Abstract • Forty-one men with metastatic breast cancer were treated with 70 trials of hormone therapy. These included 25 orchiectomies and 45 additive hormonal treatments. The overall response rate was 31%. The response rate was 32% to orchiectomy, 17% to estrogens, 43% to steroids, 25% to tamoxifen citrate, and 60% to androgens. The response to additive hormonal therapy was 31% and was not affected by prior orchiectomy (33% v 30%). Median overall response duration was 12 months, 17.5 months following orchiectomy, 8.5 months following additive hormonal therapy, five months following estrogens, 11 months following steroids, and eight months following androgens. Median survival from first metastasis was significantly prolonged in patients responding to orchiectomy and additive hormonal therapy. Patients with a disease-free interval (DFI) longer than 12 months had a 59% response rate to hormonal therapy compared with 9% of those with a DFI no more than 12 months. Response to one form of hormonal therapy did not predict later hormonal response. Ablative and additive hormonal therapy offer effective palliation to one third of male breast cancer patients, produce little toxic effects and morbidity, and improve survival duration after metastasis in responders. (Arch Intern Med 1983;143:237-240) References 1. Sachs MD: Carcinoma of the male breast. Radiology 1941;37:458-467.Crossref 2. Meyskens FL, Tormey DC, Neifeld JP: Male breast cancer: A review. Cancer Treat Rev 1976;3:83-93.Crossref 3. Crichlow RW: Carcinoma of the male breast. Semin Oncol 1974;1:145-152. 4. Yap HY, Tashima CK, Blumenschein GR, et al: Chemotherapy for advanced male breast cancer. JAMA 1980;243:1739-1741.Crossref 5. Treves N: The treatment of cancer, especially inoperable cancer of the male breast by ablative surgery (orchiectomy, adrenalectomy, and hypophysectomy) and hormone therapy (estrogens and corticosteroids): An analysis of 42 patients. Cancer 1959;12:820-832.Crossref 6. Holleb AI, Freeman HP, Farrow JH: Cancer of the male breast. NY State J Med 1968;68:544-533, 656-663. 7. Ribeiro GG: The results of diethylstilbestrol therapy for recurrent metastatic carcinoma of the male breast. Br J Cancer 1976;33:465-467.Crossref 8. Kennedy BJ, Kiang DT: Hypophysectomy in the treatment of advanced cancer of the male breast. Cancer 1972;29:1606-1612.Crossref 9. Li MC, Janelli DE, Kelly EJ, et al: Metastatic carcinoma of the male breast treated with bilateral adrenalectomy and chemotherapy. Cancer 1970;25:678-681.Crossref 10. Everson RB, Lippinan EB, McGuire WL, et al: Clinical correlation of steroid receptors and male breast cancer. Cancer Res 1980;40:991-997. 11. Donegan WL, Perez-Mesa CM: Carcinoma of the male breast: A 30-year review of 28 cases. Arch Surg 1973;106:273-279.Crossref 12. Haagensen CD: Disease of the Breast , ed 2. Philadelphia, WB Saunders Co, 1971, p 630. 13. Langlands AO, Maclean N, Kerr GR: Carcinoma of the male breast: Report of a series of 88 cases. Clin Radiol 1976;27:21-25.Crossref 14. Horn Y, Roof B: Male breast cancer: Two cases with objective regression from calusterone (7α, 17β-dimethyltestosterone) after failure of orchiectomy. Oncology 1976;33:188-191.Crossref 15. Mouridsen H, Palshof T, Paterson J, et al: Tamoxifen in advanced breast cancer. Cancer Treat Rev 1978;5:131-141.Crossref 16. Patterson JS, Battersby LA, Bach BK: Use of tamoxifen in advanced male breast cancer. Cancer Treat Rep 1980;64:801-804. 17. Fracchia AA, Farrow JH, DePalo AJ, et al: Castration for primary inoperable or recurrent breast carcinoma. Surg Gynecol Obstet 1969;128: 1226-1234. 18. DeVita V Jr, Hellman S, Rosenberg SA (eds): Cancer: Principles and Practice of Oncology . Hagerstown, Md, Harper & Row Publishers Inc, 1982, pp 945-949.
Archives of Internal Medicine – American Medical Association
Published: Feb 1, 1983