Treatment
Treatment for breast cancer depends on its specific type, its stage and the patient's overall health. Treatment usually involves surgery to remove the primary tumor, and may also include radiation therapy, chemotherapy, hormone therapy or targeted therapy. The doctor may give treatments before surgery (neoadjuvant therapy), to shrink the tumor. Or, the doctor may give additional treatments after surgery (adjuvant therapy), to destroy any remaining cancer cells in the body.
Surgery
Most men with breast cancer have a modified radical mastectomy. In this procedure, the doctor removes the entire breast, including the breast tissue, breast skin, nipple, and areola, as well as underarm lymph nodes. If the tumor is very large and has invaded the chest muscles, the surgeon will perform a radical mastectomy, in which the muscle tissue beneath the breast is also removed. Breast-conserving surgeries such as lumpectomy are not often used for male breast cancer because of the small amount of breast tissue in men.
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Radiation Therapy
Radiation therapy uses waves of high-energy rays to target and kill cancer cells. Doctors often give radiation after surgery (adjuvantly) to kill any remaining cancer cells in the breast tissue, chest and underarms, and to reduce the chance that the cancer will return. For male breast cancer, doctors usually use external radiation therapy, in which radiation is aimed at the tumor from a large machine outside of the body. Internal radiation therapy (brachytherapy) is rarely used for male breast cancer.
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Chemotherapy
Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Doctors give chemotherapy to shrink the tumor before surgery (neoadjuvant therapy) and destroy any traces of cancer left after surgery (adjuvant therapy). In more advanced stages in which the cancer has spread, chemotherapy may be the best treatment option to relieve symptoms and improve survival. Chemotherapy can be given intravenously, as a shot, or as a pill or liquid. Doctors usually use a combination of chemotherapy drugs and give the treatment in cycles.
Hormone Therapy
Some men have breast cancer that is hormone-receptor positive. In these men, the estrogen and progesterone hormones may cause the tumor to grow more aggressively. Hormone therapy blocks the effects of these hormones or lowers their levels, preventing the hormone from fueling cancer growth. Doctors often give hormone therapy to shrink the tumor before surgery or to reduce the risk of the cancer returning after surgery.
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Targeted Therapy
HER2 proteins are receptors on breast cells. These receptors help control cell growth, division and repair. In some cases of breast cancer, the HER2 gene doesn't function properly and creates too many copies of itself. This HER2 over-expression makes the cancer grow more aggressively and uncontrollably. Targeted therapy specifically targets these HER2 proteins, stopping or slowing the growth of breast cancer.
PARP inhibitors work by preventing cancer cells from repairing themselves, allowing them to die. PARP inhibitors preferentially kill cancer cells at the BRCA mutation over normal cells. Your doctor may recommend a PARP inhibitor for maintenance therapy after initial therapy or for treating recurrence.
Immunotherapy
PDL1 is a protein that helps keep immune cells from attacking nonharmful cells in the body. Normally, the immune system fights foreign substances like viruses and bacteria, and not your own healthy cells. Some cancer cells have high amounts of PDL1. This allows the cancer cells to "trick" the immune system, and avoid being attacked as foreign, harmful substances.
If your cancer cells have a high amount of PDL1, you may benefit from a treatment called immunotherapy. Immunotherapy is a therapy that boosts your immune system to help it recognize and fight cancer cells. Immunotherapy has been shown to be very effective in treating certain types of breast cancers.
Bone-directed Therapy
Breast cancer that has spread to the bones can cause increased calcium levels, bone pain, fractures and breaks. Doctors may recommend medications such as bisphosphonates or denosumab to treat these conditions. These medications can strengthen bones that have been weakened by cancer cells, and can reduce the risk of bone pain, fractures and breaks.
Clinical Trials
Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.
