Male breast cancer is a rare disease, accounting for less than 1% of all breast cancer diagnoses worldwide. Most data on male breast cancer comes from small single-institution studies, and because of the paucity of data, the optimal treatment for male breast cancer is not known. In general, treatments that are sued for female breast cancer are also appropriate to use for female breast cancer, except that it is known that male breast cancer is almost always hromonally responsive. Tamoxifen is standard of care for male breast cancer. Hormonal therapy, chemotherapy, or a combination of both have been used with some success. Initially, hormonal therapy is recommended.
Hormonal modalities include:
Luteinizing hormone-releasing hormone agonist with or without total androgen blockage (antiandrogen).
Tamoxifen for estrogen receptor–positive patients.
Hormonal therapies may be used sequentially. Standard chemotherapy combinations of CMF and CAF are recommended after failure of hormonal therapy. Responses are generally similar to those seen in women with breast cancer. Use of Herceptin was played up in the media in high profile cases but is not well supported by credible literature.
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N. Pemmaraju et al, Retrospective review of male breast cancer patients: analysis of tamoxifen-related side-effects Ann Oncol Jun 1, 2012:1471-1474
Larissa A. Korde
et al, Multidisciplinary Meeting on Male Breast Cancer: Summary and Research Recommendations JCO April 20, 2010 vol. 28 no. 12 2114-2122