Management of Male Breast Cancer: ASCO Guideline

Michael J. Hassett, Mark R. Somerfield, Elisha R. Baker, Fatima Cardoso, Kari J. Kansal, Dylan C. Kwait, Jennifer K. Plichta, Charité Ricker, Anna Roshal, Kathryn J. Ruddy, Joshua D. Safer, Catherine Van Poznak, Rachel L. Yung, Sharon H. Giordano

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

PURPOSE: To develop recommendations concerning the management of male breast cancer. METHODS: ASCO convened an Expert Panel to develop recommendations based on a systematic review and a formal consensus process. RESULTS: Twenty-six descriptive reports or observational studies met eligibility criteria and formed the evidentiary basis for the recommendations. RECOMMENDATIONS: Many of the management approaches used for men with breast cancer are like those used for women. 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; those with a contraindication to tamoxifen may be offered a gonadotropin-releasing hormone agonist/antagonist plus aromatase inhibitor. Men who have completed five years of tamoxifen, have tolerated therapy, and still have a high risk of recurrence may be offered an additional five years of therapy. Men with early-stage disease should not be treated with bone-modifying agents to prevent recurrence, but could still receive these agents to prevent or treat osteoporosis. 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. Targeted systemic therapy may be used to treat advanced or metastatic cancer using the same indications and combinations offered to women. Ipsilateral annual mammogram should be offered to men with a history of breast cancer treated with lumpectomy regardless of genetic predisposition; contralateral annual mammogram may be offered to men with a history of breast cancer and a genetic predisposing mutation. Breast magnetic resonance imaging is not recommended routinely. Genetic counseling and germline genetic testing of cancer predisposition genes should be offered to all men with breast cancer.

Original languageEnglish
Pages (from-to)1849-1863
Number of pages15
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume38
Issue number16
DOIs
StatePublished - Jun 1 2020
Externally publishedYes

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    Hassett, M. J., Somerfield, M. R., Baker, E. R., Cardoso, F., Kansal, K. J., Kwait, D. C., Plichta, J. K., Ricker, C., Roshal, A., Ruddy, K. J., Safer, J. D., Van Poznak, C., Yung, R. L., & Giordano, S. H. (2020). Management of Male Breast Cancer: ASCO Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 38(16), 1849-1863. https://doi.org/10.1200/JCO.19.03120