How should I manage a male patient diagnosed with early-stage breast cancer in terms of treatment options?

Management of a male patient diagnosed with early-stage breast cancer should follow the same principles as for female patients, as the NICE guideline on early and locally advanced breast cancer does not differentiate treatment by sex but focuses on tumour characteristics and staging. Surgical treatment is the mainstay, typically involving mastectomy due to the smaller amount of male breast tissue, with consideration of axillary staging using sentinel lymph node biopsy or axillary node clearance if lymph node metastases are present. Systemic therapy decisions depend on hormone receptor status (ER, PR) and HER2 status, assessed at diagnosis. For hormone receptor-positive disease, endocrine therapy is indicated alongside surgery. Chemotherapy may be considered based on tumour biology and stage. Radiotherapy is offered as appropriate, especially after breast-conserving surgery or if there is nodal involvement. Psychological support and involvement of a clinical nurse specialist are essential throughout care. Genetic testing for BRCA mutations may be considered if clinically indicated. Breast reconstruction options should be discussed, although less commonly pursued in men. All treatment decisions should be made in a multidisciplinary team setting and tailored to the individual patient’s circumstances and preferences ¹.