Oncotype for male breast cancer – pro

Male breast cancer has a much poorer stage for stage prognosis as compared to female breast cancer. The mainstay of therapy is hormonal. 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. There are no accepted guidelines on adjuvant therapy.

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. In any case, this member has HER negative cancer.

Use of Oncotype to make decisions is not validated for male breast cancer and there have been no males included in any Oncotype study to my knowledge. There was one 2009 abstract that llooked at cases of male breast cancer with Oncotype and concluded: “This large genomic study of male BC reveals a heterogeneous biology as measured by the standardized quantitative oncotype DX breast cancer assay, similar to that observed in female BC. Some differences, which may reflect the differences in hormone biology between males and females, were noted and deserve further study.” This remains preliminary, however.

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.

S. Shak, G. Palmer, F. L. Baehner, C. Millward, D. Watson, G. W. Sledge; Genomic Health, Redwood City, CA; Indiana University School of Medicine, Indianapolis, Molecular characterization of male breast cancer by standardized quantitative RT-PCR analysis: First large genomic study of 347 male breast cancers compared to 82,434 female breast cancers. J Clin Oncol 27:15s, 2009 (suppl; abstr 549)

Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006;367:595-604.

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