- The American Society of Clinical Oncology (ASCO) delivered its first-ever guideline for male breast cancer.
- The guideline focuses on care differing between men and women, because most care is the same.
Why this matters
- No current guidelines exist for male breast cancer, which constitutes
- An expert panel with 13 members conducted a 2-phase process:
- A survey of the ASCO Breast Cancer Advisory Group to identify areas of strong agreement on care between men and women.
- A Delphi process for consensus among the Expert Panel (≥75% agreement) on 26 observational studies addressing 10 areas of divergence between sexes.
- Funding: Not disclosed.
- Areas not covered by recommendations because care is the same across sexes: gene expression profile testing (e.g., Oncotype DX), primary surgery, adjuvant chemotherapy, adjuvant radiation therapy, and chemotherapy for advanced/metastatic disease.
- Most recommendations focus on estrogen receptor-positive cancers because 99% of male breast cancers display that subtype.
- Tamoxifen should be offered for an initial duration of 5 years; patients for whom tamoxifen is contraindicated should be given a gonadotropin-releasing hormone agonist/antagonist in combination with an aromatase inhibitor.
- MRI is not routinely recommended.
- Germline testing should be offered to all men with breast cancer.