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Breast Cancer in Men - Introduction

Approved by the Cancer.Net Editorial Board, 07/2019

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. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

Breast cancer in men is rare, occurring much less often than breast cancer in women. But 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. Tiny ducts connect the glands, lobules, and lobes to the nipple, located in the middle of the areola. The areola 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 out of control, 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.

Although breast cancer most commonly spreads to nearby lymph nodes, it can also spread further through the body to areas such as the bones, lungs, liver, and brain. This is called metastatic or stage IV breast cancer. For more information on this disease, see our Metastatic Breast Cancer guide.

If breast cancer comes back after initial treatment, it can come back in the breast and/or regional lymph nodes, called a local or regional recurrence. It can also recur elsewhere in the body, called a distant recurrence or metastatic recurrence.

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 start in the cells lining the milk ducts. Most breast cancers are ductal carcinomas.

    • Ductal carcinoma in situ (DCIS). This cancer 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 carcinoma.

  • Lobular carcinoma. This starts in the lobules. It is uncommon in men.

    • Lobular carcinoma in situ (LCIS). LCIS is located only in the lobules. LCIS is not considered cancer. However, LCIS 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:

Breast cancer subtypes

Breast cancer is not a single disease, even among the same type of breast cancer. When you are diagnosed with breast cancer, your doctor will recommend laboratory tests on the cancerous tissue. These tests will help your doctor learn more about the cancer and choose the most effective treatment plan.

Tests can determine if your cancer is:

  • Hormone receptor positive or negative. Breast cancers expressing estrogen receptors (ER) and/or progesterone receptors (PR) are called “hormone receptor positive.” These receptors are proteins found in and on cells. Tumors that have estrogen receptors are called “ER positive.” Tumors that have progesterone receptors are called “PR positive.” These cancers 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 a treatment option for these cancers. Breast cancer that does not express estrogen or progesterone receptors is called “hormone receptor negative.”

  • HER2 positive or negative. About 10% to 20% of breast cancers depend on the gene called HER2 to grow. These cancers are called “HER2 positive” and have too many 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. Cancers that do not have too much HER2 are called “HER2 negative.”

  • 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 type of breast cancer may be more common for younger men with breast cancer.

Looking for More of an Introduction?

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

  • ASCO Answers Fact Sheet: Read a 1-page fact sheet that offers an easy-to-print introduction to breast cancer. This free fact sheet is available as a PDF, so it is easy to print out.

  • ASCO Answers Guide: Get this free 52-page booklet that helps you better understand this disease and treatment options. The booklet is available as a PDF, so it is easy to print out.

  • 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. It helps explain the number of men who are diagnosed with breast cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Statistics

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will find information about the number of men who are diagnosed with breast cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on many factors. Use the menu to see other pages.

This year, an estimated 2,670 men in the United States will be diagnosed with breast cancer. Black men have the highest incidence rates (2.7 out of every 100,000 men), followed by white men (1.9 out of every 100,000 men).

It is estimated 500 men will die from breast cancer this year.

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. Overall, the 5-year survival rate for men with breast cancer is 84%. Individual survival rates depend on different factors, including the stage of disease when it is first diagnosed.

For the earliest stages of breast cancer in men, stages 0 and I (zero and one), the 5-year survival rate is 100%. Approximately 47% of men with breast cancer are diagnosed with this stage. The 5-year survival rate for men with stage II (two) disease is 87% and stage III (three) disease is 75%. 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 25%. 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 the survival rates for men with breast cancer are an estimate. The estimate comes from annual data based on the number of men with this cancer in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts and Figures 2017: Special Section – Rare Cancers in Adults, and the ACS website (January 2019).

The next section in this guide is Risk Factors. It explains what factors may increase the chance of men developing breast cancer. Use the menu to choose a different section to read in this guide

Breast Cancer in Men - Risk Factors

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE:You will find out more about the factors that increase the chance of developing breast cancer. Use the menu to see other pages.

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

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 damage 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 generation to generation (see below). In general, a man’s average risk for breast cancer is very low. 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. These men may have inherited a mutation in the BRCA1 or BRCA2 genes or other genes, which can increase risk for breast cancer. Men with BRCA2 gene mutations have a 7 in 100 chance of developing breast cancer, while 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, research continues 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. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Screening

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE:You will find out more about screening for breast cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. 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 become 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 that increases the risk of developing the disease (see Risk Factors).

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems breast cancer can cause. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 07/2019

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.

Men with breast cancer may experience the following symptoms. Sometimes, men with breast cancer do not have any of these changes when diagnosed. Many times, the cause of breast changes may be another medical condition that is not cancer.

Talk with your doctor if you have the following signs or symptoms:

  • 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 a small lump.

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

If you are concerned about any changes you experience, 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 be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. 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. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose another section to continue reading this guide.

Breast Cancer in Men - Diagnosis

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

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

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

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 the 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 type of biopsy to find 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 numb the area and 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 is diagnosed, a surgical biopsy is usually not recommended to diagnose breast cancer. Most often, non-surgical core needle biopsies (see above) are used to diagnose breast cancer. This means that only 1 surgical procedure is usually needed after diagnosis 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 scan, 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 Types of Treatment 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 Introduction) helps determine both the 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 Types of Treatment) is an option for ER-positive and/or PR-positive cancers. Learn about ER and PR testing recommendations in the Diagnosis section of the Guide to Breast Cancer.

  • HER2. The HER2 status (see Introduction) helps determine whether drugs that target the HER2 receptor might help treat the cancer (see Types of Treatment). About half of HER2-positive tumors also have hormone receptors and can benefit from both hormone and HER2-targeted therapy. Learn about the recommendations for HER2 testing in the Diagnosis section of the Guide to Breast Cancer.

  • Grade. The tumor grade is also determined from a biopsy. Grade describes how much cancer cells look like healthy cells when viewed under a microscope. The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and has different cell groupings, it is called "well differentiated" or a "low-grade tumor." If the cancerous tissue looks very different from healthy tissue, it is called "poorly differentiated" or a "high-grade tumor." The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the chance that the cancer will not return.

  • Molecular testing of the tumor. Your doctor may recommend running other laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. If you have locally advanced or metastatic breast cancer, your doctor may recommend testing for the following molecular features:

    • PD-L1, which is found on the surface of cancer cells and some of the body's immune cells. This protein stops the body’s immune cells from destroying the cancer.

    • Microsatellite instability-high (MSI-H) or DNA mismatch repair deficiency (dMMR). Tumors that have MSI-H or dMMR have difficulty repairing damage to their DNA. This means that they develop many mutations or changes. These changes make abnormal proteins on the tumor cells that make it easier for immune cells to find and attack the tumor.

    • NTRK gene fusion, which is a specific genetic change found in a range of cancers, including breast cancer.

    • PI3KCA gene mutation, which is a specific genetic change commonly found in breast 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 is an option for people with ER-positive and/or PR-positive, HER2-negative breast cancer that has not spread to the lymph nodes. This test can help patients and their doctors make decisions about whether chemotherapy should be added to hormonal therapy. This test looks at 16 cancer-related genes and 5 reference genes to calculate a “recurrence score” that estimates the risk of the cancer coming back within 10 years after diagnosis. The recurrence score is used to guide recommendations on the use of chemotherapy, which may also differ by age. It appears to provide equally helpful information for men as it does for women. Read about the recommendations for using Oncotype Dx in the Diagnosis section of the Guide to Breast Cancer.

  • Mammaprint™. This test is an option for people with ER-positive and/or PR-positive, HER2-negative breast cancer that has not spread to the lymph nodes or has only spread to 1 to 3 lymph nodes. This test uses information from 70 genes to estimate the risk of recurrence for early-stage breast cancer. For people with a high risk of the cancer coming back, this test can help patients and their doctors make decisions about whether chemotherapy should be added to hormonal therapy. This test is not recommended for people with a low risk of the cancer coming back.

  • Additional tests. There are additional tests that may be options for people with ER-positive and/or PR-positive, HER2-negative breast cancer that has not spread to the lymph nodes. These tests include PAM50 (Prosigna™), EndoPredict, and uPA/PAI and can also be used to estimate how likely a cancer will spread to other parts of the body.

The tests listed above have not been shown to be useful to predict risk of recurrence for people with HER2-positive or triple-negative breast cancer. Therefore, none of these tests are currently recommended for breast cancer that is HER2 positive or triple negative. Your doctor will use other factors to help recommend treatment options for you.

Talk with your doctor for more information about genomic tests, what they mean, and how the results might affect your treatment plan.

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 check that your bone marrow is functioning well.

  • Serum chemistry. Serum chemistry tests are often done to look at minerals in your blood, such as potassium and sodium, and to evaluate kidney function. Serum chemistry may also include tests that evaluate the health of the liver.

Additional imaging tests

Additional imaging tests may not be done until after surgery. These tests are generally only recommended for patients with higher-stage disease. Most people with early-stage breast cancer do not need additional imaging tests. Read the Stages section for more information.

Whether your doctor recommends imaging tests to find out if the cancer has spread depends on the following factors:

  • Your medical history and symptoms

  • The size and type of tumor in the breast

  • Whether the cancer has spread to lymph nodes

  • Results of your physical examination

The tests listed below may not be recommended for all patients. Talk with your doctor if you have questions about a specific test, including why it is or is not recommended.

  • 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 stand out on the image, compared to healthy bone, which appears lighter. 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 stand out.

  • 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 takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows abnormalities, including most tumors. A CT scan can be used to measure the tumor’s size and find out 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. A PET scan is usually combined with a CT scan (see above). 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. The CT scan combined with the PET scan may be used to measure the size of a tumor and to determine the location of the bright spots more accurately. A PET 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, you may need another biopsy, if possible, to confirm the diagnosis of cancer.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Stages

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

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 spread 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 5 stages: stage 0 (zero), which is noninvasive ductal carcinoma in situ (DCIS), and stages I through IV (1 through 4), 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.

Staging can be clinical or pathological. Clinical staging is based on the results of tests done before surgery, which may include physical examinations, ultrasound, and MRI scans. Pathologic staging is based on what is found during surgery to remove breast tissue and lymph nodes. The results are usually available several days after surgery. In general, pathological staging provides the most information to determine a patient’s prognosis.

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. Tumor size is measured in centimeters (cm) or millimeters (mm). A centimeter is roughly equal to the width of a standard pen or pencil, and there are 10 millimeters in a centimeter.

Stage may also be divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information in listed below.

TX: The primary tumor cannot be evaluated.

T0 (T plus zero): There is no evidence of cancer in the breast.

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

  • Tis (DCIS): DCIS is a noninvasive cancer, but if not removed it may 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.

T1: The tumor in the breast is 20 mm or smaller in size at its widest area. This is a little less than an inch. This stage is then broken into 4 substages depending on the size of the tumor:

  • T1mi is a tumor that is 1 mm or smaller

  • 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 tumor is larger than 20 mm but not larger than 50 mm.

T3: The tumor is larger than 50 mm.

T4: The tumor falls into 1 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. Regional lymph nodes include:

  • Lymph nodes located under the arm, called the axillary lymph nodes

  • Above and below the collarbone

  • Under the breastbone, called the internal mammary 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 were not evaluated.

N0: Either of the following:

  • No cancer was found in the lymph nodes.

  • Only areas of cancer 0.2 mm or smaller are in the lymph nodes.

N1: The cancer has spread to 1 to 3 axillary lymph nodes and/or the internal mammary lymph nodes. If the cancer in the lymph node is larger than 0.2 mm but 2 mm or smaller, is it called "micrometastatic" (N1mi).

N2: The cancer has spread to 4 to 9 axillary lymph nodes. Or it has spread to the internal mammary lymph nodes, but not the axillary lymph nodes.

N3: The cancer has spread to 10 or more axillary lymph nodes. Or it has spread to the lymph nodes located under the clavicle, or collarbone. It may have also spread to the internal mammary lymph nodes. Cancer that has spread to the lymph nodes above the clavicle, called the supraclavicular lymph nodes, is also described as N3.

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 are used first.

Metastasis (M)

The “M” in the TNM system describes whether the cancer has spread to other parts of the body, called distant metastasis. This is no longer considered early-stage or locally advanced cancer. For more information on metastatic breast cancer, see the Guide to Metastatic Breast Cancer.

MX: Distant spread cannot be evaluated.

M0: The disease has not metastasized.

M0 (i+): There is no clinical or radiographic evidence of distant metastases. Microscopic evidence of tumor cells is found in the blood, bone marrow, or other lymph nodes that are no larger than 0.2 mm.

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, the tumor grade, and the results of ER/PR and HER2 testing. This information is used to help determine your prognosis (see Diagnosis). The simpler approach to explaining the stage of breast cancer is to use the T, N, and M classifications. This is the approach used below to describe the different stages.

Most patients are anxious to learn the exact stage of the cancer. 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 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 to the lymph nodes and the cancer in the lymph node 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, N1mi, M0).

Stage IIA: Any 1 of these conditions:

  • There is no evidence of a tumor in the breast, but the cancer has spread to 1 to 3 axillary lymph nodes. It has not spread to distant parts of the body. (T0, N1, M0).

  • The tumor is 20 mm or smaller and has spread to 1 to 3 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 1 to 3 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 or to internal mammary lymph nodes. It has not spread to other parts of the body (any T, N2, M0). Stage IIIA may also be a tumor larger than 50 mm that has spread to 1 to 3 axillary 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 up to 9 axillary or internal mammary lymph nodes. 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 spread to 10 or more axillary lymph nodes, the internal mammary lymph nodes, and/or the lymph nodes under the collarbone. It has not spread to other parts of the body (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 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. Learn more about metastatic breast cancer.

Recurrent: Recurrent cancer is cancer that has come back after treatment, and can be described as local, regional, and/or distant. 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 College of Surgeons, Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Types of Treatment

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will learn about the different types of treatments doctors use for men with breast cancer. Use the menu to see other pages.

This section explains the types of treatments that are the standard of care for men with breast cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

Treatment overview

In cancer care, doctors specializing in different areas of cancer treatment 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 include a variety of other health care professionals, such as physician assistants, nurse practitioners, 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 Introduction)

  • Genomic markers, such as Oncotype DX™ or Mammaprint™ (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 as the first treatment. 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 remain after surgery, 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 or preoperative therapy. There may be several benefits to having other treatments before surgery:

  • Surgery may be easier to perform afterwards

  • 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

  • Hormonal therapy

Whether adjuvant therapy is needed depends on whether any cancer cells could still be in the breast or body and how well a specific treatment will work to treat the cancer. The choice of adjuvant therapy depends on the cancer’s stage, features, and a patient’s health and preferences. Although adjuvant therapy lowers the risk of recurrence, there may still be some risk of recurrence.

Along with staging, other tools can help estimate prognosis and help you and your doctor make decisions about adjuvant therapy. There are also tests that can predict the risk of recurrence for your specific tumor by testing the tumor tissue (see Diagnosis). These may also be used to better understand the risks from the cancer and whether chemotherapy will help reduce those risks.

Descriptions of the common types of treatments used for breast cancer in men are listed below. Your care plan also includes 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. Talk with your doctor about the goals of each treatment and what you can expect during and after treatment. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision making is particularly important for breast cancer because there are different treatment options. 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 may not be an option.

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

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 (see below).

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. Most patients with invasive cancer will have either a sentinel lymph node biopsy or an axillary lymph node dissection.

  • Sentinel lymph node biopsy. The sentinel lymph node biopsy procedure allows for the removal of a small number of axillary lymph nodes, avoiding the removal of multiple lymph nodes in an axillary lymph node dissection (see below). 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, and arm movement and range-of-motion problems. Such side effects 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 a small number of sentinel lymph nodes from under the arm that receives 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 lymph 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, 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. 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 more 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.

Summary of surgical options

To summarize, surgical treatment options include the following:

  • Removal of cancer in the breast: Lumpectomy or mastectomy

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

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. A potential and significant side effect of breast cancer surgery is lymphedema, which can occur when axillary 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 instead of axillary lymph node dissection reduces the risk of 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. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.

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 therapy. When radiation therapy is given by placing radioactive sources into the tumor, it is called brachytherapy. Although the research results are encouraging, intra-operative radiation therapy and brachytherapy are not widely used for breast cancer. These types of radiation therapy are typically only used for a small cancer that has not spread to the lymph nodes. Learn more about the basics of radiation therapy.

Adjuvant (after surgery) radiation therapy is recommended for some men 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 or hyperpigmentation and pain or 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 it tends to heal with time. In the past, with older equipment and radiation therapy techniques, people 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.

Therapies using medication

Systemic therapy is the use of medication to destroy cancer cells. This type of medication is given through the bloodstream to reach cancer cells throughout the body. Systemic therapies are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

Common ways to give systemic therapies include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

The types of systemic therapies used for breast cancer include:

  • Chemotherapy

  • Hormonal therapy

  • Targeted therapy

  • Immunotherapy

Each of these types of therapies is discussed below in more detail. A person may receive 1 type of systemic therapy at a time or a combination of systemic therapies given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

The medications used to treat cancer are continually being evaluated. Talking with your doctor 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. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications. Learn more about your prescriptions by using searchable drug databases.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

Chemotherapy may be given before surgery to shrink a large tumor and make surgery easier, called neoadjuvant or preoperative chemotherapy. It may also be given after surgery to reduce the risk of recurrence, called adjuvant chemotherapy.

A chemotherapy regimen, or 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, once every 3 weeks, or even once every 4 weeks. Common types of chemotherapy for breast cancer include:

  • Capecitabine (Xeloda)

  • Carboplatin (available as a generic drug)

  • Cisplatin (available as a generic drug)

  • Cyclophosphamide (available as a generic drug)

  • Docetaxel (Taxotere)

  • Doxorubicin (available as a generic drug)

  • Pegylated liposomal doxorubicin (Doxil)

  • Epirubicin (Ellence)

  • Eribulin (Halaven)

  • Fluorouracil (5-FU)

  • Gemcitabine (Gemzar)

  • Ixabepilone (Ixempra)

  • Methotrexate (Rheumatrex, Trexall)

  • Paclitaxel (Taxol)

  • Protein-bound paclitaxel (Abraxane)

  • Vinorelbine (Navelbine)

A patient may receive 1 drug at a time or combinations of different drugs given at the same time. Research has shown that combinations of certain drugs are sometimes more effective than single drugs for adjuvant treatment. The following combinations of drugs may be used as adjuvant therapy to treat breast cancer:

  • AC (doxorubicin and cyclophosphamide)

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

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

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

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

  • EC (epirubicin and 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).

The side effects of chemotherapy depend on the individual, the drug(s) used, and the schedule and dose. These side effects can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, numbness and tingling, and diarrhea or constipation. These side effects can often be very successfully prevented or managed during treatment with supportive medications, and they usually go away after 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 and are active taking care of their families, working, and exercising during treatment. But each person’s experience is different. Talk with your health care team about the possible side effects of your specific chemotherapy plan.

Learn more about the basics of chemotherapy.

Hormonal therapy

Hormonal therapy, also called endocrine therapy, is a very important treatment for tumors that test positive for either estrogen or progesterone receptors (called ER positive or PR positive; see Introduction). Hormone receptor-positive tumors use hormones to fuel their growth. Blocking the body’s hormones may then slow the growth of the tumor and kill the cancer cells. Because many men with breast cancer have ER-positive disease, hormonal therapy is often part of the treatment plan.

Hormonal therapy is usually taken for at least 5 years. It may be taken for up to 10 years, especially for cancer that has a higher risk of returning. How long to continue hormonal therapy depends on the stage of cancer, the risk of it returning, and any side effects you are experiencing.

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

  • Tamoxifen (available as a generic drug) is the primary hormonal therapy used for men with breast cancer. It blocks estrogen from binding to breast cancer cells.

  • Aromatase inhibitors (AIs) include anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara). AIs 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 AI 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 to treat 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.

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. In addition, research studies continue 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. Targeted therapies are also used to treat metastatic breast cancer.

HER2 targeted therapy
  • Trastuzumab (Herceptin, Herzuma, Ogivri, Ontruzant). This drug is approved as an adjuvant therapy for non-metastatic HER2-positive breast cancer. Currently, most patients with stage I to stage III breast cancer (see Stages) should receive a trastuzumab-based regimen often including a combination of trastuzumab with chemotherapy, followed by 1 year of adjuvant trastuzumab. 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). This drug is approved for stage II and stage III breast cancer in combination with trastuzumab and chemotherapy.

  • Neratinib (Nerlynx). This oral drug is approved as a treatment for higher-risk HER2-positive, early-stage breast cancer. It is taken for a year, starting after patients have finished 1 year of trastuzumab.

  • Ado-trastuzumab emtansine or T-DM1 (Kadcyla). This is approved for the treatment of patients with early-stage breast cancer who have had treatment with trastuzumab and chemotherapy with either paclitaxel or docetaxel followed by surgery, and who had cancer remaining (or present) at the time of surgery. T-DM1 is a combination of trastuzumab linked to very small amount of a strong 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.

Combination regimens for HER2-positive breast cancer may include:

  • AC-TH (doxorubicin, cyclophosphamide, paclitaxel, trastuzumab)

  • AC-THP (doxorubicin, cyclophosphamide, paclitaxel, trastuzumab, pertuzumab)

  • TCHP (docetaxel or paclitaxel, carboplatin, trastuzumab, pertuzumab)

  • TCH (docetaxel or paclitaxel, carboplatin, trastuzumab)

  • TH (paclitaxel, trastuzumab)

Talk with your doctor about possible side effects for a specific medication and how they can be managed.

Bone modifying drugs

Bone modifying drugs block bone destruction and help strengthen bone. They are mainly used to treat cancer that has spread to the bone. In people whose cancer has not spread, they may be used to help keep the cancer from recurring. Certain types are also used in low doses to prevent and treat osteoporosis. Osteoporosis is the thinning of the bones.

There are 2 types of drugs that block bone destruction:

  • Bisphosphonates. These block the cells that destroy bone, called osteoclasts. Bisphosphonates include the medicines zoledronic acid (Reclast, Zometa), alendronate (Binosto, Fosamax), ibandronate (Boniva).

  • Denosumab (Prolia, Xgeva). An osteoclast-targeted therapy called a RANK ligand inhibitor.
Other types of targeted therapy for breast cancer

You may have other targeted therapy options for breast cancer treatment, depending on several factors. Many of the following drugs are used for advanced or metastatic breast cancer.

  • Alpelisib (Piqray). Alpelisib is an option along with the hormonal therapy fulvestrant for men and women with hormone receptor-positive, HER2-negative metastatic breast cancer that has a PIK3CA gene mutation and has worsened during or after hormonal therapy.

  • Drugs that target the CDK4/6 protein in breast cancer cells, which may stimulate cancer cell growth. These drugs include abemaciclib (Verzenio), palbociclib (Ibrance), and ribociclib (Kisqali). They are approved for ER-positive, HER2-negative advanced or metastatic breast cancer and may be combined with some types of hormonal therapy.

  • Lapatinib (Tykerb) for HER2-positive advanced or metastatic breast cancer when other medications are no longer effective at controlling the cancer’s growth. It may be combined with the chemotherapy capecitabine, the hormonal therapy letrozole, or the HER2 targeted therapy trastuzumab.

  • Larotrectinib (Vitrakvi) for breast cancer with an NTRK fusion that is metastatic or cannot be removed with surgery and has worsened with other treatments.

  • Olaparib (Lynparza). This oral drug may be used for patients with metastatic HER2-negative breast cancer and a BRCA1 or BRCA2 gene mutation who have previously received chemotherapy. It is a type of drug called a PARP inhibitor, which destroys cancer cells by preventing them from fixing damage.

  • Talazoparib (Talzenna) for locally advanced or metastatic HER2-negative breast cancer and a BRCA1 or BRCA2 gene mutation.

Immunotherapy

Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.

  • Atezolizumab (Tecentriq). In 2019, the U.S. Food and Drug Administration (FDA) approved a combination of atezolizumab plus protein-bound paclitaxel (see Chemotherapy, above) for locally advanced triple-negative breast cancer that cannot be removed with surgery and metastatic triple-negative breast cancer. In addition, it is only approved for breast cancers that test positive for PD-L1 (see Diagnosis).

  • Pembrolizumab (Keytruda). This is a type of immunotherapy that is approved by the FDA to treat metastatic cancer or cancer that cannot be treated with surgery. These tumors must also have a molecular alteration called microsatellite instability-high (MSI-H) or DNA mismatch repair deficiency (dMMR).

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

Recurrent breast cancer

If the cancer returns 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 locoregional recurrence.

  • A location distant from the breast, including organs such as the bones, lungs, liver, and brain. This is called a distant recurrence or a metastatic recurrence.

When breast cancer recurs, a new 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, a biopsy may be needed to confirm the breast cancer recurrence and learn about the features of the cancer.

After this testing is done, you and your doctor will talk about the treatment options. The treatment plan may include some of 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 may be considered curable with further treatment. A metastatic (distant) recurrence is generally considered incurable, but it is 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 suggest clinical trials that are studying new ways to treat this type of recurrent cancer.

People with recurrent breast cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the focus of care may switch to trying to help a patient live as well as possible with the cancer.

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

People who have advanced cancer and who are expected to live less than 6 months may want to consider 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 talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable and preferable option 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. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 07/2019

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. Use the menu to see other pages.

What are clinical trials?

Researchers are always looking for better ways to care for people 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 tested in clinical trials.

Clinical trials are used for all types and stages of breast cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some people, a clinical trial is the best treatment option available. Because standard treatments are not perfect, people are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other people volunteer for clinical trials because they know that these studies are a way to contribute to the 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.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, 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, people must participate in a process known as informed consent, which is led by a doctor and research team. During informed consent, the doctor should:

  • Describe all of the treatment options, so that the person understands the standard treatment, and how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each person to participate in the clinical trial, including the number of health care provider visits, tests, and the schedule of treatment.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. Although many clinical trials allow both men and women to enroll, some breast cancer clinical trials have eligibility criteria restricting a clinical trial to women only. It is important to discuss with your doctor whether a specific clinical trial allows both men and women.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons, 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 people 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 they choose 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.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials located in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for breast cancer. Use the menu to choose another section to continue reading this guide.

Breast Cancer in Men - Latest Research

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will read about the scientific research being done to learn more about this type of cancer and how to treat it. Use the menu to see other pages.

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 best diagnostic and treatment options for you.

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

  • Radiation therapy advances. Improved radiation therapy to lower the risk of side effects.

  • New medications and drug combinations. Evaluating new systemic therapies and combinations of therapies to treat breast cancer in men, including chemotherapy, hormonal therapy, targeted therapy, and immunotherapy.

  • Palliative care/supportive care. Finding better ways of reducing symptoms and side effects of current breast cancer treatments to improve comfort and quality of life for patients.

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 Treatment. It offers some guidance in how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care” or "supportive care." It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for breast cancer are listed in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to explain any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late 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.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a cancer diagnosis. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan. Create a caregiving plan with this 1-page fact sheet that includes an action plan to help make caregiving a team effort. This free fact sheet is available as a PDF, so it is easy to print out.

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • Cancer.Net Mobile: The free Cancer.Net mobile app allows you to securely record the time and severity of symptoms and side effects.

  • ASCO Answers Managing Pain: Get this 36-page booklet about the importance of pain relief that includes a pain tracking sheet to help patients record how pain affects them. The free booklet is available as a PDF, so it is easy to print out.

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on diarrhea and rash that provide a tracking sheet to record the timing and severity of the side effect. These free fact sheets are available as a PDF, so they are easy to print out.

The next section in this guide is Follow-up Care and Monitoring. It explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Follow-Up Care and Monitoring

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will read about your medical care after breast cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. The role of screening mammograms for 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, which means that the cancer has come back. 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. 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 new 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, seizures, or dizziness

  • 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 ask specific questions about your health at follow-up visits. It’s important to share how you are feeling at those visits, and ask any questions you may have about your health or follow-up care plan.

The anticipation before having a follow-up visit or waiting for test results can add stress to you or a family member. Learn more about how to cope with this type of stress.

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. 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 have certain physical examinations, scans, or blood tests to help find and manage them.

  • Long-term effects of surgery. After surgery for breast cancer, the chest may be scarred and 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. 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.

  • Long-term effects of hormonal therapy. Patients who take hormonal therapy for many years can have symptoms such as hot flashes and mood changes. In addition, AIs can sometimes cause aches, pains, and stiffness during treatment. Talk with your doctor about what you can do to manage these symptoms if you experience them.

In addition, patients 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 discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the 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 and with 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. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Survivorship

Approved by the Cancer.Net Editorial Board, 07/2019

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a breast cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • 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.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone.

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 about coping 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 their frequent visits to the health care team end after completing 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 when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health 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

  • 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 place 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.

A new perspective on your health

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

It is important to have recommended medical checkups and tests (see Follow-up Care and Monitoring) to take care of your health. Cancer rehabilitation may 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 health care team 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 that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print out.

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

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

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 07/2019

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

Talking often with the health care team 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 a digital list and other interactive tools to manage your care. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

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 available for 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 will be leading my overall 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 of cancer care, who can help me?

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

  • If I have questions or problems, who should I call?

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?

  • Who should I contact about any side effects I experience? And how soon?

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

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

  • 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?

  • Who should I contact about any side effects I experience? And how soon?

  • 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 chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • 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 leading my follow-up care?

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

The next section in this guide is Additional Resources. It offers some more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Breast Cancer in Men - Additional Resources

Approved by the Cancer.Net Editorial Board, 07/2019

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. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer 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.

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 to choose a different section to read in this guide.