Treatment
Recommendation 1.1
➤ Men with hormone receptor-positive breast cancer who are candidates
for adjuvant endocrine therapy should be offered tamoxifen. (Strong
Recommendation; FC-L)
Recommendation 1.2
➤ Men with hormone receptor-positive breast cancer who are candidates
for adjuvant endocrine therapy but have a contraindication to
tamoxifen may be offered GnRH agonist/antagonist and an aromatase
inhibitor (AI). (Moderate Recommendation; FC-L)
Recommendation 2.1
➤ Men who are treated with adjuvant endocrine therapy should be
treated for an initial duration of five years. (Strong Recommendation;
FC-L)
Recommendation 2.2
➤ Men who have completed five years of tamoxifen, have tolerated
therapy, and still have a high risk of recurrence may be offered an
additional five years of tamoxifen therapy. (Strong Recommendation;
FC-L)
Recommendation 3
➤ Men with early-stage breast cancer should not be treated with bone-
modifying agents to prevent recurrence but could still receive these
agents to prevent or treat osteoporosis. (Moderate Recommendation;
FC-L)
Recommendation 4.1
➤ Men with advanced or metastatic, hormone receptor-positive, HER2-
negative breast cancer should be offered endocrine therapy as first-
line therapy except in cases of visceral crisis or rapidly progressive
disease. Options include tamoxifen, an aromatase inhibitor with a
GnRH agent, and fulvestrant. CDK 4/6 inhibitors can be used in men
as they are used in women. (Strong Recommendation; FC-L)
Recommendation 4.2
➤ Men who develop recurrent metastatic, hormone receptor-positive,
HER2-negative breast cancer while receiving adjuvant endocrine
therapy should be offered an alternate endocrine therapy except
in cases of visceral crisis or rapidly progressive disease. (Strong
Recommendation; FC-L)
