Chemotherapy for Breast Cancer in Men
Chemotherapy (chemo) is treatment with cancer-killing drugs that may be given intravenously (injected into your vein) or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body.
Occasionally, chemo might be given directly into the spinal fluid that surrounds the brain and spinal cord.
When is chemotherapy used for breast cancer in men?
Not all men with breast cancer will need chemo, but there are several situations in which chemo might be recommended.
Adjuvant chemotherapy is chemo given after surgery. Its purpose is to kill any cancer cells that might have been left behind or spread but can't be seen, even on imaging tests. If these cells were allowed to grow, they could form new tumors in other places in the body. Adjuvant chemo can often help lower the risk of breast cancer coming back.
Sometimes it might not be clear if adjuvant chemo will be helpful. Gene expression tests, such as Oncotype DX, can sometimes be used to help determine if someone is likely to benefit from chemo after breast surgery. While these tests have been studied mostly in women, they may be helpful for some men, too.
Neoadjuvant chemotherapy is chemo given before surgery. It’s often used to shrink the tumor so it can be removed with less extensive surgery. This approach is common when the tumor is too large to remove at the time of diagnosis.
By giving chemo first, doctors can see how the cancer responds to it. If the first set of chemo drugs doesn’t shrink the tumor, your doctor will know that other drugs are needed.
Like adjuvant chemo, neoadjuvant chemo helps kill cancer cells that have spread and lowers the risk of breast cancer coming back.
Chemo is often the main treatment for men whose cancer has spread beyond the breast and underarm area to distant organs like the liver or lungs.
Which chemotherapy drugs are used for breast cancer?
In most cases (especially as adjuvant or neoadjuvant treatment), chemo works best when combinations of drugs are used. Doctors use many different combinations, and it's not clear that any combination is clearly the best.
For adjuvant and neoadjuvant chemo, common chemo drugs include:
- Anthracyclines, such as doxorubicin (Adriamycin) and epirubicin
- Taxanes, such as paclitaxel and docetaxel
- Cyclophosphamide
- Methotrexate
- 5-fluorouracil (5-FU)
- Carboplatin
- Capecitabine
Most often, combinations of 2 or 3 of these drugs are used.
For breast cancer that has spread, common chemo drugs include:
- Taxanes, such as paclitaxel, docetaxel, and albumin-bound paclitaxel
- Anthracyclines, such as doxorubicin, pegylated liposomal doxorubicin, and epirubicin
- Platinum drugs, such as cisplatin and carboplatin
- Vinorelbine
- Capecitabine
- Gemcitabine
- Cyclophosphamide
- Ixabepilone
- Eribulin
Advanced breast cancer is most often treated with single chemo drugs, but combinations of drugs might be used in some situations.
For HER2-positive breast cancers, 1 or more drugs that target HER2 may be given along with chemo.
Antibody-drug conjugates (ADCs)
An antibody-drug conjugate (ADC) is a chemo drug linked to a monoclonal antibody (a lab-made version of an immune system protein that attaches to a specific target on cancer cells). Once in the body, the antibody part acts like a homing device, bringing the chemo directly to the cancer cells.
There are several types of ADCs that target different proteins on breast cancer cells.
ADCs that target the HER2 protein include:
- Ado-trastuzumab emtansine (Kadcyla)
- Fam-trastuzumab deruxtecan (Enhertu)
ADCs that target the Trop-2 protein include:
- Sacituzumab govitecan (Trodelvy)
- Datopotamab deruxtecan (Datroway)
See Targeted Therapy for Breast Cancer in Men for more about these drugs.
How is chemotherapy given?
Most chemo drugs for breast cancer are given into a vein (IV), either as an injection over a few minutes or as an infusion over a longer period. This can be done in a doctor’s office, infusion center, or in a hospital setting.
Often, your cancer care team will suggest placing a port, also called a central venous catheter or CVC. A CVC is put into a large vein in the chest or arm. For people with breast cancer, it’s typically placed on the opposite side of the affected breast. It stays in as long as you’re getting treatment so you won’t need to be stuck with a needle each time you need treatment or tests.
Chemo is given in cycles, with each treatment period followed by a rest period to give your body time to recover. Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it might be given 1 day a week for a few weeks or every other week. Then, at the end of the cycle, the schedule of chemo repeats to start the next cycle.
Adjuvant and neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. Treatment is often longer for advanced breast cancer, depending on how well it is working and what side effects you have.
Dose-dense chemotherapy
Doctors have found that giving the cycles of certain chemo drugs closer together can lower the chance of cancer coming back and improve survival in some people with breast cancer. For example, a drug that would normally be given every 3 weeks might be given every 2 weeks. A drug called a growth factor is often given after the chemo to help make sure the white blood cell count returns to normal in time for the next cycle.
This approach can be used for both adjuvant and neoadjuvant chemo. It can lead to more problems with low blood counts, though, so dose-dense chemo isn’t right for everyone.
Possible side effects of chemotherapy
Side effects of chemo depend on the type and dose given and the length of treatment.
Some of the most common side effects include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Diarrhea
Chemo can affect the blood-forming cells of the bone marrow, which can lead to:
- Increased chance of infections (from low white blood cell counts)
- Easy bruising or bleeding (from low blood platelet counts)
- Fatigue (from low red blood cell counts or other reasons)
These side effects usually go away after treatment is finished. Let your cancer care team know if you have any side effects, because there are often ways to lessen them. For example, drugs can be given to help prevent or reduce nausea and vomiting.
Several other side effects are also possible. Some of these are only seen with certain chemo drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting.
Many drugs used to treat breast cancer, including taxanes (docetaxel and paclitaxel), platinum drugs (carboplatin and cisplatin), vinorelbine, eribulin, and ixabepilone, can damage nerves in the hands, arms, feet, and legs. This can lead to numbness, pain, burning or tingling sensations, sensitivity to cold or heat, or weakness.
Peripheral neuropathy often goes away once treatment is stopped, but for some it might last a long time. Talk to your cancer care team about ways to prevent or manage these effects.
Doxorubicin, epirubicin, and some other drugs can damage the heart (called cardiomyopathy). The risk is higher if the drug is used for a long time or in high doses, or if other drugs that can cause heart damage (such as drugs that target HER2) are also being given.
Doctors typically check your heart function with a test like an echocardiogram (an ultrasound of the heart) or a MUGA scan before starting one of these drugs. They also carefully control the doses, watch for symptoms of heart problems, and may repeat the heart test during treatment. If heart function begins to worsen, these drugs will be temporarily or permanently stopped. Still, in some people, signs of damage might not appear until months or years after treatment stops.
Certain chemo drugs, such as capecitabine and liposomal doxorubicin, can irritate the palms of the hands and the soles of the feet. This is called hand-foot syndrome.
Early symptoms can include numbness, tingling, and redness. If it gets worse, the hands and feet can become swollen, uncomfortable, or even painful. The skin may blister and peel. There is no specific treatment, although some creams or steroids given before chemo may help. These symptoms gradually get better when the drug is stopped or the dose is lowered.
The best way to prevent severe hand-foot syndrome is to tell your doctor when symptoms first come up, so that the drug dose can be changed or other medications can be given.
There is very little research on chemo brain in men, but many women being treated for breast cancer report a slight decrease in mental functioning. There may be some long-lasting problems with concentration and memory.
Although many women have linked this to chemo, it also has been seen in women who did not get chemo as a part of their treatment.
In studies of chemo brain as a side effect of treatment, the symptoms most often go away within a few years. Even though most research has been done in women, there's no reason to expect this to be any different in men being treated for breast cancer.
Very rarely, certain chemo drugs can cause diseases of the bone marrow such as a myelodysplastic syndrome or even acute myeloid leukemia, a cancer of white blood cells. When this happens, it is usually within 10 years of treatment. For most men, though, chemo's benefits of helping to prevent breast cancer from coming back or extending life likely far exceed the risk of this serious but rare complication.
Many people do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These may be very subtle changes that happen slowly over time.
Fatigue is often another common problem for those who have had chemo. This may last up to several years. It can often be helped, so it is important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have problems with sleep, these can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
More information about chemotherapy
For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
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- References
Developed by the P站视频 medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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National Cancer Institute. Male Breast Cancer Treatment (PDQ?)–Health Professional Version. 2024. Accessed at https://www.cancer.gov/types/breast/hp/male-breast-treatment-pdq on July 23, 2025.
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Last Revised: October 15, 2025
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