Phil had no idea men could get breast cancer. His diagnosis felt ‘like a tonne of bricks’

Until a few months ago, Phil Smith had no idea men could get breast cancer.

Phil, 64, of the NSW Central West town of Parkes, was blissfully unaware the blood stains on his shirt were a sign of the insidious disease. Thankfully, his wife Donna knew men could also be afflicted with it and urged him to get checked – something that may well have saved his life.

It was Donna who first noticed the pinprick-sized spot on his white undershirt in December 2025.

“It was right where my nipple is, and that happened over a period of a couple of days,” Phil told nine.com.au.

Donna became more concerned when she noticed drops of blood on their bedsheets and urged Phil to get checked.

“She told me to go and get it checked and I laughed. I said, ‘Don’t be silly. Men don’t get breast cancer’.”

With it taking weeks to get into a GP in Parkes, Donna encouraged her husband to mention the bloodstains to his rheumatologist during a check-up a few weeks later.

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Despite there being no lump or pain on examination, the doctor thought it was “strange” and wrote a referral for an ultrasound.

“The lady that did the ultrasound said there is a very small dot at nine o’clock behind my nipple,” Phil said.

She assured him it could be a couple of things, including a small blood clot, and with Christmas approaching, he had to wait until the New Year to get the results.

“I would be lying if I said it was out of my mind,” Phil said.

Then in early January came a call from Phil’s rheumatologist telling him he had arranged for him to see a surgeon straight away. The surgeon in turn asked him to have more tests, including another ultrasound, a mammogram and a needle biopsy, which he had the same day.

Despite the urgency, Phil was convinced it wouldn’t be anything serious. Two weeks later he returned to the surgeon and was told he had breast cancer.

“It was like a tonne of bricks falling on you,” he recalled.

“Then looking over at my wife and looking at her face, it made me feel even worse.”

With tests showing he had a type of breast cancer known as ductal cancer in situ, the surgeon wanted to operate straight away, but the couple, their four children and three grandchildren were weeks away from a once-in-a-lifetime trip to the US they had been planning for a year.

Going would delay the surgery by two months, but after taking a few days to think about it, and against medical advice, Phil decided to proceed with the trip and have the surgery when he got home.

Two days after returning, he underwent a mastectomy. He was meant to spend one night in hospital, but complications arose.

Male mastectomies can be more difficult because of a lack of breast tissue. In Phil’s case, he suffered internal bleeding.

He collapsed after suffering dangerously low blood pressure and required a second emergency surgery, during which 800ml of blood was drained from his chest. 

He finally went home after four days, but a nurse had to come every day to empty a drain that remained in place for 20 days.

Six weeks after the surgery, Phil returned for his results and learned the cancer had grown rapidly in the two months between diagnosis and surgery.

His cancer was classified as stage 3 aggressive, hormone-receptive breast cancer, but luckily, it had not spread to his lymph nodes, and he did not require chemotherapy or radiotherapy.

Instead, he was placed on Tamoxifen to lower his oestrogen levels. He will stay on the medication for at least five years.

Phil also underwent genetic screening for 17 genes linked to cancer. He learned this month he tested positive for the BRCA2 gene, which increases the risk of developing some cancers, including breast, ovarian, prostate and pancreatic cancer.

“It’s a bit of worry, too, because I lost a brother when he was 55 from pancreatic cancer,” Phil said,

He will now undergo monitoring for prostate and pancreatic cancer, on top of the three-month check-ups to ensure the breast cancer doesn’t recur.

It also means there is a 50-50 chance Phil has passed the gene to his children, meaning they will also have to be tested.

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Despite what he has gone through, as well as the monetary and physiological impacts of battling cancer in regional Australia – including up to 75-minute-each-way trips to the larger towns of Dubbo and Orange for tests and treatment – and large out-of-pocket expenses, Phil counts himself lucky his cancer was found before it spread.

He now wants to spread awareness and warn other men not to be complacent with their health.

Apart from the discharge from his nipple, he had no other symptoms; no pain, no lump and his nipple didn’t look any different.

“I think the biggest thing I did was bury my head in the sand [because] I’ve never known a male that had breast cancer,” he said.

“But now I know. It doesn’t happen often, but it does happen. If you’re not sure, get it checked. It’s not hard to do.”

During his treatment, Phil was supported by McGrath Foundation Breast Care Nurse Dianne Green, who services the Parkes area.

Breast Care Nurses provide free clinical and emotional and psychosocial support to people diagnosed with breast cancer and their families.

Dianne answered worried calls and emails from the couple “at all times of the day and night”. 

After he recovered, she even arranged for him to attend a fishing trip with other breast cancer patients: “I was the only male.”

Dianne told Phil she had only seen four cases of breast cancer in men in her 20 years as a McGrath breast care nurse.

In fact, breast cancer in men is so rare, it only accounts for 1 per cent of cases, according to leading breast cancer charity and research organisation, Breast Cancer Trials.

Of the 20,336 new cases of breast cancer diagnosed in Australia in 2025, 207 were men. Half of all male breast cancer cases are diagnosed later, at stages 3 or 4, meaning poorer outcomes.

Just last week, Canadian-born actor and former professional wrestler Tyler Mane announced his own diagnosis via Instagram.

“I’ll be honest, my first reaction was to keep it secret. I mean, it’s kind of embarrassing,” the X-Men star shared.

“But then I found out that men are more likely to be diagnosed in advanced stages because it’s not talked about and not looked for.

“In fact, my doctors all dismissed it and it was only because my wife pushed me to get the lump removed that I got in early.”

Mane, 59, is now undergoing chemotherapy.

Breast Cancer Trials medical adviser and oncologist Dr Nick Zdenkowski said breast cancer in men was considered a rare condition, affecting about 220 Australian men every year.

“This equates to about 1 per cent of all breast cancer diagnoses,” he told nine.com.au.

“Breast cancer in men is more often diagnosed at a later stage compared with women.

“This is because there is less awareness about it, and men may not self-examine, or they may notice a lump but assume that it is nothing to be worried about.

“The other reason for later diagnosis is that there is no screening program for men.”

Zdenkowski said signs of breast cancer in men were similar to women and included an abnormal lump, nipple discharge, persistent skin redness, nipple inversion, or lumps under the arm.

“It may occur in any breast cancer subtype, but compared with women, it is more likely to be hormone sensitive (oestrogen-receptor positive) and HER2 negative,” he said.

“Any man with breast cancer should have genetic testing to see if it is an inherited form, as this is more likely to be the case compared with women.”

Zdenkowski said treating men’s breast cancer with surgery could be more difficult due to the smaller amount of breast tissue and larger breast tumours at diagnosis, making it hard for surgeons to achieve clear margins.

“Surgery to the male breast can lead to asymmetry and embarrassment about appearance,” he said.

“Reconstruction is not well established for men and lumpectomy surgery is infrequently used.” 

Zdenkowski said a major challenge around male breast cancer was the stigma associated with it being considered a “women’s cancer”.

“Having a well-known figure such as Tyler Mane going public is helpful in destigmatising this condition,” he said.

“Some men feel reluctant to bring their symptoms to medical attention, and then even after diagnosis they may be reluctant to talk about it, which then perpetuates the stigma and lack of awareness.

“This can all have a major negative impact on men’s mental health.”

While Phil praised the healthcare professionals involved in his diagnosis and treatment, he said it was Donna who deserved the most thanks.

“If it wasn’t for Donna, I would never have worried about it,” he said.

“They said it was aggressive. If I would have left it for six months, who knows?”