Male breast cancer: a disease distinct from female breast cancer
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Male breast cancer (BC) is rare, representing approximately 1% of cancers that occur in men and approximately 1% of all BCs worldwide. Because male BC is rare, not much is known about the disease, and treatment recommendations are typically extrapolated from data available from clinical trials enrolling female BC patients.
We review the epidemiology, risk factors, prognosis, and the varied molecular and clinicopathologic features that characterize male BC. In addition, we summarize the available data for the use of systemic therapy in the treatment of male BC and explore the ongoing development of targeted therapeutic agents for the treatment of this subgroup of BCs.
There are important biological differences between male and female BC. Male BC is almost exclusively hormone receptor positive (+), including the androgen receptor (AR), and is associated with an increased prevalence of BRCA2 germline mutations, especially in men with increased risk for developing high-risk BC. Additional research is warranted to better characterize male BC. To accomplish this, a multi-national consortium approach, such as the International Male Breast Cancer Program, is needed in response to the scarcity of patients. This approach allows the pooling of information from a large number of men with BC and the creation of registries for future therapeutic-focused clinical trials.
Given the unique biology of BC in men, promising new therapeutic targets are currently under investigation, including the use of poly-ADP-ribose polymerase inhibitors or AR-targeted agents either as monotherapy or in combination with other agents.
KeywordsMale breast cancer Androgen receptor Biomarkers Anti-androgen Endocrine therapy Androgen and estrogen biosynthesis inhibition
The authors thank Kelly Kilibarda, PhD and Elise Eller, PhD of Whitsell Innovations, Inc., Chapel Hill, NC, USA for providing medical writing support, which was funded by Innocrin Pharmaceuticals Inc., Durham, North Carolina, USA, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).
Compliance with ethical standards
Conflict of interest
Ayca Gucalp receives salary support to conduct clinical trials from Innocrin Pharmaceuticals, Pfizer, Novartis, and Merck. She also received an honorarium for participating on an advisory board for Pfizer. Tiffany A. Traina is a compensated Seviteronel Breast Cancer Steering Committee member (Innocrin Pharmaceuticals) and receives research support from Innocrin Pharmaceuticals for trials of seviteronel. Joel R. Eisner and Edwina S. Baskin-Bey declare that they are employed by and have stock ownership in Innocrin Pharmaceuticals. Joel S. Parker is a compensated advisor to Innocrin Pharmaceuticals and author of the PAM50 patent and related patents for Nanostring Technologies, Inc. Ben H. Park has ownership interest and is a paid member of the scientific advisory board of Loxo Oncology and is a paid consultant for Foundation Medicine, Inc.; Jackson Laboratories; Casdin Capital; and Roche. Under separate licensing agreements between Horizon Discovery, Ltd and The Johns Hopkins University, Ben H. Park is entitled to a share of royalties received by the university on sales of products. The terms of this arrangement are managed by The Johns Hopkins University in accordance with its conflict of interest policies. Fatima Cardoso serves on advisory boards for Amgen, Astellas/Medivation, AstraZeneca, Celgene, Daiichi-Sankyo, Eisai, GE Oncology, Genentech, GlaxoSmithKline, Macrogenics, Merck-Sharp, Merus BV, Mylan, Mundipharma, Novartis, Pfizer, Pierre-Fabre, Roche, Sanofi, Seattle-Genetics, and Teva. All other authors declare that they have no potential conflict of interest.
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