Primary standard treatment is a modified radical mastectomy with axillary dissection.[1,2,3] Responses are generally similar to those seen in women with breast cancer. Breast conservation surgery with lumpectomy and radiation therapy has also been used and results have been similar to those seen in women with breast cancer. (Refer to the PDQ summary on Breast Cancer Treatment for more information.)
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In men with node-negative tumors, adjuvant therapy should be considered on the same basis as for a woman with breast cancer since there is no evidence that response to therapy is different for men or women.
In men with node-positive tumors, both chemotherapy plus tamoxifen and other hormonal therapy have been used and can increase survival to the same extent as in women with breast cancer. Currently, no controlled studies have compared adjuvant treatment options. Approximately 85% of all male breast cancers are estrogen receptor–positive, and 70% of them are progesterone receptor–positive.[2,6] Response to hormone therapy correlates with presence of receptors. Hormonal therapy has been recommended in all receptor-positive patients.[1,2] Tamoxifen use, however, is associated with a high rate of treatment-limiting symptoms, such as hot flashes and impotence in male breast cancer patients. (Refer to the PDQ summaries on Fever, Sweats, and Hot Flashes and Sexuality and Reproductive Issues for more information on these symptoms.) Responses are generally similar to those seen in women with breast cancer. (Refer to the PDQ summary on Breast Cancer Treatment for more information.)
Adjuvant chemotherapy regimens include:
CMF: cyclophosphamide plus methotrexate plus fluorouracil.
CAF: cyclophosphamide plus doxorubicin plus fluorouracil.
Surgical excision or radiation therapy combined with chemotherapy is recommended. Responses are generally similar to those seen in women with breast cancer.[2,5] (Refer to the PDQ summary on Breast Cancer Treatment for more information.)
Hormonal therapy, chemotherapy, or a combination of both have been used with some success. Initially, hormonal therapy is recommended.[2,5]