Man, 64, Diagnosed with Stage 3 Breast Cancer After Wife Spots Bloodstains; Men Can Get Breast Cancer, Doctors Warn

A 64-year-old Australian man was diagnosed with stage 3 aggressive breast cancer after his wife noticed tiny bloodstains on his undershirt and bedsheets. Phil Smith of Parkes, New South Wales, initially dismissed her concerns, saying he did not believe men could get breast cancer.

In December 2025, Smith’s wife, Donna, saw a bloodstain on his white undershirt, followed by drops of blood on their sheets. She urged him to get checked, but he laughed it off. Because it would take weeks to see a general practitioner, she convinced him to mention the bleeding at a scheduled rheumatologist appointment. The doctor found the symptom unusual and referred him for an ultrasound.

The ultrasound revealed “a very small dot at nine o’clock behind my nipple,” Smith recounted. Further tests, including a mammogram and needle biopsy, led to a diagnosis of ductal carcinoma in situ (DCIS), a non-invasive form of breast cancer. Doctors recommended immediate surgery.

Smith and his family were weeks away from a planned vacation to the United States. He decided to postpone surgery for about two months to take the trip, against medical advice. Two days after returning home, he underwent a mastectomy. The procedure was followed by serious complications: internal bleeding caused his blood pressure to drop dangerously low, requiring emergency surgery to drain about 800 milliliters of blood from his chest. He remained in the hospital for four days and then had a surgical drain for 20 more days.

Six weeks later, doctors told Smith the cancer had grown rapidly during the delay and was reclassified as stage 3 aggressive, hormone receptor-positive breast cancer. Fortunately, it had not spread to his lymph nodes, so he did not require chemotherapy or radiation. Instead, he began taking tamoxifen, a medication he will remain on for at least five years.

Genetic testing later revealed that Smith carries the BRCA2 gene mutation, which increases the risk of several cancers, including breast, prostate, and pancreatic cancer. His brother died of pancreatic cancer at age 55. Smith will now undergo ongoing screening for prostate and pancreatic cancer. His diagnosis also means each of his four children has a 50 percent chance of inheriting the mutation.

According to the Cleveland Clinic, one out of every 100 breast cancer diagnoses affects males. Smith urges other men to be vigilant: “I’ve never known a male that had breast cancer. But now I know. It doesn’t happen often, but it does happen. If you’re not sure, get it checked.”

Meanwhile, advances in precision medicine are transforming breast cancer care, allowing doctors to tailor treatment according to the biology of each tumour and the patient’s overall health. Treatment is no longer determined solely by disease stage. Tumour samples are now tested for key biomarkers, including oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67, a marker of how quickly cancer cells are growing. These biomarkers classify breast cancers into subtypes such as hormone receptor-positive, HER2-positive, and triple-negative disease, and guide treatment decisions.

For hormone receptor-positive breast cancer — the type Smith had — hormone therapy or targeted therapy can be offered instead of chemotherapy. Patient factors, such as age, fitness, and other medical conditions, are also weighed. For example, a patient with severe heart disease or poorly controlled diabetes may not be a candidate for certain treatments, while an older but otherwise healthy patient might still be suitable for intensive therapies.

Beyond biomarker testing, genomic testing can analyze cancer cell genes. Cancer cells are sent to a specialized laboratory in the United States for analysis, and a risk score is generated to predict whether chemotherapy is likely to benefit the patient. Some patients, including those with stage two breast cancer and lymph node involvement, may not require chemotherapy if testing shows low risk. This testing is becoming more accessible and is sometimes covered by insurance.

Surgical approaches are also becoming more personalized. The decision between breast-conserving surgery (lumpectomy) and mastectomy depends on the tumour size relative to breast size, as well as the number and location of tumours. Patients with multiple tumours in different areas may need a mastectomy. Tumour biology — grade, receptor status, and aggressiveness — helps determine whether additional treatment such as chemotherapy or radiation should take priority over reconstruction.

Patients who carry inherited mutations like BRCA2 associated with a higher risk of breast cancer may be advised to consider risk-reducing surgery, including removal of both breasts followed by immediate reconstruction.