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Treatment of Advanced Disease

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Male Breast Cancer

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Abstract

In many series of MBC cases the majority had stage III/IV disease at presentation and this has shown little improvement with time. Historical methods of palliation involved ablative surgery including orchidectomy, adrenalectomy and hypophysectomy. The earliest form of additive therapy was estrogens, stilboestrol, ethinylestradiol and hexoestrol but these were associated with major side effects and were replaced by tamoxifen when this became available in the 1970s. Tamoxifen remains the most widely used palliative therapy for mMBC and comparative studies suggest that it is more effective than aromatase inhibitors. Approximately 15% of the estradiol is derived from the testis and when peripheral synthesis is there is a feedback surge of the testicular estrogen causing tumour stimulation. Multicentre studies are needed to determine the role of tamoxifen and gnRH analogues together with potential benefits of third line chemotherapy in selected cases.

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  1. Research Oncology, Guy’s Hospital, London, United Kingdom

    Ian Fentiman

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Fentiman, I. (2017). Treatment of Advanced Disease. In: Male Breast Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-04669-3_10

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