Updated: November 2004
Cancer of the male breast is uncommon, about one percent of all breast cancers. Investigation of breast cancer in the male is identical to that of the female patient, including mammography as an initial investigation.
Because the male breast is very small, it is common for even small tumours to involve both skin and deep tissues with the result that the prognosis may be guarded. Surgery should be planned so that there will be wide margins on both the skin and deep tissues. This may require removal of some underlying muscle. Axillary dissection is also required and it is important to assess the hormone receptor status since most, but not all, carcinomas of the male breast contain hormone receptors.
Because of the small size of the male breast adjuvant radiotherapy is often recommended to reduce local recurrence. However the indications for post mastectomy radiation for males are essentially the same as those for females.
There are no series of male patients which have been adequately studied in regard to adjuvant systemic therapy. However, experience demonstrates that the clinical behaviour of male and female breast cancers are very similar. For the moment, adjuvant hormonal or chemotherapeutic recommendations are the same, stage-for-stage, as for a woman of the same age (see "in situ disease"). The role of aromatase inhibitors and fulvestrant in males has not been established. Orchiectomy or LHRH may provide a response after progression on tamoxifen in the metastatic setting.