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Male Breast Cancer Treatment (PDQ®)
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General Information about Male Breast Cancer
Key Points:
Male breast cancer is a disease in which malignant (cancer)
cells form in the tissues of the breast.
Breast cancer may occur in
men. Men at any age may develop breast cancer, but it is usually detected
(found) in men between 60 and 70 years of age. Male breast cancer makes up less
than 1% of all cases of breast cancer.
The following types of breast cancer are found in men:
Lobular carcinoma in
situ (abnormal cells found in one of the
lobes or sections of the breast),
which sometimes occurs in women, has not been seen in men.
Radiation exposure, high levels of estrogen, and a family
history of breast cancer can increase a man’s risk of developing breast cancer.
Anything that increases your risk of getting a disease is called a risk factor. Risk factors for breast
cancer in men may include the following:
Male breast cancer is sometimes caused by inherited gene
mutations (changes).
The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups.
Men who have an altered gene related to breast cancer have an increased risk of developing this disease.
Tests have been developed that can detect altered genes. These genetic tests are sometimes done for members of families with a high risk of cancer. See the following PDQ summaries for more information:
- Genetics of Breast and Ovarian Cancer
- Prevention of Breast Cancer
- Screening for Breast Cancer
Men with breast cancer usually have lumps that can be felt.
Lumps and other symptoms may be caused by male breast cancer. Other conditions may cause the same symptoms. A doctor should be seen if changes in the breasts are noticed.
Tests that examine the breasts are used to detect (find) and diagnose breast cancer in men.
The following tests and procedures may be used:
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Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The following are different types of biopsies:
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Needle biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a fine-needle aspiration
biopsy.
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Core
biopsy: The removal of part of a lump or suspicious tissue using a wide needle.
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Excisional
biopsy: The removal of an entire lump or suspicious tissue.
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Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out whether estrogen and progesterone could affect the way cancer grows. The test results show whether hormone therapy may stop the cancer from growing.
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HER2 test: A test to measure the amount of HER2 in cancer tissue. HER2 is a growth factor protein that sends growth signals to cells.
When cancer forms, the cells may make too much of the protein, causing more cancer cells to grow. If cancer is found in the breast, tissue from the tumor is checked in the laboratory to find out if there is too much HER2 in the cells. The test results show whether monoclonal antibody therapy may stop the cancer from growing.
Survival for men with breast cancer is similar to survival for
women with breast cancer.
Survival for men with breast cancer is similar to that for women
with breast cancer when their stage
at diagnosis is the same. Breast
cancer in men, however, is often diagnosed at a later stage. Cancer found at a
later stage may be less likely to be cured.
Certain factors affect prognosis
(chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on
the following:
- The stage
of the cancer (whether it is in the breast only or has spread to other places
in the body).
- The type of breast cancer.
- Estrogen-receptor and progesterone-receptor levels in the tumor tissue.
- Whether the cancer is also found in the other breast.
- The patient’s age
and general health.
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Stages of Male Breast Cancer
After breast cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the breast or to other parts of
the body. This process is called staging.
The information gathered from the
staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Breast cancer in men is staged
the same as it is in women. (See the PDQ summary on
Breast Cancer Treatment
for more information.) The spread of cancer from the breast to
lymph nodes and other parts of the
body appears to be similar in men and women.
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Recurrent Male Breast Cancer
Recurrent breast cancer is cancer that has recurred
(come back) after it has been treated. The cancer may come back in
the breast, in the chest wall, or
in other parts of the body.
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Treatment Option Overview
Key Points:
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.
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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
for more information.)
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Initial Surgery
Treatment for men diagnosed with breast cancer is usually modified radical
mastectomy.
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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.
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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.
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Node-positive:
For men whose cancer is node-positive (cancer has spread to the lymph nodes),
adjuvant therapy may include the following:
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.
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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:
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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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:
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Changes to This Summary (10/19/2007)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
This information is provided from the PDQ® database in collaboration with the NCI.
