How is breast cancer in men treated?

General information about treatment of breast cancer in men

Most of the information about treating male breast cancer comes from doctors' experience with treating female breast cancer. Because so few men have breast cancer, it is hard for doctors to study the treatment of male breast cancer patients separately in clinical trials.

Treatments can be classified into broad groups, based on how they work and when they are used.

The main types of treatment for breast cancer are:

• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Targeted therapy
• Bone-directed therapy (bisphosphonates and denosumab)

Local versus systemic therapy

Local therapy is intended to treat a tumor at the site without affecting the rest of the body. Surgery and radiation therapy are examples of local therapies.

Systemic therapy refers to drugs, which can be given by mouth or directly into the bloodstream to reach cancer cells anywhere in the body. Chemotherapy, hormone therapy, and targeted therapy are systemic therapies.

Adjuvant and neoadjuvant therapy

Patients who have no detectable cancer after surgery are often given treatment to help keep the cancer from coming back. This is known as adjuvant therapy. Doctors know that even in the early stages of breast cancer, cancer cells may break away from the main breast tumor and begin to spread. These cells can't be felt on a physical exam or seen on x-rays or other imaging tests, and they cause no symptoms. But they can become new tumors in nearby tissues and other organs (and bones). The goal of adjuvant therapy is to kill these hidden cells. Systemic therapy (like chemotherapy, hormone therapy, and targeted therapy) and radiation can both be used as adjuvant therapy.

Not every patient needs adjuvant therapy. Whether or not you are likely to benefit from adjuvant therapy depends upon the stage and characteristics of your cancer and what type of surgery you had. Generally, if the tumor is larger or the cancer has spread to lymph nodes, it is more likely to have spread through the bloodstream, and you are more likely to see a benefit. But other features may determine whether or not a patient should be offered adjuvant therapy. Recommendations on adjuvant therapy are discussed in the sections on these treatments and in the section “Treatment by stage of breast cancer in men.”

Some patients are given treatment, such as chemotherapy or hormone therapy, before surgery. The goal of this treatment is to shrink the tumor in the hope it will allow a less extensive operation to be done. This is called neoadjuvant therapy.