Treatment of early, localized, or operable breast cancer may include the following:
Initial Surgery
Treatment for men diagnosed with breast cancer is usually modified radical mastectomy.
Breast-conserving surgery with lumpectomy followed by radiation therapy may be used for some men.
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 targeted 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.
Hormone therapy with tamoxifen (to block the effect of estrogen) or less often, aromatase inhibitors (to reduce the amount of estrogen in the body).
Targeted therapy with a monoclonal antibody (trastuzumab or pertuzumab).
For men with locally recurrent disease (cancer that has come back in a limited area after treatment), treatment options include:
Radiation therapy combined with chemotherapy.
Treatment of Metastatic Male Breast Cancer
Treatment options for metastatic breast cancer (cancer that has spread to distant parts of the body) may include the following:
Hormone therapy
In men who have just been diagnosed with metastatic breast cancer that is hormone receptor-positive or if the hormone receptor status is not known, treatment may include:
Aromatase inhibitor therapy (anastrozole, letrozole, or exemestane) with or without an LHRH agonist. Sometimes cyclin-dependent kinase inhibitor therapy (Palbociclib) is also given.
In men whose tumors are hormone receptor-positive or hormone receptor unknown, with spread to the bone or soft tissue only, and who have been treated with tamoxifen, treatment may include:
Aromatase inhibitor therapy with or without LHRH agonist.
Other hormone therapies such as megestrol acetate, estrogen or androgen therapy, or anti-estrogen therapy such as fulvestrant.
Targeted therapy
In men with metastatic breast cancer that is hormone receptor-positive and has not responded to other treatments, options may include targeted therapy such as:
Antibody-drug conjugate therapy with ado-trastuzumab emtansine.
Cyclin-dependent kinase inhibitor therapy (Palbociclib) combined with letrozole.
In men with metastatic breast cancer that is HER2/neu positive, treatment may include:
Targeted therapy such as trastuzumab, pertuzumab., ado-trastuzumab emtansine, or lapatinib.
Chemotherapy
In men with metastatic breast cancer that is hormone receptor negative, has not responded to hormone therapy, has spread to other organs, or has caused symptoms, treatment may include:
Chemotherapy with one or more drugs.
Surgery
Total mastectomy for men with open or painful breast lesions. Radiation therapy may be given after surgery.
Surgery to remove cancer that has spread to the brain or spine. Radiation therapy may be given after surgery.
Surgery to remove cancer that has spread to the lung.
Surgery to repair or help support weak or broken bones. Radiation therapy may be given after surgery.
Surgery to remove fluid that has collected around the lungs or heart.
Radiation therapy
Radiation therapy to the bones, brain, spinal cord, breast, or chest wall to relieve symptoms and improve quality of life.
Strontium-89 (a radionuclide) to relieve pain from cancer that has spread to bones throughout the body.
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