Men represent 1% of all breast cancer (BC) diagnoses, which means that most treatments and services offered in oncology have been based on women's (biological sex) experiences. However, a comprehensive framework of how breast cancer is experienced by men is lacking. This systematic review and metasynthesis aims to synthesize studies documenting men's breast cancer narratives into an empirically based explanatory framework, as well as to compare experiences across the two sexes. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, six databases were searched to identify studies on men's breast cancer narratives. The narratives were synthesized and analyzed using an interpretative technique which allows elucidating more refined meanings, explanatory theories, and new concepts. Our final sample included 38 qualitative and mixed-method studies from North America, Europe, Israel, Australia, and New Zealand, comprising 586 participants. The narratives highlighted 14 themes: being identified as a mutation carrier, being in the health care system, bearing the burden of breast cancer, contested masculinity, existential ordeal, illness avoidance behaviors, lack of male breast cancer knowledge, receiving femalefocused treatments and services, altered self-image, self in relation to others, source support, stigma of living with a "woman's disease," survivor identity, and symptom and illness appraisal. The proposed Trajectory of Male Breast Cancer framework provides an empirical basis to draw from for service provision and future oncology research (PROSPERO: CRD42022310411).
Public Significance StatementSmit et al.'s (2019) Trajectory of Breast Cancer (TBC) framework was developed to better understand the experience of women living with breast cancer through the trajectory, but male breast cancer has not been considered. The proposed Trajectory of Male Breast Cancer (TMBC) framework is adapted for men living with breast cancer and helps explain how men live with the disease from screening to survivorship. This new theoretical framework is an important step toward understanding men living with breast cancer and improving health and mental health services.