Breast Cancer, Male: Surgery

Surgery is the most common treatment for men with breast cancer. About 98 percent of male breast cancer patients are treated with mastectomy (surgical removal of the breast). Breast-conserving surgery is usually not an option for male breast cancer patients.

Many male breast cancers also require removal of the axillary (armpit) lymph nodes. We offer all our male breast cancer patients the option of having a sentinel lymph node biopsy, a surgical procedure that helps doctors determine if the cancer has spread from the breast to other organs. Sentinel lymph node biopsy is a procedure that was spearheaded by Memorial Sloan Kettering physicians and can spare patients who do not have cancer in the sentinel node from having more lymph nodes removed.

Mastectomy

Before the 1970s, male breast cancer was usually treated by radical mastectomy, the surgical removal of the entire breast, its underlying chest wall muscles, and lymph nodes under the closest arm. Today most patients can be treated by total mastectomy, in which the breast is removed but the chest wall muscles are spared.

Breast-Conserving Surgery

Breast-conserving surgery is usually not a treatment option for men due to the small amount of tissue located under the nipple in the male breast. However, some men may benefit from breast-conserving surgical procedures. The most common form of breast-conserving surgery for men is lumpectomy, in which the surgeon removes only the cancerous breast tissue and a margin of normal tissue around it, sparing the rest of the breast. Patients who choose this treatment require radiation therapy to the breast area after surgery.

Sentinel Lymph Node Biopsy

The first lymph node (or group of nodes) under the arm that is reached by metastatic tumor cells — cells that have broken away from a primary tumor and spread via the bloodstream — is called the sentinel lymph node. Its status is an important prognostic factor in patients with male breast cancer.

During surgery on a primary breast tumor, the surgeon identifies and removes the sentinel lymph node under the arm, which is examined by a pathologist. If a sentinel lymph node is found to contain cancer cells, the remaining lymph nodes are removed in a procedure called axillary lymph node dissection. If the sentinel lymph node is free of cancer, the remaining lymph nodes are spared.