Ultrasound is a helpful tool. Needle biopsies, FNA or core, are used to obtain a histological diagnosis. Mastectomy is usually the surgery of choice. A modified radical is most often used, unless there is chest wall involvement of the muscle, which requires a radical mastectomy with removal of the pectoralis muscles. Radiation therapy is often used because of the close proximity of the tumor to the chest wall.
More men present with later stage disease than women because of the lack of screening programs.
Chemotherapy protocol drugs are identical to female breast cancer drugs. Cytoxan, Methotrexate, and 5FU are usually used in combination as first round chemotherapy. Tamoxifen is added if the tumor tested positive for estrogen or progesterone receptors. Now, men are more often treated with various anti-hormonal drugs. Buserelin, used in combination with a steroidal anti-androgen called cyproterone acetate, has proven to have equal response rates for controlling the disease.