Initial Surgery
Adjuvant Therapy
Distant Metastases

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

Treatment for men diagnosed with breast cancer is usually modified radical mastectomy. Breast-conserving surgery with lumpectomy may be used for some men.

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).

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.

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