Herceptin and tamoxifen for male breast cancer – pro

Male breast cancer is rare. Less than 1% of all breast carcinomas occur in men.The pathology is similar to that of female breast cancer, and infiltrating ductal cancer is the most common tumor type.Intraductal cancer has been described as well. Inflammatory carcinoma and Paget disease of the nipple have also been seen in men, but lobular carcinoma in situ has not. Lymph node involvement and the hematogenous pattern of spread are similar to those found in female breast cancer. The TNM staging system for male breast cancer is identical to the staging system for female breast cancer.

Male breast cancer is usually treated the same as female brest cancer. Because it is rare, the assumption that male breast cancer should be treated the same as female breast cancer, has never been scientifically studies. Male breast cancer responds well to hormonal treatments.Hormonal therapy, chemotherapy, or a combination of both have been used with some success. Initially, hormonal therapy is recommended.

Tamoxifen with Herceptin may be synergistic and research in this area is continuing.Most of teh work is preclincial at this time but severa; pahse II studies ahve been eprformed and pahse III trials are initiated. Taken together the evidence suggests that targeted non-chemotherapeutic combinations of trastuzumab with hormonal therapy, which are currently being studied in large-scale clinical trials, represent active cancer therapy, allowing the individualisation of treatment based on tumour characteristics but remain experimental, especially for male breast cancer at this time.

Giordano SH, Buzdar AU, Hortobagyi GN: Breast cancer in men. Ann Intern Med 137 (8): 678-87, 2002.

Giordano SH: A review of the diagnosis and management of male breast cancer. Oncologist 10 (7): 471-9, 2005

Athanassios Argiris, Chun-Xia Wang, Steve G. Whalen and Michael P. DiGiovanna
Synergistic Interactions between Tamoxifen and Trastuzumab (Herceptin) Clinical Cancer Research Vol. 10, 1409-1420, February 2004

A. Vazquez-Martin, R. Colomer, S. Ropero, J. Abel Menendez, A. Argiris, C.-X. Wang, D. C. Koay, and M. P. DiGiovanna
Growth and Molecular Interactions between Tamoxifen and Trastuzumab
Clin. Cancer Res., May 1, 2005; 11(9): 3597 – 3597.

A. Jones Combining trastuzumab (Herceptin®) with hormonal therapy in breast cancer: what can be expected and why? Annals of Oncology 14:1697-1704, 2003

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