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Male Breast Cancer — SCE Medical Oncology MCQ

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ModerateBreast CancerMale Breast CancerSCE Medical Oncology

A 72-year-old man is diagnosed with breast cancer (ER+/HER2-, T2 N1). Male breast cancer accounts for approximately 1% of all breast cancers. What key difference exists in the endocrine management of male breast cancer compared with postmenopausal female breast cancer?

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Correct answer: D — Tamoxifen is the preferred adjuvant endocrine therapy; aromatase inhibitors should NOT be used as monotherapy in men

In male breast cancer, aromatase inhibitors as monotherapy are less effective than in postmenopausal women because men retain testicular androgen production that can be aromatised peripherally. If an AI is used, it must be combined with a GnRH agonist (chemical castration) or orchidectomy to suppress testicular function. Tamoxifen is the preferred first-line adjuvant endocrine agent in male breast cancer.

Reference: ESMO 2024 Male Breast Cancer Guidelines; Giordano et al NEJM 2018