Tamoxifen-failed male breast cancer with a high level of circulating estrogen: report of a case

• Published in: Surgery today (Tokyo, Japan) Vol. 31; no. 2; pp. 149 - 151
• Main Authors: Takei, H, Iino, Y, Horiguchi, J, Maemura, M, Koibuchi, Y, Yokoe, T, Morishita, Y, Jordan, V C
• Format: Journal Article
• Language: English
• Published: Japan 01.01.2001
• Subjects: Adult; Antimetabolites, Antineoplastic - therapeutic use; Antineoplastic Agents, Hormonal - pharmacology; Antineoplastic Agents, Hormonal - therapeutic use; Breast Neoplasms, Male - drug therapy; Breast Neoplasms, Male - pathology; Breast Neoplasms, Male - surgery; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Drug Administration Schedule; Drug Resistance, Neoplasm; Drug Therapy, Combination; Estradiol - blood; Fatal Outcome; Fluorouracil - therapeutic use; Humans; Male; Neoplasm Recurrence, Local; Tamoxifen - pharmacology; Tamoxifen - therapeutic use; Time Factors
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s005950170199

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.