Breast Cancer in Men: From One Man To Another
Breast Cancer in Men: From One Man To Another
Breast Cancer in Men: From One Man To Another
02 Contents
UNDERSTANDING CANCER
03 What is breast
cancer?
03 How common is
breast cancer in
men?
05 Symptoms
06 The diagnosis
08 Before the
operation Breast Cancer in Men
09 Telling people
10 The operation
13 The follow up
appointment
18 Radiation
Treatment
19 Hormonal Therapy
20 Other treatment
20 Work
20 Family history
22 Notes
27 Feedback
1
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Breast Cancer in Men
1
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Breast Cancer in Men Contents
02 Contents What is breast cancer?
How common is breast cancer in men?
3
3
What is breast cancer?
03 What is breast
cancer? Symptoms 5 Breast cancer is a malignant tumour that starts in the breast
The diagnosis 6 tissue. Men have breast tissue too, comprised of fat, fibrous
03 How common is
breast cancer in After the tests 7 tissues, fine ducts and glandular elements or lobules. The
men? Before the operation 8 majority of breast cancers begin in the ducts (ductal cancer).
05 Symptoms Telling people 9 A small number start in the sacs or lobules (lobular cancers).
06 The diagnosis The operation 10 Within these two groups there are different subtypes of
The surgery — mastectomy 11 breast cancer. Some grow very slowly. Others develop
07 After the tests
Drainage after surgery 12 more rapidly.
08 Before the Side effects of surgery 13
operation Breast cancer can spread to lymph glands and to other parts
The follow-up appointment 13
09 Telling people Exercise 15
of the body, such as the bones and liver.
27 Feedback
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Breast Cancer in Men
02 Contents
Symptoms
03 What is breast
cancer?
“I went to the doctor with a lump in my nipple and a blood
stained discharge from the nipple. This led to a mammogram Some breast changes may be early signs of breast cancer,
03 How common is
and an ultrasound prior to an appointment with a surgeon. including:
breast cancer in
men? The mammogram was mildly uncomfortable and the • a lump or lumpiness
ultrasound completely painless.
05 Symptoms • thickening of the tissue (this is the most common
06 The diagnosis change); nipple changes; for example, a blood-stained
At the first appointment with the surgeon she suggested
discharge from a nipple, an inverted nipple (unless the
07 After the tests a biopsy and this was done at a local radiology clinic.
nipple has always been turned in), or a rash on a nipple
This involved a local anaesthetic and a minor procedure
08 Before the
operation to collect samples from the lump. The biopsy took about • skin dimpling
20 minutes and was painless.” Brian • a change in shape
09 Telling people
13 The follow up • a rash or red marks which appear only on the breast.
appointment
For more information, read the Cancer Society’s booklet Breast cancer is often thought of as a women’s disease
15 Exercise Breast Cancer/Te Matepukupuku o ngā Ū, which is available and this can make men feel embarrassed to seek help, and
16 Chemotherapy from your local Cancer Society or by contacting the Cancer when given a breast cancer diagnosis. Don’t delay – if you
Information Helpline 0800 CANCER (226 237). You can have a breast symptom get professional advice. Most breast
18 Radiation
Treatment also read, download or listen to this booklet on the Cancer symptoms in men are not due to cancer.
Society’s website (www.cancernz.org.nz).
19 Hormonal Therapy
20 Other treatment
20 Work
20 Family history
22 Notes
27 Feedback
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Breast Cancer in Men
02 Contents
03 What is breast
cancer? “In Late 2009 I was diagnosed with breast cancer. “When the surgeon told me I had breast cancer it hit me
Things happened pretty quickly after that. What — with going like a punch in the stomach. I couldn’t believe it and didn’t
03 How common is
breast cancer in
to different clinics here and there, and being prodded with really take in much that was said. I left the surgeon’s
men? various instruments and what-nots, I somehow thought I was rooms clutching an information folder I had been given,
a bit of a celebrity, getting all this attention, even though feeling numb and frightened. I knew an operation had been
05 Symptoms
it was for cancer. My wife was right there beside me. scheduled but a lot that was said hadn’t struck. Fortunately,
06 The diagnosis Lord, what would we do without them?” Dennis my wife was with me and she was able to fill in the gaps
07 After the tests for me.” Brian
08 Before the
operation
09 Telling people
10 The operation
The diagnosis After the tests
13 The follow up The diagnosis is based on information gathered from When you see your surgeon to hear the diagnosis, you will
appointment a range of tests. These will probably include a mammogram, probably already have started to think about your future.
15 Exercise an ultrasound and a biopsy. You can read about these The actual diagnosis of breast cancer hits hard and you
in a booklet called Breast Cancer/Te Matepukupuku can feel out of control and uncertain. Having your wife,
16 Chemotherapy
o ngā Ū which is available from your local Cancer partner or friend with you at the diagnosis and any further
18 Radiation Society or by phoning the Cancer Information Helpline appointments will be a great support. The information you
Treatment
0800 CANCER (226 237). You can also read, download receive at these appointments will be heard by the other
19 Hormonal Therapy or listen to this booklet on the Cancer Society’s website person. This will ensure you both know what is going on.
20 Other treatment (www.cancernz.org.nz).
20 Work
20 Family history
22 Notes
27 Feedback
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Breast Cancer in Men
02 Contents
03 What is breast
cancer? “I decided to take the process one step at time and not “I decided to be upfront and tell a lot of people in a straight
get too involved in what might happen later. This meant forward, factual way. I figured that the information would
03 How common is
breast cancer in concentrating on the operation and recovery and waiting get around anyway and maybe not accurate. Everyone I told
men? for test results before thinking about the next steps. was great and I had offers of help with lawns, jobs around
05 Symptoms
I also had the niggling feeling that the diagnosis was the house and transport. Nobody seemed to think breast
a mistake and that the tests had been mixed up.” Brian cancer in a man was strange or peculiar. The only problem
06 The diagnosis
I had was when someone was kind and said something nice
07 After the tests and this stirred up my emotions.” Brian
08 Before the
operation
09 Telling people
10 The operation
Before the operation Telling people
13 The follow up There are two main options. You can collect information, You need to decide who to tell about your breast cancer.
appointment read books, look up websites and become very well-informed Most people are happy to tell family, close friends and some
15 Exercise or you can take things one step at a time. people at work.
16 Chemotherapy The approach you take depends on your way of doing things. As breast cancer is often seen as a ‘woman’s cancer’ some
18 Radiation If you go for full information, ask your surgeon to supply men find it difficult or embarrassing talking about their
Treatment you with information or contact your local Cancer Society breast cancer. You may want to start by telling close friends
19 Hormonal Therapy or phone the Cancer Information Helpline 0800 CANCER and family and then once you feel more comfortable and
(226 237). confident talking about your cancer, let other people know.
20 Other treatment
The more open you are about your breast cancer, the easier
20 Work If you decide to go one step at a time you need to focus on the
it may be for others to support you.
operation and your recovery from the surgery. The laboratory
20 Family history
results from samples taken during your operation will dictate
22 Notes what happens next and you can get information relevant
27 Feedback to you at a later appointment.
8 9
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Breast Cancer in Men
02 Contents
The operation The surgery—mastectomy
03 What is breast
cancer?
The first treatment for breast cancer is usually surgery This is the removal of all the breast tissue including some
03 How common is on the breast and on the glands in the armpit (the axillary of the skin and the nipple. The chest muscles are not
breast cancer in lymph nodes). Examination of the cancer and the lymph removed. Some lymph glands in the armpit are removed
men?
nodes by a pathologist, after the operation, will indicate during the operation, usually through the same incision.
05 Symptoms any further treatment. Most people will go home the day after the operation.
06 The diagnosis
For more information on breast surgery contact your local Male mastectomy
07 After the tests Cancer Society for the Breast Cancer/Te Matepukupuku
08 Before the o ngā Ū booklet, phone the Cancer Information Helpline
operation 0800 CANCER (226 237) or visit the Cancer Society’s
09 Telling people website (www.cancernz.org.nz) to read, download or
listen to the booklet. You can also read about breast cancer
10 The operation
in men on the National Breast and Ovarian Cancer Centre’s
13 The follow up website: http://www.nbocc.org.au/men/
appointment
15 Exercise
16 Chemotherapy
18 Radiation
Treatment
19 Hormonal Therapy
20 Other treatment
20 Work
20 Family history
22 Notes
Illustration reproduced with permission from
27 Feedback Alexa Rutherford 2010
10 11
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Breast Cancer in Men
02 Contents
Side effects of surgery
03 What is breast
cancer? For information on the side effects of surgery, contact
“I spent one night in hospital and went home with a drain
03 How common is tube in place. There was never any pain and I was able to your local Cancer Society for a copy of the Breast Cancer/
breast cancer in Te Matepukupuku o ngā Ū booklet, phone the Cancer
men? start a series of exercises and use my arm freely. A district
nurse visited daily for about a week to change the drain Information Helpline 0800 CANCER (226 237)
05 Symptoms or read, download or listen to the booklet on our
bottles and check progress. When the drain was removed
06 The diagnosis by the surgeon, after about a week, there was some website (www.cancernz.org.nz). See pages 32
sensation but no pain.” Brian and 33 of the Breast Cancer booklet for information
07 After the tests
on the side effects of surgery.
08 Before the
operation
09 Telling people
Drainage after surgery The follow-up appointment
10 The operation
13 The follow up After your operation you will have one or two tubes (called About a week after your operation you will see the surgeon
appointment drains) coming from the area of your operation and draining again. This is when you will get the results from the tests
15 Exercise into small bottles. If you have ever grazed yourself you will of the breast tissue removed in the operation. You will get
have noticed a clear or blood-stained liquid on the surface information on the stage and grading of your cancer and
16 Chemotherapy
of the graze. This is the same liquid coming from your wound. possible further treatment. For information on staging and
18 Radiation grading cancer contact your local Cancer Society for a copy
Treatment The drains will stay in place for about a week and will then
of the Breast Cancer/Te Matepukupuku o ngā Ū booklet;
be removed. If fluid continues to build up after the tubes
19 Hormonal Therapy phone the Cancer Information Helpline 0800 CANCER
come out it can be easily drained using a needle which goes
20 Other treatment (226 237) or read, download or listen to the booklet on
in near the operation wound. Because the area is numb you
the Cancer Society’s website (www.cancernz.org.nz).
20 Work should not feel anything.
20 Family history
22 Notes
27 Feedback
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Breast Cancer in Men
02 Contents
03 What is breast
cancer?
03 How common is
breast cancer in “I know it hasn’t been long for any sort of results — I am “My wife and I belong to a Country Music Club, and we have
men?
feeling very ‘up and at ‘em’, but that is how I am.” Dennis three ladies there that have breast cancer. They think I’m
05 Symptoms quite special, and I feel very humble to have their company,
06 The diagnosis even if they do rib me about it.” Dennis
08 Before the
operation
09 Telling people
10 The operation
This is also an opportunity to ask questions. The Breast
Cancer booklet has a list of questions at the back that
Exercise
13 The follow up could help you with your list. For information about being active when you have cancer
appointment and lymphoedema contact your local Cancer Society;
“I asked four questions:
15 Exercise phone the Cancer Information Helpline 0800 CANCER
• What happens next? (226 237) or read the following Information Sheets on
16 Chemotherapy
• Can the cancer reappear in the chest area? the Cancer Society’s website (www.cancernz.org.nz):
18 Radiation
Treatment Somewhere else?
“Exercise after breast cancer surgery”
19 Hormonal Therapy • What is the best outlook? Worst outlook?
“Living with lymphoedema”.
20 Other treatment • Is there anything else you think I need to know?
After your cancer has been removed, your surgeon will
20 Work My wife was with me at this appointment and, once again,
discuss your cancer with other specialists to determine
20 Family history
this was a real support.” Brian
what further treatment, if any, will be recommended.
22 Notes
27 Feedback
14 15
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Breast Cancer in Men
02 Contents
Chemotherapy If you are feverish (your temperature is 38 degrees
C or more), or if you feel unwell in any way — don’t
03 What is breast
cancer? Only some men will need chemotherapy. This is the wait to see what happens—take action quickly.
03 How common is treatment of cancer with drugs. The aim is to destroy cancer Contact your cancer doctor or nurse, and follow
breast cancer in cells while having the least possible effect on normal cells. the advice given.
men?
The drugs are usually given intravenously via a drip and, • sore mouth
05 Symptoms therefore, circulate around the body. Chemotherapy is a
systemic treatment (treating the whole body) compared with • nausea and vomiting
06 The diagnosis
surgery and radiation treatment, which are local treatments • loss of appetite or taste changes
07 After the tests
to a specific area in the body (chestwall, axilla, etc). • feeling off-colour and tired
08 Before the
operation There are different regimens or combinations of drugs used • thinning or loss of hair
09 Telling people in breast cancer. Treatment is often in cycles at three-weekly • weight gain or loss.
intervals, and may last for several months.
10 The operation
Individual chemotherapy drugs may have particular side
13 The follow up effects, and these will be discussed with you.
appointment
15 Exercise
Side effects of chemotherapy Exercise, even during treatment, will help you to feel less
tired. Gentle exercise such as walking is ideal. But some
16 Chemotherapy In addition to destroying cancer cells, chemotherapy can
men find that more strenuous exercise is helpful too.
18 Radiation also damage some normal cells, especially those that divide
Treatment rapidly. Rapidly dividing cells include those lining the mouth, If you have temporary hair loss, you are entitled to
19 Hormonal Therapy stomach and bowel, as well as those in skin, hair and bone a benefit to buy a wig or hair piece.
marrow. If these normal cells are damaged during therapy,
20 Other treatment
you might experience side effects such as:
20 Work
• infections ― the drugs can lower your ability
20 Family history
to fight infections
22 Notes
27 Feedback
16 17
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Breast Cancer in Men
02 Contents
Radiation treatment • Do not use deodorant or sunscreen in or around the
area that is being treated.
03 What is breast
cancer?
Sometimes, radiation is given after mastectomy and axillary • Wear loose-fitting cotton clothing over the treatment area.
03 How common is surgery to reduce the likelihood of developing recurrence
breast cancer in (the return of cancer) in/over the chest wall or in the axillary
men?
or supraclavicular (above the collar bone) lymph nodes.
05 Symptoms Hormonal therapy
Radiation treatment is the use of radiation (rays of energy
06 The diagnosis
called photons or little particles called electrons) to destroy Hormonal therapy is often used in addition to surgery
07 After the tests cancer cells, usually using a machine called a Linear and radiation treatment for treating breast cancer in men.
08 Before the Accelerator. You will see a radiation oncologist who Most breast cancers in men need hormones called oestrogens
operation will discuss this treatment with you. to grow. Hormonal therapies work by decreasing the amount
09 Telling people of oestrogen in the body or by stopping the cancer cells
Treatment is given four to five days a week over about four getting oestrogen. The most common one used in men
10 The operation to five weeks. It is painless and only takes a few minutes is the anti-oestrogen (tamoxifen). Aromatase inhibitors,
13 The follow up for each treatment. another class of oestrogen lowering drugs used in women,
appointment
are not effective in men.
15 Exercise
19 Hormonal Therapy • general tiredness The most common side effects of hormonal therapy include:
20 Other treatment • some reddening or ‘sunburning’ of the skin. • hot flushes (sudden feeling of being heated, accompanied
20 Work
by sweating and redness in the chest, neck and face).
Follow the advice of your radiation therapists on skin care.
20 Family history
And less commonly:
The following tips will help you through your treatment:
22 Notes • nausea
27 Feedback • Where possible, keep your skin dry and clean. • headaches
After washing gently pat your skin dry.
• decrease in libido/sexual interest.
• Do not use aftershave or lotions without first checking
with your doctor, nurse or radiation therapist.
18 19
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Breast Cancer in Men
02 Contents
Other treatment Partner’s view
03 What is breast “Expecting to be told at your appointment that there was
cancer? Trastuzumab (Herceptin) is a targeted breast cancer therapy no cancer, the positive diagnosis was shocking. I went into
03 How common is for people whose breast cancer is HER 2 positive. HER 2 ‘I have to be strong’ mode. How crazy to do that. I needed
breast cancer in positive means that these people have a particular protein
men? a really good cry that I didn’t allow myself, which also didn’t
called HER 2 on their cancer cells. HER 2 positive patients give our family the chance to react. Again, in the same
05 Symptoms have a more aggressive breast cancer and will be offered circumstances, I would let myself go, then get on with it.
06 The diagnosis chemotherapy and Herceptin to kill cancer cells that might
have spread even if scans are “negative”. Now each time I look at the rather large scar, I think
07 After the tests
‘There is the scar that has, hopefully, given us more time
08 Before the Herceptin is given intravenously once every week or every together.’ and we make each moment together so special.”
operation three weeks, and is usually well-tolerated. Uncommonly, Brian’s wife
09 Telling people it may cause some impairment of heart pumping function.
A heart echo test will be done regularly.
10 The operation
For more information
13 The follow up
appointment
15 Exercise
Work National Breast and Ovarian Cancer Centre:
“Breast Cancer in Men”
16 Chemotherapy Your surgeon will tell you when you can start work again and http://www.nbocc.org.au/men/treatment/surgery.php
18 Radiation this will depend on the type of job you do. The Cancer Society
Treatment has an Information Sheet titled “Cancer: Insurance, Legal Breast Cancer Care (UK)
and Employment Issues” on their website (www.cancernz. Men and breast cancer
19 Hormonal Therapy
org.nz) you may find useful.
20 Other treatment http://www.breastcancercare.org.uk/breast-cancer-
breast-health/living-with-breast-cancer/men-and-
20 Work
breast-cancer/
20 Family history Family history
22 Notes
When men get breast cancer, there is a higher chance that
27 Feedback
this may be caused by an inherited fault in a gene called
BRAC2. If you have a family history of breast cancer you
should discuss this with your specialist.
20 21
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Breast Cancer in Men
02 Contents
Notes
03 What is breast
cancer?
You may wish to use this space to write down any questions
03 How common is you want to ask your doctor, nurses or health providers
breast cancer in at your next appointment.
men?
05 Symptoms
06 The diagnosis
08 Before the
operation
09 Telling people
10 The operation
13 The follow up
appointment
15 Exercise
16 Chemotherapy
18 Radiation
Treatment
19 Hormonal Therapy
20 Other treatment
20 Work
20 Family history
22 Notes
27 Feedback
22 23
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Breast Cancer in Men
02 Contents
Notes Cancer Society of New Zealand Inc.
03 What is breast
cancer?
Te Kāhui Matepukupuku o Aotearoa
03 How common is
breast cancer in
men? Cancer Society of New Zealand Inc.
05 Symptoms www.cancernz.org.nz
06 The diagnosis
National Office
07 After the tests
PO Box 12700, Wellington 6144
08 Before the
operation Telephone: (04) 494-7270
09 Telling people
Auckland Division
10 The operation
PO Box 1724, Auckland 1140
13 The follow up
appointment
Telephone: (09) 308-0160
Covering: Northland
15 Exercise
24 25
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Breast Cancer in Men
02 Contents
03 What is breast
cancer? Feedback
03 How common is
breast cancer in Wellington Division Breast Cancer in Men: From one man to another
men?
52-62 Riddiford Street, Wellington 6021 We would like to read what you thought of this booklet:
05 Symptoms
Telephone: (04) 389-8421 whether you found it helpful or not. If you would like to give
06 The diagnosis Covering: Marlborough, Nelson, us your feedback please fill out this questionnaire, cut it out
07 After the tests Wairarapa and Wellington and send it to the Information Manager at the address at the
bottom of the following page.
08 Before the
operation Canterbury/West Coast Division
1. Did you find this booklet helpful?
09 Telling people PO Box 13450, Christchurch 8141
Telephone: (03) 379-5835 Yes No
10 The operation
Covering: South Canterbury, West Coast, Ashburton Please give reason(s) for your answer.
13 The follow up
appointment
Otago/Southland Division
15 Exercise
PO Box 6258, Dunedin 9059
16 Chemotherapy
Telephone: (03) 477-7447
18 Radiation
Treatment 2. Did you find the booklet easy to understand?
19 Hormonal Therapy Yes No
20 Other treatment
Please give reason(s) for your answer.
20 Work
20 Family history
22 Notes
27 Feedback
3. Did you have any questions not answered in the booklet?
Yes No
26 27
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Breast Cancer in Men
02 Contents
03 What is breast
cancer?
03 How common is
breast cancer in 4. What did you like the most about the booklet? Information, support and research
men? The Cancer Society of New Zealand offers information and support services to people with cancer
and their families. Printed materials are available on specific cancers and treatment.
05 Symptoms The Cancer Society is a major funder of cancer research in New Zealand. The aim of research is
to determine the causes, prevention and effective methods of treating various types of cancer.
06 The diagnosis
The Society also undertakes health promotion through programmes, such as those encouraging
SunSmart behaviour, being physically active and eating well and discouraging smoking.
07 After the tests
We would appreciate your support
08 Before the 5. What did you like the least about the booklet? Many Cancer Society services would not be possible without the generous support of many
operation New Zealanders. You can make a donation by phoning 0900 31 111, through our website
at www.cancernz.org.nz or by contacting your local Cancer Society.
09 Telling people Acknowledgements
The Cancer Society would like to thank Brian and his wife for offering us his original draft of Breast
10 The operation Cancer in Men: From one man to another.
The Cancer Society would like to thank for their reviews, advice and contributions:
13 The follow up
appointment 6. Any other comments? Associate Professor Ian Campbell
Breast and General Surgeon, Waikato Clinical School, Hamilton.
15 Exercise Burton King FRACS
Breast and General Surgeon, GLENMORE SURGEONZ, Wellington.
16 Chemotherapy Associate Professor Chris Atkinson
Medical Director, Cancer Society of New Zealand; Chair, Cancer Control Council;
18 Radiation Radiation Oncologist, St George’s Cancer Care Centre, Christchurch.
Treatment
Meg Biggs, Julie Holt, Liz Wright
Personal information (optional) Cancer Society Information Nurses
19 Hormonal Therapy
Are you a person with cancer, or a friend/relative/whānau? Sarah Stacy Stacy Baynes
20 Other treatment Information Manager
Consumer reviewers
20 Work The Cancer Society wishes to acknowledge the input and expertise of our consumer reviewers.
27 Feedback Thank you for helping us review this booklet. Cancer Society of New Zealand Inc. (2010)
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system
The Editorial Team will record your feedback when or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording
or otherwise, without the prior permission of the publisher.
it arrives, and consider it when this booklet is reviewed
for its next edition.
Please return to: The Information Manager, Cancer Society
of New Zealand, PO Box 12700, Wellington 6144.
28
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Breast Cancer in Men
02 Contents
03 What is breast
www.cancernz.org.nz
cancer?
03 How common is
breast cancer in
men?
05 Symptoms
06 The diagnosis
ANY CANCER, ANY QUESTION
07 After the tests 0800 CANCER (226 237)
08 Before the
operation Cancer Information Helpline
09 Telling people
10 The operation
13 The follow up
appointment
15 Exercise
16 Chemotherapy
18 Radiation
Treatment
19 Hormonal Therapy
20 Other treatment
20 Work
20 Family history
22 Notes
27 Feedback
PI 214
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