a special medication to suppress the virus before you receive chemotherapy. Without this medication, the chemotherapy can help the virus to grow and cause damage to the liver.

  • Blood tumor marker tests. Serum tumor markers are tumor proteins in a person's blood. Higher levels of a serum tumor marker may be due to cancer or a noncancerous condition. Tumor marker testing is not recommended for early-stage breast cancer because the markers are not usually high, but they may be useful to monitor the growth of recurrent or metastatic disease along with symptoms and imaging tests. Tumor markers should not be used to monitor for a recurrence, as such testing does not appear to improve a patient’s chance of recovery. Learn more about tumor markers for breast cancer.      

Additional tests

The tests your doctor recommends to evaluate whether the cancer has spread and its stage depends on your medical history, symptoms, how much the disease has grown in the breast and lymph nodes, and the results of your physical examination. Read Stages for more information. Many of these tests may not be done until after surgery. These tests are generally only recommended for patients with higher-stage disease. Most patients with early-stage breast cancer do not need additional imaging tests.

  • X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. A chest x-ray may be used to look for cancer that has spread from the breast to the lungs.

  • Bone scan. A bone scan may be used to look for spread of cancer to the bones. A radioactive dye or tracer is injected into a patient’s vein, and then the scan is performed several hours later using a special camera. The tracer collects in areas of the bone that are healing, which occurs in response to damage from the cancer cells. The areas where the tracer collects appear dark, compared to healthy bone, which appears gray. Some cancers do not cause the same healing response and will not show up on the bone scan. Areas of advanced arthritis or healing after a fracture will also appear dark.

  • Computed tomography (CT or CAT) scan. A CT scan may be used to look for tumors in organs outside of the breast, such as the lung, liver, bone, and lymph nodes. A CT scan creates a three-dimensional picture of the inside of the body with a special x-ray machine. A computer combines these images into a detailed, cross-sectional view that shows abnormalities, including most tumors. A CT scan can also be used to measure the tumor’s size and if it is shrinking with treatment. A contrast dye may be injected into a patient’s vein before the scan to provide better detail.

  • Positron emission tomography (PET) scan. A PET scan may also be used to find out whether the cancer has spread to organs outside of the breast. Similar to a CT scan, a PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into a patient’s vein. This sugar substance is then taken up by cells that use the most energy because they are actively dividing. Because cancer cells tend to use energy actively, they absorb more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body. Areas that are most active appear as bright spots, and the intensity of the brightness can be measured to better describe these areas. A combination PET/CT scan may also be used to measure the size of tumors and to determine the location of the bright spots more accurately. A PET/CT scan will also show any abnormalities in the bone, similar to the bone scan.

After diagnostic tests are completed, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the amount of cancer in the body; this is called staging. If there are suspicious areas found outside of the breast, at least one area may be biopsied if possible to confirm the diagnosis of cancer.

The next section in this guide is Stages, and it explains the system doctors use to describe the extent of the disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where the cancer is located, how much the cancer has grown, and if or where it has spread. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

TNM staging system

The most commonly used tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many? 

  • Metastasis (M): Has the cancer metastasized to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero), which is noninvasive ductal carcinoma in situ (DCIS), and stages I through IV (one through four), which are used for invasive breast cancer. The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

There are two types of TNM staging for breast cancer. First, the clinical stage is based on the results of tests done before surgery, which may include physical examination, mammogram, ultrasound, and MRI scans. Then, the pathologic stage is assigned based on the pathology results from the breast tissue and any lymph nodes removed during surgery. It is usually determined several days after surgery. In general, more importance is placed on the pathologic stage than the clinical stage.

Here are more details on each part of the TNM system for breast cancer:

Tumor (T)

Using the TNM system, the “T” plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are divided into smaller groups that help describe the tumor in even more detail.

TX: The primary tumor cannot be evaluated.

T0: There is no evidence of cancer in the breast.

Tis: Refers to carcinoma in situ. The cancer is confined within the ducts or lobules of the breast tissue and has not spread into the surrounding tissue of the breast. There are three types of breast carcinoma in situ:

Tis (DCIS): DCIS is a noninvasive cancer, but if not removed it can develop into an invasive breast cancer later. DCIS means that cancer cells have been found in breast ducts and have not spread past the layer of tissue where they began.

Tis (LCIS): Lobular carcinoma in situ (LCIS) describes abnormal cells found in the lobules or glands of the breast. LCIS is not cancer, but it increases the risk of developing invasive breast cancer.

Tis (Paget’s): Paget’s disease of the nipple is a rare form of early, noninvasive cancer that is only in the skin cells of the nipple. Sometimes Paget’s disease is associated with another, invasive breast cancer. If there is also an invasive breast cancer present, it is classified according to the stage of the invasive tumor.

T1: The invasive part of the tumor in the breast is 20 millimeters (mm) or smaller in size at its widest area. This is a little less than an inch. This stage is then broken into three substages depending on the size of the tumor:

  • T1a is a tumor that is larger than 1 mm, but 5 mm or smaller

  • T1b is a tumor that is larger than 5 mm, but 10 mm or smaller

  • T1c is a tumor that is larger than 10 mm, but 20 mm or smaller.

T2: The invasive part of the tumor is larger than 20 mm but not larger than 50 mm.

T3: The invasive part of the tumor is larger than 50 mm.

T4: The tumor falls into one of the following groups:

  • T4a means the tumor has grown into the chest wall.

  • T4b is when the tumor has grown into the skin.

  • T4c is cancer that has grown into the chest wall and the skin.

  • T4d is inflammatory breast cancer.

Node (N)

The “N” in the TNM staging system stands for lymph nodes. Lymph nodes located under the arm, above and below the collarbone, and under the breastbone are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes. As explained above, if the doctor evaluates the lymph nodes before surgery, based on other tests and/or a physical examination, a letter “c” for “clinical” staging is placed in front of the “N.” If the doctor evaluates the lymph nodes after surgery, which is a more accurate assessment, a letter “p” for “pathologic” staging is placed in front of the “N.” The information below describes the pathologic staging.

NX: The lymph nodes cannot be evaluated.

N0: No cancer was found in the lymph nodes.

N0(i+): When very small areas of “isolated” tumor cells are found in a lymph node under the arm, called the axillary lymph nodes. This is usually less than 0.2 mm or less than 200 cells. In this stage, the nodes are still called N0, but an “i+” is also listed.

N1mic: Cancer in the axillary lymph nodes is larger than 0.2 mm but less than 2 mm in size and can only be seen through a microscope. This is often called a micrometastasis.

N1: The cancer has spread to one to three axillary lymph nodes under the arm, and is at least 2 mm in size. This is called a macrometastasis. This category can include positive internal mammary lymph nodes if they are found during a sentinel lymph node procedure and not otherwise clinically detected. The internal mammary lymph nodes are located under the sternum or breastbone.

N2: The cancer within the lymph nodes falls into one of the following groups:

  • N2a is when the cancer has spread to 4 to 9 axillary, or underarm, lymph nodes.

  • N2b is when the cancer has spread to or to internal mammary lymph nodes without spread to the axillary nodes.

N3: The cancer falls within one of the following groups:

  • N3a is when the cancer has spread to 10 or more lymph nodes under the arm or to those located under the clavicle, or collarbone.

  • N3b is when the cancer has spread to the internal mammary nodes and the axillary nodes.

  • N3c is when the cancer has spread to the lymph nodes located above the clavicle, called the supraclavicular lymph nodes.

If there is cancer in the lymph nodes, knowing how many lymph nodes are involved and where they are helps doctors to plan treatment. The pathologist can find out the number of axillary lymph nodes that contain cancer after they are removed during surgery. It is not common to remove the supraclavicular or internal mammary lymph nodes during surgery. If there is cancer in these lymph nodes, treatment other than surgery, such as radiation therapy, chemotherapy, and hormonal therapy is used.

Metastasis (M)

The “M” in the TNM system indicates whether the cancer has spread to other parts of the body, called distant metastasis.

MX: Distant spread cannot be evaluated.

M0: The disease has not metastasized.

M0 (i+): There is no clinical or radiographic evidence of distant metastases, but microscopic evidence of tumor cells is found in the blood, bone marrow, or other lymph nodes that are no larger than 0.2 mm in a patient without other evidence of metastases.

M1: There is evidence of metastasis to another part of the body, meaning there are breast cancer cells growing in other organs.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications. Most patients are anxious to learn the exact stage of the cancer. However, it is important to keep in mind that tumor biology, including the diagnostic markers outlined above, has a significant impact on the type of treatment that is recommended, as well as on the prognosis. Your doctor will generally confirm the stage of the cancer when the testing after surgery is finalized, usually about 5 to 7 days after surgery. When systemic or whole body treatment is given before surgery, called neoadjuvant therapy, the stage of the cancer is primarily determined clinically. Doctors may refer to stage I to stage IIA cancer as early stage, and stage IIB to stage III as locally advanced.

Stage 0: Stage zero (0) describes disease that is only in the ducts and lobules of the breast tissue and has not spread to the surrounding tissue of the breast. It is also called noninvasive cancer (Tis, N0, M0).

Stage IA: The tumor is small, invasive, and has not spread to the lymph nodes (T1, N0, M0).

Stage IB: Cancer has spread only to the lymph nodes, and is larger than 0.2 mm but less than 2 mm in size. There is either no evidence of a tumor in the breast or the tumor in the breast is 20 mm or smaller (T0 or T1, N1mic, M0).

Stage IIA: Any one of these conditions:

  • There is no evidence of a tumor in the breast, but the cancer has spread to the axillary lymph nodes but not to distant parts of the body. (T0, N1, M0).

  • The tumor is 20 mm or smaller and has spread to the axillary lymph nodes (T1, N1, M0).

  • The tumor is larger than 20 mm but not larger than 50 mm and has not spread to the axillary lymph nodes (T2, N0, M0).

Stage IIB: Either of these conditions:

  • The tumor is larger than 20 mm but not larger than 50 mm and has spread to one to three axillary lymph nodes (T2, N1, M0).

  • The tumor is larger than 50 mm but has not spread to the axillary lymph nodes (T3, N0, M0).

Stage IIIA: The cancer of any size has spread to 4 to 9 axillary lymph nodes, but not to other parts of the body (T0, T1, T2 or T3, N2, M0). Stage IIIA may also be a tumor larger than 50 mm that has spread to one to three lymph nodes (T3, N1, M0).

Stage IIIB: The tumor has spread to the chest wall or caused swelling or ulceration of the breast or is diagnosed as inflammatory breast cancer. It may or may not have spread to the lymph nodes under the arm, but it has not spread to other parts of the body (T4; N0, N1 or N2; M0).

Stage IIIC: A tumor of any size that has not spread to distant parts of the body but has spread to 10 or more axillary lymph nodes or the lymph nodes in the N3 group (any T, N3, M0).

Stage IV (metastatic): The tumor can be any size and has spread to other organs, such as the bones, lungs, brain, liver, distant lymph nodes, or chest wall (any T, any N, M1). Metastatic cancer spread found when the cancer is first diagnosed occurs about 5% to 6% of the time. This may be called de novo metastatic breast cancer. Most commonly, metastatic breast cancer is found after a previous diagnosis of early breast cancer.

Recurrent: Recurrent cancer is cancer that has come back after treatment, and can be either local or distant or both. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual Seventh Edition published by Springer-Verlag New York, www.cancerstaging.net.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will learn about the different ways doctors use to treat men with this type of cancer. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best known treatments available) for this specific type of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials. A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Clinical trials may test approaches such as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options. For more information, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, doctors specializing in different areas of cancer treatment—such as surgery, radiation oncology, and medical oncology—work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, nutritionists, and others.

The biology and behavior of a breast cancer affects the treatment plan. Some tumors are small but grow fast, while others are large and grow slowly. Treatment options and recommendations are very personalized and depend on several factors, including:

  • The stage of the tumor

  • The tumor’s subtype, including hormone receptor status (ER, PR) and HER2 status (see Overview)

  • Genomic markers, such as Oncotype DX™ or Mammaprint™ (if appropriate) (See Diagnosis)

  • The patient’s age, general health, and preferences

  • The presence of known mutations in inherited breast cancer genes, such as BRCA1 or BRCA2

Even though the breast cancer care team will specifically tailor the treatment for each patient and the breast cancer, there are some general steps for treating breast cancer.

For both DCIS and early-stage invasive breast cancer, doctors generally recommend surgery to remove the tumor. To make sure that the entire tumor is removed, the surgeon will also remove a small area of healthy tissue around the tumor. Although the goal of surgery is to remove all of the visible cancer, microscopic cells can be left behind, either in the breast or elsewhere. In some situations, this means that another surgery could be needed to remove remaining cancer cells.

For larger cancers, or those that are growing more quickly, doctors may recommend systemic treatment with chemotherapy or hormonal therapy before surgery, called neoadjuvant therapy. There may be several benefits to having other treatments before surgery:

  • Surgery may be easier to perform

  • Your doctor may find out if certain treatments work well for the cancer

  • You may also be able to try a new treatment through a clinical trial

After surgery, the next step in managing early-stage breast cancer is to lower the risk of recurrence and to get rid of any remaining cancer cells. If present, these cancer cells are undetectable but are believed to be responsible for both local and distant recurrence of cancer. Treatment given after surgery is called adjuvant therapy. Adjuvant therapies may include radiation therapy, chemotherapy, targeted therapy, and/or hormonal therapy (see below for more information on each of these treatments). Whether adjuvant therapy is needed depends on the chance that any cancer cells remain in the breast or the body and the chance that a specific treatment will work to treat the cancer. Although adjuvant therapy lowers the risk of recurrence, it does not completely get rid of the risk.

Along with staging, other tools can help estimate prognosis and help you and your doctor make decisions about adjuvant therapy. The website Adjuvant! Online, available at another, independent website called www.adjuvantonline.com, is a tool that your doctor can use to interpret a variety of prognostic factors. This website should only be used with the interpretation of your doctor. In addition, other tests that can predict the risk of recurrence for your specific tumor by testing your tumor tissue (such as Oncotype Dx™ and Mammaprint™) may be also used to better understand the risks from the cancer and whether chemotherapy will help reduce those risks.

When surgery to remove the cancer is not possible, it is called inoperable. The doctor will then recommend treating the cancer in other ways. Chemotherapy, targeted therapy, radiation therapy, and/or hormonal therapy may be given to shrink the cancer.

For recurrent cancer and metastatic cancer, treatment options depend on how the cancer was first treated and the characteristics of the cancer mentioned above, such as ER, PR, and HER2.

Descriptions of the most common treatment options for breast cancer in men are listed below. Your care plan should also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect during and after treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery is also used to examine the nearby underarm or axillary lymph nodes. A surgical oncologist is a doctor who specializes in treating cancer with surgery. Learn more about the basics of cancer surgery.

  • A lumpectomy is the removal of the tumor and a small, cancer-free margin of healthy tissue around the tumor. Because men do not have much breast tissue, a lumpectomy is generally not an option.

  • A mastectomy is the surgical removal of the entire breast. This procedure is more commonly performed in men.

Lymph node removal and analysis

Cancer cells can be found in the axillary lymph nodes in some cancers. It is important to find out whether any of the lymph nodes near the breast contain cancer. This information is used to determine treatment and prognosis.

  • Sentinel lymph node biopsy. The sentinel lymph node biopsy procedure allows for the removal of one to a few lymph nodes, avoiding the removal of multiple lymph nodes in an axillary lymph node dissection (see below) procedure for patients whose sentinel lymph nodes are free of cancer. The smaller lymph node procedure helps lower the risk of several possible side effects, including swelling of the arm called lymphedema, the risk of numbness, as well as arm movement and range-of-motion problems, which are long-lasting issues that can severely affect a person’s quality of life.

    In a sentinel lymph node biopsy, the surgeon finds and removes about 1 to 3 sentinel lymph nodes from under the arm that receive lymph drainage from the breast. The pathologist then examines these lymph nodes for cancer cells. To find the sentinel lymph node, the surgeon injects a dye and/or a radioactive tracer into the area of the cancer and/or around the nipple. The dye or tracer travels to the lymph nodes, arriving at the sentinel node first. The surgeon can find the node when it turns color if the dye is used or gives off radiation if the tracer is used.

    If the sentinel lymph node is cancer-free, research has shown that it is likely that the remaining lymph nodes will also be free of cancer and no further surgery is needed. If the sentinel lymph node shows that there is cancer, then the surgeon may perform an axillary lymph node dissection to remove more lymph nodes to look for cancer, depending on the stage of the cancer, the features of the tumor, and the amount of cancer in the sentinel lymph nodes. It is recommended that patients with signs of cancer in the axillary lymph nodes receive an axillary lymph node dissection, regardless of whether a sentinel lymph node biopsy is done. Find out more about ASCO's recommendations for sentinel lymph node biopsy.

  • Axillary lymph node dissection. In an axillary lymph node dissection, the surgeon removes many lymph nodes from under the arm, which are then examined by a pathologist for cancer cells. The actual number of lymph nodes removed varies from person to person. If cancer is found in the sentinel lymph node, whether more surgery is needed to remove additional lymph nodes varies depending on the specific situation.

Most patients with invasive cancer will have either a sentinel lymph node biopsy or an axillary lymph node dissection. A sentinel lymph node biopsy alone may not be done if there is obvious evidence of cancer in the lymph nodes before any surgery. In this situation, a full axillary lymph node dissection is preferred.

Summary of surgical options

To summarize, surgical treatment options include the following:

  • Removal of cancer in the breast: Usually a removal of the cancer and all of the breast tissue

  • Lymph node evaluation: Sentinel lymph node biopsy and/or axillary lymph node dissection

Talk with your doctor about the specific surgery recommended for you and the possible side effects of that surgery, including how side effects will be managed. The most significant side effect of surgery is lymphedema, which can occur when lymph nodes are removed or damaged during surgery. Because the lymph nodes are part of the channels that drain the lymphatic fluid from the arm, damage to the area may hold back the flow of lymphatic fluid and cause it to back up in the arm. The use of sentinel node biopsy has been shown to reduce the risk of developing lymphedema.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using a probe in the operating room, it is called intra-operative radiation. When radiation is given by placing radioactive sources into the tumor, it is called brachytherapy. Although the research results are encouraging, intra-operative radiation and brachytherapy are not widely used for breast cancer, and treatment is typically reserved for a small cancer with no evidence that it has spread to the lymph nodes. Learn more about the basics of radiation therapy.

Adjuvant (after surgery) radiation therapy is recommended for some men after surgery depending on the type of surgery, the size of their tumor, the number of cancerous lymph nodes under the arm, and the width of the tissue margin around the tumor removed by the surgeon.

Radiation therapy can cause side effects, including fatigue, swelling of the breast, redness and/or skin discoloration/hyperpigmentation and pain/burning in the skin where the radiation was directed, sometimes with blistering or peeling. Very rarely, a small amount of the lung can be affected by the radiation, causing pneumonitis, a radiation-related swelling of the lung tissue. This risk depends on the size of the area that received radiation therapy, and this tends to heal with time. In the past, with older equipment and radiation therapy techniques, men and women who received treatment for breast cancer on the left side of the body had a small increase in the long-term risk of heart disease. Modern techniques are now able to spare most of the heart from the effects of radiation therapy. 

Systemic therapy

Systemic therapy is treatment taken by mouth or through a vein that gets into the bloodstream to reach cancer cells throughout the body. There are three general categories of systemic therapy used for breast cancer: chemotherapy, hormonal therapy, and targeted therapy. Each treatment is described below in more detail. Treatment options are based on information about the cancer and your overall health and treatment preferences.

Chemotherapy 

Chemotherapy is the use of drugs to destroy cancer cells. Chemotherapy works by stopping the cancer cells’ ability to grow and divide. Chemotherapy is prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

Chemotherapy may be given before surgery to shrink a large tumor and make surgery easier, called neoadjuvant chemotherapy. It may also be given after surgery to reduce the risk of recurrence, called adjuvant chemotherapy. Chemotherapy may also be given if a patient has a metastatic breast cancer recurrence.

A chemotherapy regimen (schedule) consists of a specific treatment schedule of drugs given at repeating intervals for a set period of time. Chemotherapy may be given on many different schedules depending on what worked best in clinical trials for that specific type of regimen. It may be given once a week, once every 2 weeks (also called dose-dense), once every 3 weeks, or even once every 4 weeks. Common drugs for breast cancer include:

  • Capecitabine (Xeloda)

  • Carboplatin (Paraplatin)

  • Cisplatin (Platinol)

  • Cyclophosphamide (Neosar)

  • Docetaxel (Docefrez, Taxotere)

  • Doxorubicin (Adriamycin)

  • Pegylated liposomal doxorubicin (Doxil)

  • Epirubicin (Ellence)

  • Fluorouracil (5-FU, Adrucil)

  • Gemcitabine (Gemzar)

  • Methotrexate (multiple brand names)

  • Paclitaxel (Taxol)

  • Protein-bound paclitaxel (Abraxane)

  • Vinorelbine (Navelbine)

  • Eribulin (Halaven)

  • Ixabepilone (Ixempra)

A patient may receive one drug at a time or combinations of different drugs at the same time. Research has shown that combinations of certain drugs are sometimes more effective than single drugs for adjuvant treatment. The following drugs or combinations of drugs may be used as adjuvant therapy to treat breast cancer:

  • AC (doxorubicin and cyclophosphamide)

  • AC or EC (epirubicin and cyclophosphamide) followed by T (doxorubicin and cyclophosphamide, followed by paclitaxel or docetaxel, or the reverse)

  • CAF (cyclophosphamide, doxorubicin, and 5-FU)

  • CEF (cyclophosphamide, epirubicin, and 5-FU)

  • CMF (cyclophosphamide, methotrexate, and 5-FU)

  • EC (epirubicin, cyclophosphamide)

  • TAC (docetaxel, doxorubicin, and cyclophosphamide)

  • TC (docetaxel and cyclophosphamide)

Therapies that target the HER2 receptor may be given with chemotherapy for HER2-positive breast cancer (see Targeted therapy, below). One example is the antibody trastuzumab. Combination regimens for HER2-positive breast cancer may include:

  • ACTH (doxorubicin, cyclophosphamide, paclitaxel, trastuzumab)

  • TCH (docetaxel, carboplatin, trastuzumab)

  • THP (paclitaxel or docetaxel, trastuzumab, pertuzumab)

  • TCHP (docetaxel, carboplatin, trastuzumab, pertuzumab)

  • TH (paclitaxel, trastuzumab)

The side effects of chemotherapy depend on the individual, the drug(s) used, and the schedule and dose used. These side effects can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects can often be very successfully prevented or managed during treatment with supportive medications, and they usually go away once treatment is finished. Rarely, long-term side effects may occur, such as heart damage, nerve damage, or secondary cancers. Many patients feel well during chemotherapy treatment and are active taking care of their families, working, and exercising during treatment, although each person’s experience can be different. Talk with your health care team about the possible side effects of your specific chemotherapy plan.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor, oncology nurse, or pharmacist is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Hormonal therapy

Hormonal therapy, also called endocrine therapy, is an active treatment for most tumors that test positive for either estrogen or progesterone receptors (called ER-positive or PR-positive; see Overview), in both early-stage and metastatic cancer. Because most men with breast cancer have ER-positive disease, hormonal therapy is often part of the treatment plan. This type of tumor uses hormones to fuel its growth. Blocking the hormones usually slows the growth of the tumor.

Adjuvant endocrine therapy typically involves taking a hormonal agent for 5 years. Recent data have suggested that taking adjuvant endocrine therapy for up to 10 years may be better than 5 years, especially for higher-risk tumors. A decision on appropriate duration of therapy considers stage and risk of the cancer, as well as the specific side effects the patient may be experiencing.

Hormonal therapy after surgery may be used by itself or after chemotherapy. Hormonal therapy options for men include:

  • Tamoxifen (Nolvadex, Soltamox) is the primary hormonal therapy used for men with breast cancer. It blocks estrogen from binding to breast cancer cells.

  • Aromatase inhibitors decrease the amount of estrogen made by the body. This type of treatment is effective in treating breast cancer in postmenopausal women, but there is not much information on its use for men with breast cancer. Caution is urged in using aromatase inhibitors in men who still have their testicles (testes), as these treatments could cause androgen levels to increase. If an aromatase inhibitor is used, an additional injection medication to decrease androgen production may be offered as well.

  • Fulvestrant (Faslodex) is a drug that is given by injection once a month. It is used when treating metastatic breast cancer. It stops estrogen from helping a cancer grow in a way that is different from tamoxifen. Like aromatase inhibitors, there is not much information on its use for men, but research has shown that it may be effective.

Side effects of hormonal therapy can include hot flashes, decreased sexual desire or ability, and mood swings.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. These treatments are very focused, and work differently than chemotherapy. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor, although this is considered experimental. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

The first approved targeted therapies for breast cancer were hormonal therapies. Then, HER2 targeted therapies were approved to treat HER2-positive breast cancer. Newer medications, including palbociclib (Ibrance) and Everolimus (Afinitor), are targeted therapies approved for metastatic ER-positive HER2-negative breast cancer. Palbociclib may cause damage to sperm and should not be used in men if pregnancy is being considered. Targeted therapy is also used to prevent growth of cancer that has spread to the bone and to maintain bone health. Talk with your doctor about possible side effects of specific medications and how they can be managed.

HER2 targeted therapy

  • Trastuzumab is approved for both the treatment of advanced HER2-positive breast cancer and as an adjuvant therapy for non-metastatic HER2-positive breast cancer. For metastatic cancer, trastuzumab can be given in combination with different types of chemotherapy. Patients receiving trastuzumab have a small (2% to 5%) risk of heart problems. This risk is increased if a patient has other risk factors for heart disease or receives chemotherapy that also increases the risk of heart problems at the same time. These heart problems may go away and can be treatable with medication.

  • Pertuzumab (Perjeta) is approved for the treatment of advanced breast cancer. Research shows that adding pertuzumab to trastuzumab and chemotherapy for advanced breast cancer not yet treated with either chemotherapy or trastuzumab increases the effectiveness of treatment and lengthens lives with few additional side effects. Based on this data, the combination of trastuzumab, pertuzumab, and chemotherapy has become the standard of care for the treatment of untreated advanced breast cancer. Pertuzumab is also approved as neoadjuvant treatment for breast cancer in the United States, in combination with trastuzumab and chemotherapy, and is being studied as an adjuvant treatment for early-stage disease.

  • Ado-trastuzumab emtansine or T-DM1(Kadcyla) is approved for the treatment of metastatic breast cancer for patients who have previously received trastuzumab and chemotherapy with either paclitaxel or docetaxel. T-DM1 is one medication that is a combination of trastuzumab linked to a type of chemotherapy. This allows the drug to deliver chemotherapy into the cancer cell while lessening the chemotherapy received by healthy cells. T-DM1 is given by vein every 3 weeks. Studies are now testing T-DM1 as a treatment for early-stage breast cancer.

  • Lapatinib (Tykerb) is commonly used for HER2-positive metastatic breast cancer when trastuzumab and pertuzumab in combination with docetaxel are no longer effective at controlling the cancer’s growth. The combination of lapatinib and the chemotherapy capecitabine is approved to treat advanced or metastatic HER2-positive breast cancer when a patient has already received chemotherapy and trastuzumab. Lapatinib is also used in combination with trastuzumab for patients whose cancers were growing on trastuzumab. Lapatinib is considered following treatment with T-DM1. Lapatinib may also have some ability to penetrate into the brain, and may be considered when treating HER2 positive breast cancer that has spread to the brain.

Osteoclast targeted therapy (drugs that block bone destruction)

  • Bisphosphonates are drugs that block the cells that destroy bone, called osteoclasts. Bisphosphonates are commonly used in low doses to prevent and treat osteoporosis. Osteoporosis is the thinning of the bones. For breast cancer that has spread to bone, higher doses of bisphosphonates have been shown to reduce the side effects of cancer in the bone, including broken bones and pain. Pamidronate (Aredia) and zoledronic acid (Zometa) are two intravenous bisphosphonates used to treat breast cancer bone metastasis.

  • Denosumab (Xgeva) is another osteoclast-targeted therapy called a RANK ligand inhibitor. Recent studies have shown that denosumab works well to treat breast cancer bone metastases, and may be better than bisphosphonates at controlling the symptoms of bone metastases. Denosumab is also effective at treating osteoporosis and is being studied as a cancer treatment in early-stage breast cancer.

Learn more about drugs that block bone destruction.

Getting care for symptoms and side effects

Cancer and its treatment cause symptoms and side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called supportive or palliative care, and it includes supporting the patient with his physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medications, nutritional support, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each option in your treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care

Recurrent breast cancer

If the cancer does return after treatment for early-stage disease, it is called recurrent cancer. When breast cancer recurs, it may come back in the following parts of the body:

  • The same place as the original cancer, which is called a local recurrence.

  • The chest wall or lymph nodes under the arm or in the chest. This is called a regional recurrence.

  • Another place, including distant organs such as the bones, lungs, liver, and brain. This is called a distant recurrence or a metastatic recurrence. For more information on a metastatic recurrence, see the Metastatic breast cancer section below.

When breast cancer recurs, a cycle of testing will begin again to learn as much as possible about the recurrence. Testing may include imaging tests, such as those discussed in the Diagnosis section. In addition, another biopsy may be needed to confirm the breast cancer recurrence and learn about the features of the cancer.

After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above such as surgery, radiation therapy, chemotherapy, targeted therapy, and hormonal therapy, but they may be used in a different combination or at a different pace. The treatment options for recurrent breast cancer depend on the following factors:

  • Previous treatment(s) for the original cancer

  • Time since the original diagnosis

  • Location of the recurrence

  • Characteristics of the tumor, such as ER, PR, and HER2 status

A local recurrence is frequently considered curable with further treatment. A metastatic (distant) recurrence is generally considered incurable, but it is generally treatable. Some patients live for years after a metastatic recurrence of breast cancer.

Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer.

Men and women with recurrent breast cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

Metastatic breast cancer

If cancer has spread to another location in the body or comes back in a distant location, it is called metastatic breast cancer. In general, metastatic breast cancer is incurable, although it is generally treatable and controlled for some time. Some patients live years after a metastatic recurrence of breast cancer, depending on a number of factors.

Patients with diagnosed with metastatic breast cancer are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about getting a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials studying new treatments.

Your health care team may recommend a treatment plan that includes a combination of systemic therapies, such as chemotherapy, hormonal therapy, and targeted therapies. Radiation therapy and surgery may be used in certain situations for men with metastatic breast cancer. Palliative care is also important to help relieve symptoms and side effects. For instance, radiation therapy is often used to treat painful bone metastases.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

If treatment fails

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal. At some point, options for treatment become very limited and the cancer will become difficult to control.

This diagnosis is stressful, and advanced cancer is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in an inpatient hospice environment. Nursing care and special equipment can make staying at home a workable and preferable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials and it offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with breast cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was previously tested in clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and manage the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating breast cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with breast cancer.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient's options, so that the person understands the standard treatment, and how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Insurance coverage of clinical trial costs differs by location and by study. In some programs, expenses associated with participating in the research, such as transportation, childcare, meals, and accommodations are reimbursed. It’s important to talk with the research team and your insurance company to learn about how the treatment in a clinical trial will be covered.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason, including if the new treatment is not working or if there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for breast cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research and it explains areas of scientific research currently going on for this type of cancer. Or, use the menu on the side of your screen to choose another section to continue reading this guide.    

Breast Cancer in Men - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about breast cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • New surgical methods that save tissue or prevent scarring are being tested in clinical trials.

  • Improved radiation therapy to lower the risk of side effects

  • New therapies and combinations of therapies, including chemotherapy, hormonal therapy, and targeted therapy are being studied in clinical trials.

  • Clinical trials are underway to find better ways of reducing symptoms and side effects of current breast cancer treatments in order to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding breast cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Side Effects and it offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Coping With Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of cancer, but it may help to know that in addition to treatment to slow, stop, or eliminate the cancer, preventing and controlling side effects is a major focus of your health care team. This is called palliative care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

There are possible side effects for every cancer treatment, but patients don’t experience the same side effects when given the same treatments for many reasons. That can make it hard to predict exactly how you will feel during treatment. Common side effects from each treatment option for breast cancer are described in detail within the Treatment Options section. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the cancer’s stage, the length and dosage of treatment(s), and your overall health.

Talking with your health care team about side effects

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. 

And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with breast cancer. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your cancer care.

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the Follow-up Care and Monitoring section of this guide or talking with your doctor.

The next section in this guide is Follow-up Care and Monitoring and it explains the importance of check-ups after cancer treatment is finished. Or, use the menu on the side of your screen to choose another section to continue reading this guide.    

Breast Cancer in Men - Follow-Up Care and Monitoring

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. Although continued breast screening by mammography is important for women after breast cancer, the role of screening mammograms in men after breast cancer is not well understood and men should discuss this with their doctors. In some instances, patients may be able to visit survivorship clinics that specialize in the post-treatment needs of people diagnosed with breast cancer. ASCO offers its full recommendations for follow-up care for breast cancer survivors in a separate article here.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return, and will help you make decisions about your treatment. Learn more about coping with the fear of recurrence.

Breast cancer can come back in the breast or other areas of the body. Generally, a recurrence is found when a person has symptoms or an abnormal finding on physical examination. The symptoms depend on where the cancer has recurred and may include:

  • A lump under the arm or along the chest wall

  • Bone pain or fractures

  • Headaches or seizures

  • Chronic coughing or trouble breathing

  • Abdominal pain or a yellowing of the skin and eyes called jaundice

  • Extreme tiredness

  • Feeling generally unwell

Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

  • Long-term effects of surgery. After surgery for treat breast cancer, the chest may be scarred and may have a different appearance than before surgery. If lymph nodes were removed as part of the surgery or affected during treatment, lymphedema may occur, even many years after treatment, and this is a life-long risk for survivors.

  • Long-term effects of radiation therapy. Some patients experience breathlessness, a dry cough, and/or chest pain 2 to 3 months after finishing radiation therapy because the treatment can cause swelling and a hardening or thickening of the lungs called fibrosis. These symptoms may seem similar to the symptoms of pneumonia but do not go away with antibiotics. The symptoms can be treated with medications called steroids. Most patients fully recover with treatment. Talk with your doctor if you develop any new symptoms after radiation therapy or if the side effects are not going away.

  • Long-term effects of trastuzumab and/or chemotherapy. Patients who received trastuzumab or certain types of chemotherapy called anthracyclines may be at risk of heart problems. Talk with your doctor about the best ways to check for heart problems.

In addition, men and women recovering from breast cancer have other side effects that may continue after treatment. Learn about ways of coping with cancer-related fatigue, a drop in cognitive function that is sometimes called "chemobrain", and other late effects of cancer treatment.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship and it describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Breast Cancer in Men - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will read about how to with challenges in everyday life after a breast cancer diagnosis. To see other pages, use the menu on the side of your screen.

What is survivorship?

The word survivorship means different things to different people. Two common definitions include:

  • Having no signs of cancer after finishing treatment.

  • The process of living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

In some ways, survivorship is one of the most complex aspects of the cancer experience because it is different for every person.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life. Some people may even prefer to put the experience behind them and feel that their lives have not changed in a major way.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from breast cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Many people find it easier to stick with an exercise program with a partner. Consider asking your spouse/partner or a friend to join you. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical check-ups and tests (see Follow-up Care and Monitoring) to take care of your health. Cancer rehabilitation may also be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: This 44-page booklet (available as a PDF) helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment. 

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your cancer care team. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Breast Cancer in Men - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of breast cancer do I have?

  • Can you explain my pathology report (laboratory test results) to me?

  • What stage is the breast cancer? What does this mean?

  • What is my prognosis?

  • Should I see a genetic counselor?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are open to me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • Who will be part of my health care team, and what does each member do?

  • Who is going to help coordinate my treatment?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?

  • What support services are available to me? Are there support services specifically for men with breast cancer? What about support for my family?

  • Whom should I call for questions or problems?

  • Is there anything else I should be asking?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy, chemotherapy, or targeted therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the risk of the cancer returning? Are there signs and symptoms I should watch for?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be coordinating my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources, and it offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Breast Cancer in Men - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2015

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Breast Cancer in Men. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Breast Cancer in Men. Use the menu on the side of your screen to select another section, to continue reading this guide.