Surgery for Male Breast Cancer

Nearby lymph nodes—small glands that make and store lymphocytes, which are white blood cells that help fight infection—may also be removed. Breast cancer often spreads to the lymph nodes first.

Men usually are diagnosed with invasive cancer, so NYU Langone doctors often perform a mastectomy, in which they remove the entire breast.

Lumpectomy, also called a partial mastectomy, may be an option for men who have certain types of breast cancer, including ductal carcinoma in situ, early invasive ductal carcinoma, or early invasive lobular carcinoma. At NYU Langone, this surgery is usually followed by radiation therapy.

During a lumpectomy, our surgeons remove the cancer along with a border, or margin, of surrounding tissue to ensure no cancer cells remain. Afterward, a pathologist evaluates the tissue margin under a microscope to see if it contains any cancerous cells. If it does, more tissue may need to be surgically removed.

In mastectomy, a surgeon removes the entire breast, nipple, and areola, the ring of pigmented skin surrounding the nipple. NYU Langone doctors may recommend the procedure for men who have extensive ductal carcinoma in situ and those who have a large invasive cancer or multiple tumors.

NYU Langone doctors sometimes remove both breasts, depending on the risk of developing cancer in the other breast. This is called a bilateral mastectomy. You and your doctors can discuss whether this is the right option for you.

In men who have invasive cancer, doctors perform sentinel lymph node removal during a lumpectomy or mastectomy to determine if cancer has spread. Lymph nodes are part of the lymphatic system, which consists of organs and vessels that drain excess fluid from tissues and help the body fight infection.

A radioactive fluid called a tracer is injected in or around the breast before surgery, and a blue dye may be injected in the same area after you are in the operating room. The tracer travels through the breast tissue to nearby lymph nodes under the arm. The first node or several nodes to absorb the tracer are called the sentinel nodes. If cancer spreads outside the breast, it is likely to travel to these nodes first.

NYU Langone doctors can find this node or nodes using a gamma probe, a device that detects the radioactive fluid. This helps them determine where to make an incision to remove the node. The blue dye helps doctors to identify the sentinel node or nodes during surgery.

Doctors remove the sentinel nodes through a small incision under the arm and examine them to determine whether they contain cancer. If cancer is not present, then doctors don’t need to remove additional lymph nodes.

If cancer is found in the sentinel nodes, your surgeon may recommend another procedure, called axillary lymph node dissection, to remove additional nodes to determine if they contain cancer.

During an axillary lymph node dissection, doctors may remove as many as 10 to 15 lymph nodes from the underarm area to evaluate them for cancer.

This procedure is more likely than sentinel lymph node removal to cause a condition called lymphedema. Lymphedema may develop after lymph vessels in the breast and underarm are damaged by surgery. These vessels carry lymph fluid, which contains bacteria and waste products, away from the body’s organs and tissues. Damage to the vessels may cause fluid to build up, creating swelling and discomfort in the arm.

NYU Langone doctors can help you take steps to prevent lymphedema and manage it if it occurs.

The length of your hospital stay depends on the extent of the surgery. For example, if you have a lumpectomy with a sentinel lymph node removal, you may go home the same day. If you have a mastectomy with an axillary lymph node dissection, you may need to stay overnight. During this time, doctors and nurses monitor your health and help to manage any pain or discomfort.

Men who have axillary lymph node dissection may go home with a drain placed under the arm. This tube drains fluid away from the wound and may need to stay in place for several days to help reduce swelling.