Overview
Metastatic infiltrating duct carcinoma in men is a form of breast cancer that has spread beyond the breast. Management strategies often mirror those used for female breast cancer.Diagnosis
Management
For hormone receptor-positive metastatic breast cancer, endocrine therapy is recommended as first-line treatment, unless there is visceral crisis or rapidly progressive disease 1.
Targeted systemic therapy can be used for advanced or metastatic cancer with the same indications and combinations as for women 1.
For men with hormone receptor-positive breast cancer candidates for adjuvant endocrine therapy, tamoxifen for an initial duration of five years should be offered 1.
If there is a contraindication to tamoxifen, a gonadotropin-releasing hormone agonist/antagonist plus an aromatase inhibitor may be offered 1.
Men who have completed five years of tamoxifen, tolerated it, and have a high risk of recurrence may be offered an additional five years of therapy 1.
Bone-modifying agents should not be used to prevent recurrence in men with early-stage disease but can be used for osteoporosis 1.Special Populations
Key Recommendations
Men with hormone receptor-positive breast cancer who are candidates for adjuvant endocrine therapy should be offered tamoxifen for an initial duration of five years 1. (Evidence: Moderate)
Men with advanced or metastatic disease should be offered endocrine therapy as first-line therapy, except in cases of visceral crisis or rapidly progressive disease 1. (Evidence: Moderate)
Targeted systemic therapy may be used to treat advanced or metastatic cancer using the same indications and combinations offered to women 1. (Evidence: Moderate)References
1 Hassett MJ, Somerfield MR, Baker ER, Cardoso F, Kansal KJ, Kwait DC et al.. Management of Male Breast Cancer: ASCO Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2020. link