Men with breast cancer and their encounters with masculinity: An interpretative phenomenological analysis using photography.

Abstract

Underacknowledged clinically and socially, breast cancer in men is a critical health issue, with complex ramifications for those affected. Experiential research exploring men's meaning making of breast cancer accordingly is scant. In this innovative multimethod inquiry, 31 British men, accessed from both clinical care and community contexts, took photographs to illustrate their breast cancer experiences and discussed these in extended semistructured interviews. Verbal and photographic data were analyzed together using interpretative phenomenological analysis through the emerging "visual voice" paradigm. Findings illuminated both the multiple difficulties men encountered and the coping strategies they employed. In particular, the complex and dynamic ways in which men navigated, made sense of, and performed masculinity through their breast cancer journey was pivotal to understanding these experiences and how they presented their accounts, verbally and visually. Thus, the analysis presented identifies and illustrates three experiential and interconnected encounters with masculinity: "Threatened-exposed," "Protected-asserted," and "Reconsidered-reconfigured" which are presented both thematically and through a novel schematic representation. We demonstrate how men's relationship with masculinity shapes their accounts of both the embodied lived experience of breast cancer and how the cancer experience, with its many changes, challenges, and consequences, is communicated to others. How and why men encounter/perform these different masculinities at different points in time across the breast cancer trajectory, and how this aids their adjustment to illness and life postdiagnosis is considered. We conclude with recommendations for improved future breast cancer care and support and suggest future research directions with this community of hitherto underresearched and underrepresented men. Public Significance StatementBreast cancer is the most common type of cancer in the U.K. and is responsible for proportionally more male deaths annually than some male-specific cancers, for example, testicular cancer. Yet, the illness in men remains poorly understood, especially men's lived breast cancer experiences. The findings of this study reveal the multiple difficulties men encounter and the coping strategies they employ relative to a breast cancer diagnosis, demonstrating the complex and dynamic ways in which men navigate, make sense of, and perform masculinities through their breast cancer journey, and the centrality of this to their experiences. Understanding how men experience breast cancer serves to improve future breast cancer care and support for affected men.

A scar for life: Male breast cancer and the experience of the post-surgical body.

“…In light of the study’s topic, which could potentially pose a threat to a man’s masculinity, we believed that with a female interviewer, men would at least be spared the potential threat of being interviewed by another (potentially perceived healthy and masculine) man interviewing them. This notion was also endorsed by Quincey, 2017. Interviews took place from May to November 2018 and from April to October 2019, and the interview location was based on participants’ requests.…”

“…Although the surgical treatment for MBC alters men’s upper bodies and leaves men without a nipple and areola, and with a surgical scar and chest asymmetry (Al-Kalla et al, 2014), no study till date has focused solely on men’s bodily experience following surgical treatment for breast cancer. Body image issues have been raised within participants’ references to their MBC experience, but only as one among many other aspects of their illness experience (Donovan & Flynn, 2007; France et al, 2000; Iredale et al, 2006; Naymark, 2006; Pituskin et al, 2007; Quincey, 2017; Quincey et al, 2021; Rayne et al, 2017; Thompson & Haydock, 2020; Williams et al, 2003). In addition, these references have not been uniform.…”

“…In addition, these references have not been uniform. A few findings have indicated that some men are not bothered by their postmastectomy body disfigurement (Pituskin et al, 2007; Quincey, 2017; Quincey et al, 2021; Rayne et al, 2017; Thompson & Haydock, 2020) and even report feeling pride in their surgical scar, describing it as representing their successful battle against breast cancer (Pituskin et al, 2007; Thompson & Haydock, 2020). Furthermore, two studies that directly assessed participants’ postmastectomy-related body image concerns, among other aspects of their MBC experience, also revealed that most men did not feel that their body image was affected or challenged (Rayne et al, 2017; Thompson & Haydock, 2020).…”

“…Furthermore, two studies that directly assessed participants’ postmastectomy-related body image concerns, among other aspects of their MBC experience, also revealed that most men did not feel that their body image was affected or challenged (Rayne et al, 2017; Thompson & Haydock, 2020). Other references, however, reveal that the physical change caused by a mastectomy may have detrimental effects on men’s body image (Donovan & Flynn, 2007; France et al, 2000; Halls, 2003; Iredale et al, 2006; Naymark, 2006; Pituskin et al, 2007; Quincey, 2017; Quincey et al, 2021; Sime, 2012; Williams et al, 2003). The abovementioned findings imply that breast cancer surgery may disrupt men’s body image.…”

“…In addition to these medical-related Israeli data, the sociocultural aspects of masculinity must also be considered. That is, given that being diagnosed with MBC can challenge men's masculine identity (Quincey et al, 2016(Quincey et al, , 2021, it is important to take into account the construction of Israeli masculinity and the ideal Israeli masculine body.…”