Treatment of Metastatic Male Breast Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

Treatment options for metastatic breast cancer (cancer that has spread to distant parts of the body) may include the following:

Hormone therapy

In men who have just been diagnosed with metastatic breast cancer that is hormone receptor positive or if the hormone receptor status is not known, treatment may include:

• Tamoxifen therapy.
• Aromatase inhibitor therapy (anastrozole, letrozole, or exemestane) with or without an LHRH agonist. Sometimes cyclin-dependent kinase inhibitor therapy (palbociclib) is also given.

In men whose tumors are hormone receptor positive or hormone receptor unknown, with spread to the bone or soft tissue only, and who have been treated with tamoxifen, treatment may include:

• Aromatase inhibitor therapy with or without LHRH agonist.
• Other hormone therapy such as megestrol acetate, estrogen or androgen therapy, or anti-estrogen therapy such as fulvestrant.

Targeted therapy

In men with metastatic breast cancer that is hormone receptor positive and has not responded to other treatments, options may include targeted therapy such as:

• Trastuzumab, lapatinib, pertuzumab, or mTOR inhibitors.
• Antibody-drug conjugate therapy with ado-trastuzumab emtansine.
• Cyclin-dependent kinase inhibitor therapy (palbociclib) combined with letrozole.

In men with metastatic breast cancer that is HER2/neu positive, treatment may include:

• Targeted therapy such as trastuzumab, pertuzumab, ado-trastuzumab emtansine, or lapatinib.

Chemotherapy

In men with metastatic breast cancer that is hormone receptor negative, has not responded to hormone therapy, has spread to other organs or has caused symptoms, treatment may include:

• Chemotherapy with one or more drugs.

Surgery

• Total mastectomy for men with open or painful breast lesions. Radiation therapy may be given after surgery.
• 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 lung.
• Surgery to repair or help support weak or broken bones. Radiation therapy may be given after surgery.
• Surgery to remove fluid that has collected around the lungs or heart.

Radiation therapy

• Radiation therapy to the bones, brain, spinal cord, breast, or chest wall to relieve symptoms and improve quality of life.
• Strontium-89 (a radionuclide) to relieve pain from cancer that has spread to bones throughout the body.

Other treatment options

Other treatment options for metastatic breast cancer include:

• Drug therapy with bisphosphonates or denosumab to reduce bone disease and pain when cancer has spread to the bone. (See the PDQ summary on Cancer Pain for more information about bisphosphonates.)
• Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment.