Male Breast Cancer Treatment

by National Cancer Institute

(Page 2 of 2)

There are different types of treatment for men with breast cancer.

Different types of treatment are available for men with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Four types of standard treatment are used to treat men with breast cancer:

Surgery

Surgery for men with breast cancer is usually a modified radical mastectomy (removal of the breast, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes part of the chest wall muscles).

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

New types of treatment are being tested in clinical trials. These include the following:

Monoclonal antibodies as adjuvant therapy

Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies are also used in combination with chemotherapy as adjuvant therapy (treatment given after surgery to increase the chances of a cure).

Trastuzumab (Herceptin) is a monoclonal antibody that blocks the effects of the growth factor protein HER2.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options for Male Breast Cancer

Breast cancer in men is treated the same as breast cancer in women. (See the PDQ summary on Breast Cancer Treatment 4 for more information.)

Initial Surgery

Treatment for men diagnosed with breast cancer is usually modified radical mastectomy.

Adjuvant Therapy

Therapy given after an operation when cancer cells can no longer be seen is called adjuvant therapy. Even if the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given radiation therapy, chemotherapy, hormone therapy, and/or monoclonal antibody therapy after surgery to try to kill any cancer cells that may be left.

Node-negative: For men whose cancer is node-negative (cancer has not spread to the lymph nodes), adjuvant therapy should be considered on the same basis as for a woman with breast cancer because there is no evidence that response to therapy is different for men and women.

Node-positive: For men whose cancer is node-positive (cancer has spread to the lymph nodes), adjuvant therapy may include the following:

• Chemotherapy plus tamoxifen (to block the effect of estrogen).
• Other hormone therapy.
• A clinical trial of trastuzumab (Herceptin).

These treatments appear to increase survival in men as they do in women. The patient's response to hormone therapy depends on whether there are hormone receptors (proteins) in the tumor. Most breast cancers in men have these receptors. Hormone therapy is usually recommended for male breast cancer patients, but it can have many side effects, including hot flashes and impotence (the inability to have an erection adequate for sexual intercourse).

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Distant Metastases

Treatment for men with distant metastases (cancer that has spread to other parts of the body) may be hormone therapy, chemotherapy, or both. Hormone therapy may include the following:

• Orchiectomy (the removal of the testicles to decrease hormone production).
• Luteinizing hormone-releasing hormone agonist with or without total androgen blockade (to decrease the production of sex hormones).
• Tamoxifen for cancer that is estrogen-receptor positive.
• Progesterone (a female hormone).
• Aromatase inhibitors (to lessen the amount of estrogen produced).

Hormone therapies may be used in sequence (one after the other). Standard chemotherapy regimens may be used if hormone therapy does not work. Men usually respond to therapy in the same way as women who have breast cancer.

Treatment Options for Locally Recurrent Male Breast Cancer

For men with locally recurrent disease (cancer that has come back in a limited area after treatment), treatment is usually either:

• surgery combined with chemotherapy; or
• radiation therapy combined with chemotherapy.

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