Tamoxifen-failed male breast cancer with a high level of circulating estrogen: report of a case.
We report herein the case of a 40-year-old man with grade II invasive ductal carcinoma of the breast (pT1, pN0, M0: stage I) in whom a recurrence developed shortly after completion of a 2-year course of tamoxifen and 5-fluorouracil therapy following a mastectomy. Although the metastatic tumor was estrogen receptor-positive, hormone therapy combined with chemotherapy had no significant effect on tumor growth, and the patient died from disseminated tumors 2 years 6 months after completion of the adjuvant therapy. It is noteworthy that the circulating estradiol level increased from 18.0 to 892.3 pg/ml during the period of tumor progression and dissemination. We interpret these findings as an indication of high aromatase activity in the metastatic tumors. We suggest that extending tamoxifen treatment to 5 years or longer be recommended for the standard adjuvant hormone therapy of male breast cancer to prevent the early recurrence of hormone-responsive disease.
Takei
H
H
Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan.
Iino
Y
Y
Horiguchi
J
J
Maemura
M
M
Koibuchi
Y
Y
Yokoe
T
T
Morishita
Y
Y
Jordan
V C
VC
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D018567:Breast Neoplasms, Male / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood*; D017809:Fatal Outcome; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D013629:Tamoxifen / Q000494:pharmacology* / Q000627:therapeutic use; D013997:Time Factors
D000964:Antimetabolites, Antineoplastic; D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D004958:Estradiol; D005472:Fluorouracil