Male Breast Cancer

Inflammatory Male Breast Cancer

• In inflammatory breast cancer, cancer has spread to the skin of the breast and the breast looks red and swollen and feels warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin. The skin of the breast may also show a dimpled appearance called peau d ‘orange (like the skin of an orange). There may not be any lumps in the breast that can be felt. Inflammatory breast cancer may be stage IIIB, stage IIIC, or stage IV.

Treatment for male breast cancer may cause side effects.

• There are several types of treatment for men with breast cancer.

• Different types of treatment are available for men with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Five types of standard treatment are used to treat men with breast cancer:

• Surgery

  • Surgery for men with breast cancer is usually a modified radical mastectomy, surgery to remove the whole breast that has cancer. This may include removal of the nipple, areola (the dark-colored skin around the nipple), and skin over the breast. Most of the lymph nodes under the arm are also removed.

  • Modified radical mastectomy. The whole breast and most of the lymph nodes under the arm are removed.

  • Breast-conserving surgery, an operation to remove the cancer but not the breast itself, is also used for some men with breast cancer. A lumpectomy is done to remove the tumor (lump) and a small amount of normal tissue around it. Radiation therapy is given after surgery to kill any cancer cells that are left.

  • Breast-conserving surgery. The tumor and some normal tissue around it are removed, but not the breast itself. Some lymph nodes under the arm may be removed. Part of the chest wall lining may also be removed if the cancer is near it.

• Chemotherapy

  • Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).

• Hormone therapy

  • Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working.

  • Hormone therapy with tamoxifen is often given to patients with estrogen-receptor and progesterone-receptor-positive breast cancer and to patients with metastatic breast cancer (cancer that has spread to other parts of the body).

  • Hormone therapy with an aromatase inhibitor is given to some men who have metastatic breast cancer. Aromatase inhibitors decrease the body's estrogen by blocking an enzyme called aromatase from turning androgen into estrogen. Anastrozole, letrozole, and exemestane are types of aromatase inhibitors.

  • Hormone therapy with a luteinizing hormone-releasing hormone (LHRH) agonist is given to some men who have metastatic breast cancer. LHRH agonists affect the pituitary gland, which controls how much testosterone is made by the testicles. In men who are taking LHRH agonists, the pituitary gland tells the testicles to make less testosterone. Leuprolide and goserelin are types of LHRH agonists.

  • Other types of hormone therapy include megestrol acetate or anti-estrogen therapy, such as fulvestrant.

• Radiation therapy

  • Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.

• Targeted therapy

  • Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy does. Monoclonal antibody therapy, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, and mammalian target of rapamycin (mTOR) inhibitors are types of targeted therapies used to treat men with breast cancer.

• Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies can then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

  • Types of monoclonal antibody therapy include the following:

    • Trastuzumab is a monoclonal antibody that blocks the effects of the growth factor protein HER2.

    • Pertuzumab is a monoclonal antibody that may be combined with trastuzumab and chemotherapy to treat breast cancer.

    • Ado-trastuzumab emtansine is a monoclonal antibody linked to an anticancer drug. This is called an antibody-drug conjugate. It may be used to treat men with hormone receptor-positive breast cancer that has spread to other parts of the body.

  • How do monoclonal antibodies work to treat cancer? This video shows how monoclonal antibodies, such as trastuzumab, pembrolizumab, and rituximab, block molecules cancer cells need to grow, flag cancer cells for destruction by the body’s immune system, or deliver harmful substances to cancer cells.

  • Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow. Lapatinib is a tyrosine kinase inhibitor that may be used to treat men with metastatic breast cancer.

  • Cyclin-dependent kinase inhibitors are targeted therapy drugs that block proteins called cyclin-dependent kinases, which cause the growth of cancer cells. Palbociclib is a cyclin-dependent kinase inhibitor used to treat men with metastatic breast cancer.

  • Mammalian targets of rapamycin (mTOR) inhibitors block a protein called mTOR, which may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow.