Male Breast Cancer
To plan treatment, your doctor will consider your age and general health, as well as the size of the tumor, its biomarker status (ER, PR, HER2), the stage of the cancer and genetic markers present, such as BRCA1 and BRCA2 mutations, and the results of genomic testing. Then, together, you and your doctor will define your treatment goals.
Surgery is the most common treatment for most breast cancers.
One of the most performed surgeries for men is a modified radical mastectomy. This includes the removal of the breast, many underarm lymph nodes, the lining over the chest muscles and sometimes part of the muscles in the chest wall.
A lumpectomy is also commonly used. This surgery removes the tumor along with a small margin of normal-appearing tissue around it. A lumpectomy is usually followed by radiation therapy, which is designed to kill microscopic cancer cells hiding in other parts of the breast.
Axillary lymph node surgery is usually necessary to stage the cancer or to control cancer that has spread to the nodes. Most men will undergo an initial staging procedure called a sentinel lymph node biopsy of their lymph nodes at the same time as their breast surgery. If the sentinel nodes contain cancer cells, sometimes a more extensive operation to remove additional tissue from the underarm may be necessary. This is called an axillary lymph node dissection.
Radiation therapy is almost always delivered after lumpectomy to destroy cancer cells that may be hidden in normal-appearing breast tissue. Research shows that a person with a small tumor who has radiation therapy after a lumpectomy has a similar survival rate and risk of recurrence as someone who has a mastectomy.
Post-mastectomy radiation therapy is sometimes necessary. For those patients with a high risk of the cancer growing back on the chest wall area (after mastectomy and/or axillary surgery), radiation can lower this risk. Radiation therapy may also be used to control symptoms from specific areas of cancer involvement, such as bone or brain metastases.
Chemotherapy may be used as neoadjuvant (preoperative) therapy to shrink a large, bulky tumor so it can be removed surgically, or it may be offered to reduce the tumor’s size so that a patient can have more surgical options. Neoadjuvant chemotherapy also offers the advantage of helping your doctor determine how well the chemotherapy drugs work against the tumor and identify whether additional therapy is needed post-operatively. Adjuvant (after surgery) chemotherapy is given to destroy cancer cells that may remain in the body (hiding in other organs such as the liver, lungs or bones). Some cancer cells may be too small to detect with laboratory testing or on imaging studies.
Targeted therapy is given orally in pill form or intravenously (IV) into a vein in your arm. It may be given alone or in combination with other drug therapies. It may be used as neoadjuvant or adjuvant therapy. Some patients will be candidates for extended adjuvant therapy, which is designed to further reduce the risk of recurrence.
Hormone therapy may be used depending on the stage of the cancer. Men who have breast cancer should not receive testosterone or additional androgens. Types of hormone therapy that may be used include aromatase inhibitors and luteinizing hormone-releasing hormone (LHRH) analogs. Men who have hormone receptor-positive breast cancer may receive hormonal therapy for at least 5 and up to 10 years. Your doctor will discuss how long you should continue hormone therapy after considering the stage of cancer, the risk of it returning and any side effects you have.
Immunotherapy may be given intravenously (IV) to stimulate the body’s own immune system to treat certain breast cancers.
Bone-modifying drugs are typically used when the cancer has metastasized to the bone.
Clinical trials that examine new types of therapy may be another treatment option.
|Commonly Used Medications|
|Some Possible Combinations|
As of 1/27/23