Treatment overview for breast cancer in men

Treatments used for men are similar to those used for breast cancer in women.

Your doctor can advise you on the best plan of treatment, taking into account a number of factors. These include your age and general health, the type, stage and grade of the cancer and whether it is ER+ and/or HER2-positive.

Treatments may work locally or systemically. Local treatments work against cancer in one particular site in the body. Surgery and radiotherapy are both local treatments.

The effects of systemic treatments are more generalised. They can work against cancer in many areas of the body at one time. Hormonal therapy and chemotherapy are examples of systemic therapies.

Early and locally advanced breast cancer Back to top

The main aims of treatment for early and locally advanced breast cancer are to remove all signs of the cancer and to reduce the risk of breast cancer coming back.

Surgery| is the main treatment for breast cancer. Breast surgery in men usually involves removing all of the breast tissue in the affected breast (mastectomy). For some men with small, early cancers, surgery to remove the cancer may be the only treatment that is needed. But often additional treatment is given after surgery to reduce the risk of cancer coming back. This is called adjuvant treatment.

Radiotherapy|  may be used after surgery to destroy any cancer cells that may be left behind in the chest wall or nearby lymph nodes. Radiotherapy is usually given as a series of short daily treatments, from Monday to Friday, over three weeks.

Hormonal therapy| is often used to treat men who have breast cancer with oestrogen receptors, called ER+ breast cancer. Rarely, hormonal therapy is given before surgery to shrink the cancer and make the operation easier. This is called neo-adjuvant therapy. More commonly, hormonal therapy is given after surgery to reduce the risk of cancer coming back.

Hormonal therapy can be taken as tablets every day or given as injections every 1-3 months or as a combination of both tablets and injections. Hormonal therapy is usually taken for five years or more.

Chemotherapy |may be given before an operation to shrink the cancer or more usually after surgery to reduce the risk of cancer coming back. A combination of two or more chemotherapy drugs is often used. A course of chemotherapy is usually given over 4–6 months.

HER2-positive breast cancer

Men who have breast cancer with a high number of receptors for HER2 on their surface, (HER2-positive) may be given treatment with Herceptin (trastuzumab). So far research into using Herceptin to treat breast cancer has only been carried out in women so it’s not clear how well it works for men.

Secondary breast cancer Back to top

If the cancer has spread beyond the breast and lymph nodes in the armpit to elsewhere in the body this is called secondary breast cancer. The most common places that breast cancer cells may spread to are the bone, liver, lung or brain.

Secondary breast cancer can also spread to lymph nodes, such as those in the lower part of the neck. Although secondary breast cancer can spread to any of these areas, it most commonly affects just one or two parts of the body.

Treatment for secondary breast cancer depends on a number of factors, so can be different for each person. The most appropriate treatment depends on where the breast cancer has spread to. A man with secondary breast cancer affecting the bones will have different symptoms and may need different treatment from a man with secondary breast cancer affecting the liver.

It isn’t usually possible to cure breast cancer that has spread elsewhere in the body, but treatment may be able to control it for quite a long time. Treatment may also be used to reduce symptoms and improve quality of life.

The main treatments for cancer that has spread are hormonal therapy and chemotherapy, although surgery and radiotherapy may be helpful in some situations. The choice of treatment depends on where in the body the cancer has spread to, whether the cancer has oestrogen receptors and which treatments, if any, have already been given.

Hormonal therapy| is the most commonly used treatment for ER+ breast cancer that has spread. Hormonal therapy can be taken as tablets, as injections or as a combination of both. It’s usually taken for as long as it is effective. It is often used to treat secondary breast cancer in the bone.

Chemotherapy |may be used if it’s known the cancer won’t respond to hormonal therapy (for example, ER- breast cancer). It may also be used to treat secondary cancer that is growing quickly or has spread to the liver or lungs.

Radiotherapy|  may be used to shrink a tumour that is causing pain, especially in the bone. This is known as palliative radiotherapy.

HER2-positive breast cancer

Men who have breast cancer with a high number of receptors for HER2 on their surface, may be given treatment with trastuzumab (Herceptin|).