ASCO GUIDELINES Bundle

Management of Male Breast Cancer

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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)

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