See the Treatment Options Overview section for information about the treatments listed below.
Male breast cancer is treated in the same way as female. (For more information, see the PDQ summary on Breast Cancer Treatment (Adults).)
Early/localized/operable male breast cancer
Treatment for early, localized, or operable breast cancer may include the following:
Treatment for male patients diagnosed with breast cancer is usually modified radical surgery.
Radiotherapy after lumpectomy breast-conserving surgery may be indicated for some men.
Adjuvant therapy is treatment when the cancer is no longer visible after surgery. Even if the surgeon removes all visible cancer during surgery, the patient will still receive radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy after surgery to kill any cancer cells that may remain.
Lymph node negative: Adjuvant therapy should be considered for male patients whose cancer is lymph node negative (the cancer has not spread to the lymph nodes) on the same basis as for female patients with breast cancer, because there is no evidence that men and women respond differently to treatment.
Lymph node positive: In male patients with lymph node positive cancer (cancer has spread to the lymph nodes), adjuvant therapy should include the following.
chemotherapy
hormone therapy with tamoxifen (blocks the action of estrogen) or, less commonly, hormone therapy with an aromatase inhibitor (reduces the amount of estrogen in the body)
Targeted therapy with monoclonal antibodies (trastuzumab or patuximab).
These therapies appear to increase survival in male patients as much as in female patients. The patient’s response to hormone therapy depends on the presence of hormone receptors (proteins) in the tumor. hormone therapy is often recommended for male breast cancer patients, but this therapy has many side effects, including hot flushes and impotence (inability to have a full erection during intercourse).
Locally recurrent male breast cancer
For information about the treatments listed below, see the Treatment Options Overview section.
For men with locally recurrent disease (cancer that recurs in a confined area after treatment), treatment options include:
Surgery
Radiotherapy combined with chemotherapy.
Male metastatic breast cancer
Treatment options for metastatic breast cancer (cancer that has spread to distant parts of the body) include:
For men with metastatic breast cancer newly diagnosed as hormone receptor-positive, if hormone receptor status is unknown, treatment may include:
Tamoxifen therapy.
Aromatase inhibitor therapy (anastrozole, letrozole, exemestane) in combination or not with an LHRH agonist. Periodin-dependent kinase inhibitor therapy (paboxinib) is also sometimes given.
If the patient’s tumor is hormone receptor positive or hormone receptor unknown and the tumor has spread only to bone or soft tissue and has been treated with tamoxifen, treatment may include:
Aromatase inhibitor therapy in combination with or without an LHRH agonist.
Other hormone therapy such as medroxyprogesterone acetate, estrogen or androgen therapy, or anti-estrogen therapy (e.g., fulvestrant).
For patients with metastatic breast cancer who are hormone receptor positive and do not respond to other treatments, options include targeted therapies such as:
trastuzumab, lapatinib, patuximab, or mTOR inhibitors.
Treatment with antibody-drug couples of trastuzumab-metanephrine couples.
Periodin-dependent kinase inhibitor therapy (paboxinib) in combination with letrozole.
In HER2-/neu-positive men with metastatic breast cancer, treatment may include:
Targeted therapy such as trastuzumab, patuximab, trastuzumab-metanercept couples, or lapatinib.
For men with metastatic breast cancer who are hormone receptor negative, have not responded to hormone therapy, have spread to other organs, or have caused symptoms, treatment may include:
Chemotherapy with one or more drugs.
Total mastectomy is used in men with ruptured or painful breast lesions. Surgery may be followed by radiation therapy.
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 lungs.
Surgery to repair or help support weak bones or fractures. Radiation therapy may be given after surgery.
Surgery to remove fluid that collects in the lungs or around the heart.
Radiation therapy to the bones, brain, spinal cord, breast, or chest wall to reduce symptoms and improve the patient’s quality of life.
Strontium-89 (a radionuclide) can reduce pain in bones throughout the body caused by the spread of cancer.
Other treatment options for metastatic breast cancer include:
Bisphosphonates or denosumab to reduce bone disease and bone pain when the cancer has spread to the bones. (For more information on bisphosphonates, see the PDQ summary on cancer pain.)
Clinical trials testing new anti-cancer drugs, new drug combinations, and new treatment pathways.