Treatment of advanced male breast cancer

The modalities used to treat 27 male patients with metastatic breast cancer at Memorial Hospital from 1957–1979 are reviewed. The overall objective orchiectomy response rate was 48% (11/23). The median response was 11 months (6–96 months). The median survival in responders was 58 months, whereas the median survival in orchiectomy failures was 24 months. Four patients had estrogen receptor protein determinations (ERP). Two positive ERP patients and one borderline ERP patient responded (18–34 months). One ERP‐negative patient failed orchiectomy. The number of major ablations in this series (two responses/two adrenalectomies, two failures/two hypophysectomies) does not permit conclusions, although review of the literature suggests that major ablation may be valuable in patients responding to orchiectomy. Two of three patients who refused ablative therapy responded (three months, ten months) to single agent provera. Administering stilbesterol to the ten‐month responder and to the patient who failed provera resulted in two additional responses (four months, continuing, and 22 months). Of six patients who failed orchiectomy and subsequently received chemotherapy, four patients responded (7–40 months). The median survival in these patients was 40 months (33–44 months). This review supports the importance of orchiectomy in the treatment of metastatic male breast cancer. Although the numbers are small, these data suggest that estrogen receptor determinations may be useful in selecting patients for orchiectomy. Selective additive hormone therapy may be useful in patients who refuse orchiectomy. Chemotherapy may provide worthwhile palliation in patients who fail orchiectomy.

[1]  G. Hortobagyi,et al.  Chemotherapy for advanced male breast cancer. , 1980, Journal of the American Medical Association (JAMA).

[2]  W. McGuire,et al.  Clinical correlations of steroid receptors and male breast cancer. , 1980, Cancer research.

[3]  G. Blumenschein,et al.  Male breast cancer. A natural history study , 1979, Cancer.

[4]  G. Hortobagyi,et al.  Hormonal therapy with tamoxifen in male breast cancer. , 1979, Cancer treatment reports.

[5]  F. Pannuti,et al.  A possible new approach to the treatment of metastatic breast cancer: massive doses of medroxyprogesterone acetate. , 1978, Cancer treatment reports.

[6]  Y. Nomura,et al.  Detection of the estrogen receptor and response to endocrine therapy in male breast cancer patients. , 1977, Gan.

[7]  G. Ribeiro.  Carcinoma of the male breast: A review of 200 cases , 1977, The British journal of surgery.

[8]  D. Tormey,et al.  Male breast cancer: a review. , 1976, Cancer treatment reviews.

[9]  J. Urban,et al.  Estrogen receptor protein in lesions of the male breast. A preliminary report , 1976, Cancer.

[10]  N. Javadpour,et al.  The role of orchiectomy in the management of advanced male breast cancer , 1976, Cancer.

[11]  W. Donegan,et al.  Carcinoma of the Male Breast: A 30-Year Review of 28 Cases , 1973 .

[12]  D. Kiang,et al.  Hypophysectomy in the treatment of advanced cancer of the male breast , 1972 .

[13]  R. Kim,et al.  Metastatic carcinoma of the male breast treated with bilateral adrenalectomy and chemotherapy , 1970, Cancer.

[14]  A. Huvos,et al.  Castration for primary inoperable or recurrent breast carcinoma. , 1969, Surgery, gynecology & obstetrics.

[15]  C. Huggins,et al.  Carcinoma of male breast. , 1955 .

[16]  Holleb Ai,et al.  Cancer of male breast. II. , 1968 .

[17]  R. Buxton,et al.  Metastatic Carcinoma of the Male Breast: Remission by Adrenalectomy , 1965, Annals of surgery.

[18]  H. Volk,et al.  Objective remission of metastatic breast carcinoma in a male who recieved 17-alpha hydroxy progesterone caproate (delalutin). , 1961, Cancer chemotherapy reports.

[19]  N. Treves.  The treatment of cancer, especially inoperable cancer, of the male breast by ablative surgey (orchiectomy, adrenalectomy, and hypophysectomy) and hormone therapy (estrogens and corticosteroids). An analysis of 42 patients , 1959, Cancer.