MBC Educational Series

Feeling the Burn: Neuropathy in Cancer Patients and the Overlooked Burden in Male Breast Cancer

Written by: Lennard M. Goetze, Ed.D  |  Phil Hoekstra, Ph.D

This article is an original work prepared for publication exclusively for the Male Breast Cancer Global Alliance. No copyrighted sources were reproduced or paraphrased. All content is intended for educational purposes.

Neuropathy is one of the most common and distressing complications faced by people undergoing cancer treatment—and one of the least adequately addressed in routine survivorship care. Characterized by numbness, tingling, burning pain, electric-shock sensations, temperature sensitivity, and loss of balance, neuropathy can profoundly disrupt mobility, sleep, work, and quality of life. While chemotherapy-induced peripheral neuropathy (CIPN) is widely recognized in oncology, the experience of neuropathy in male breast cancer (MBC) patients remains underrepresented in clinical discourse, research priorities, and survivorship resources.

Men diagnosed with breast cancer often enter care pathways designed primarily around female patients. As a result, side effects such as neuropathy may be under-screened, under-discussed, and under-treated in male survivors—despite the same exposure to neurotoxic chemotherapies, radiation, and adjunctive therapies. Advocacy groups in male breast cancer care have increasingly called attention to this gap, noting that lingering neuropathy becomes a silent burden that outlasts remission and shapes long-term recovery.

 

Why Does Neuropathy Happen in Cancer Care?

Neuropathy in cancer patients arises from multiple converging mechanisms:

1) Chemotherapy Neurotoxicity
Certain chemotherapeutic agents—such as taxanes, platinum compounds, and vinca alkaloids—directly damage peripheral nerves. These drugs interfere with axonal transport, mitochondrial function, and myelin integrity, leading to sensory loss and neuropathic pain that often begins in the toes and fingertips before ascending proximally. Because nerves regenerate slowly, symptoms may persist long after treatment ends.

2) Radiation-Induced Nerve Injury
Radiation can cause fibrosis and microvascular compromise around nerve bundles. While breast cancer radiation targets the chest wall and axillary region, downstream effects on autonomic regulation and microcirculation can alter distal nerve health, contributing to sensory disturbances and cold intolerance in the extremities.

3) Microcirculatory Injury
Cancer therapies can damage small blood vessels that nourish nerves. Reduced perfusion deprives peripheral nerves of oxygen and nutrients, compounding neurotoxicity. The feet—being the most distal tissues—often reveal these deficits first.

4) Inflammation and Immune Dysregulation
Targeted therapies and immunotherapies can trigger inflammatory cascades that affect small fibers and autonomic nerves. In susceptible individuals, this results in burning pain, hypersensitivity, and temperature dysregulation.

5) Compounding Risk Factors
Pre-existing diabetes, vitamin deficiencies, thyroid dysfunction, alcohol exposure, and occupational neurotoxin exposure can amplify neuropathic vulnerability—factors that may be overlooked in male breast cancer care pathways.

Why Male Breast Cancer Patients Are at Particular Risk

Male breast cancer patients frequently report feeling “out of place” in oncology settings, which can discourage proactive reporting of side effects. Neuropathy may be normalized as “expected discomfort” rather than recognized as a treatable condition. Additionally, men may delay reporting sensory changes until functional impairment—falls, gait instability, or sleep disruption—becomes unavoidable. This delay narrows the window for early intervention.

Furthermore, MBC survivors may lack access to gender-specific survivorship education and peer support where neuropathy management strategies are shared. The result is an unmet clinical demand: to screen, detect, identify, and treat neuropathy earlier and more systematically in men with breast cancer.

Screening and Detection: Moving Beyond Symptom Checklists

Traditional neuropathy screening relies heavily on patient-reported symptoms and bedside exams. While essential, these approaches can miss early physiologic changes. Modern survivorship care benefits from combining subjective reporting with functional and imaging-based tools:

·        Quantitative sensory testing to track vibration and thermal thresholds

·        Nerve conduction studies to evaluate large-fiber involvement

·        Thermal imaging to visualize microcirculatory and autonomic changes associated with neuropathic stress patterns in the feet and hands

·        Gait and balance assessments to identify functional risk

Thermal imaging, in particular, offers a non-invasive way to detect asymmetric temperature patterns and distal perfusion changes that often accompany neuropathic dysfunction. While not a standalone diagnostic, it complements neurologic testing by revealing functional changes that may precede overt nerve conduction abnormalities.

Standard Solutions for Managing Cancer-Related Neuropathy

There is no single cure for CIPN, but a multimodal management strategy can significantly reduce suffering:

Pharmacologic Options

·        Neuropathic pain agents (e.g., duloxetine)

·        Topical analgesics for focal pain

·        Careful medication review to avoid neurotoxic overlaps

Rehabilitation and Physical Therapy

·        Balance training and proprioceptive exercises

·        Gait stabilization and fall-prevention programs

·        Strength training to reduce compensatory injury

Lifestyle and Supportive Interventions

·        Foot protection and proper footwear to prevent unnoticed injury

·        Nutritional assessment (B vitamins, metabolic support)

·        Sleep and pain hygiene strategies

Adjunctive Non-Invasive Modalities

·        Neuromodulation techniques

·        Image-guided monitoring of extremity health to track response to interventions

·        Education on daily foot checks to catch early skin or sensory changes

Neuropathy and Dermatomal Mapping

Peripheral neuropathy and radiculopathy often produce burning, tingling, or electric pain in specific distributions. Thermography can visualize these patterns along dermatomes—the “wiring diagram” of the skin mapped to spinal nerve roots. Dr. Hoekstra describes how thermal gradients trace neuropathic pathways, helping localize nerve impingement in the spine or peripheral nerves in the limbs. When combined with autonomic challenge testing, clinicians can differentiate acute inflammatory phases (often warmer) from chronic ischemic or denervated phases (often cooler).

 

This capability is especially valuable in pain management and personal injury contexts, where objective documentation of nerve-related dysfunction supports diagnosis, treatment planning, and medico-legal clarity.

The Case for Proactive Neuropathy Care in MBC Survivorship

For male breast cancer survivors, neuropathy is not merely a side effect—it is a quality-of-life determinant. Persistent numbness or burning pain undermines confidence in walking, returning to work, and re-engaging in daily life. When neuropathy is under-identified, survivors feel unseen; when it is proactively addressed, recovery becomes tangible.

Elevating neuropathy screening within male breast cancer survivorship reframes care from survival alone to functional restoration. By integrating early detection tools, imaging-informed surveillance, and multidisciplinary treatment pathways, clinicians can move from reactive pain management to proactive nerve protection. In doing so, the cancer community honors a simple truth voiced by patients themselves: relief from neuropathy is not optional—it is essential to healing.

 

 

Part 2 —

A Diagnostic Perspective on Neuropathy in Cancer Care

By: Robert L. Bard, MD, DABR, FAIUM, FASLMS

From a diagnostic imaging perspective, neuropathy in cancer patients is not a mysterious side effect—it is a predictable consequence of how modern oncology therapies interact with nerve biology, microcirculation, and tissue metabolism. Peripheral nerves are uniquely vulnerable structures. They rely on uninterrupted blood supply, intact mitochondrial function, and stable axonal transport to maintain sensory and motor signaling over long distances. Cancer treatments disrupt each of these systems in different ways, which explains why neuropathy often emerges first in the feet and hands.

Chemotherapeutic agents are designed to target rapidly dividing cells, but many also interfere with microtubule dynamics and mitochondrial integrity within neurons. This impairs axonal transport—the cellular “highway” that delivers nutrients and signaling molecules along nerve fibers. When transport fails, distal segments of long nerves become metabolically deprived, producing the classic stocking-and-glove distribution of numbness, burning pain, and temperature sensitivity. In parallel, treatment-related injury to the small vessels that nourish nerves reduces oxygen delivery, compounding neural stress in the most distal tissues.

Radiation therapy introduces a different pathway to neuropathy. By inducing endothelial injury and fibrotic change within irradiated fields and adjacent neurovascular bundles, radiation alters vascular regulation and autonomic signaling. Even when radiation is localized to the chest wall or axilla in breast cancer care, downstream effects on autonomic tone can influence distal circulation and nerve health. Over time, this dysregulation manifests as altered temperature control, color changes, edema, and sensory disturbances in the extremities.

Imaging provides a unique window into these processes because neuropathy is not solely a neural problem—it is a neurovascular and metabolic disorder with structural and functional signatures. High-resolution ultrasound can visualize peripheral nerves, revealing enlargement, altered echotexture, and perineural edema associated with inflammatory or compressive neuropathies. Doppler ultrasound adds physiologic context by assessing regional blood flow, highlighting areas of microcirculatory compromise that parallel sensory symptoms. When nerve irritation coexists with ischemic stress, imaging helps distinguish primary neural pathology from secondary vascular contributors—an important distinction for targeted intervention.

Functional imaging modalities further extend diagnostic insight. Thermal imaging, for example, visualizes patterns of cutaneous temperature regulation that reflect autonomic control of microcirculation. In neuropathic states, asymmetry, distal cooling, or focal hotspots often parallel patient-reported burning or numbness. While not a standalone diagnostic tool, thermal imaging complements neurologic testing by revealing functional dysregulation that may precede structural nerve changes detectable by conduction studies. This functional perspective is particularly valuable in early survivorship, when symptoms are evolving and intervention windows are still open.

Imaging also supports longitudinal care. Neuropathy in cancer patients is dynamic: symptoms may worsen during therapy, plateau, or slowly recover afterward. Serial imaging—tracking nerve morphology, regional perfusion, and functional temperature patterns—provides objective markers of change over time. These markers inform clinical decisions about dose modification, rehabilitation strategies, protective footwear, and referral timing to neurology or pain management. In male breast cancer survivorship, where neuropathy may be underreported, objective imaging evidence helps validate patient experience and accelerates appropriate care pathways.

From a broader diagnostic standpoint, neuropathy rarely exists in isolation. Imaging frequently reveals concurrent contributors such as spinal degenerative changes, entrapment neuropathies, or vascular insufficiency that magnify treatment-related nerve injury. By integrating peripheral nerve imaging with regional vascular assessment, clinicians can address layered pathology rather than treating neuropathy as a single-cause phenomenon. This integrative approach aligns with precision survivorship—tailoring interventions to the dominant drivers of nerve dysfunction in each patient.

Ultimately, the value of imaging in cancer-related neuropathy lies in its ability to translate subjective symptoms into objective, trackable physiology. When patients say their feet burn, go numb, or feel “disconnected,” imaging provides clinicians with a map of where neurovascular stress is occurring and how it changes with time and therapy. This diagnostic clarity reframes neuropathy from an inevitable side effect to a monitorable condition—one that can be detected earlier, managed more precisely, and mitigated before it becomes a permanent barrier to recovery and quality of life.

 

References

1.     Argyriou, A. A., Bruna, J., Marmiroli, P., & Cavaletti, G. (2012). Chemotherapy-induced peripheral neurotoxicity (CIPN): An update. Critical Reviews in Oncology/Hematology, 82(1), 51–77. https://doi.org/10.1016/j.critrevonc.2011.04.012

2.     Cavaletti, G., & Marmiroli, P. (2010). Chemotherapy-induced peripheral neurotoxicity. Nature Reviews Neurology, 6(12), 657–666. https://doi.org/10.1038/nrneurol.2010.160

3.     Hershman, D. L., et al. (2014). Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO clinical practice guideline. Journal of Clinical Oncology, 32(18), 1941–1967. https://doi.org/10.1200/JCO.2013.54.0914

4.     National Cancer Institute. (2024). Peripheral neuropathy (PDQ®)–Health professional version. https://www.cancer.gov/about-cancer/treatment/side-effects/nerve-problems/peripheral-neuropathy-pdq

5.     Staff, N. P., Grisold, A., Grisold, W., & Windebank, A. J. (2017). Chemotherapy-induced peripheral neuropathy: A current review. Annals of Neurology, 81(6), 772–781. https://doi.org/10.1002/ana.24951

6.     Giordano, S. H. (2018). Breast cancer in men. New England Journal of Medicine, 378(24), 2311–2320. https://doi.org/10.1056/NEJMra1707939

7.     Loprinzi, C. L., et al. (2020). Management of cancer treatment–related peripheral neuropathy. Journal of Clinical Oncology, 38(28), 3325–3348. https://doi.org/10.1200/JCO.20.01399

8.     Mols, F., Beijers, T., Vreugdenhil, G., & van de Poll-Franse, L. (2014). Chemotherapy-induced peripheral neuropathy and its association with quality of life among cancer survivors. Supportive Care in Cancer, 22(8), 2261–2269. https://doi.org/10.1007/s00520-014-2208-4

 

CANCER TREATMENTS & THE FEET - A SENTINEL ORGAN

How oncology therapies reshape peripheral circulation, nerve health, and tissue integrity—and why the feet serve as a diagnostic sentinel

By: Lennard M. Goetze, Ed.D  / Phil Hoekstra, Ph.D

 

Introduction

Modern cancer therapies have transformed survival outcomes, yet survivorship often carries a hidden burden: long-term compromise of peripheral circulation, nerve integrity, and tissue resilience—most visibly expressed in the feet. Chemotherapy disrupts microvascular networks and damages peripheral nerves; radiation alters vascular regulation and autonomic signaling; and targeted and immunotherapies introduce new patterns of inflammatory and ischemic stress. These physiologic disruptions commonly manifest in the lower extremities as numbness, burning pain, edema, color changes, delayed wound healing, nail pathology, and skin breakdown—symptoms that erode mobility, independence, and quality of life.

PodiatryScan reframes the feet as a sentinel region for treatment-related injury—where early shifts in perfusion, nerve function, and tissue tolerance can be detected, monitored, and managed longitudinally. Rather than waiting for survivorship complications to escalate into disability, a proactive surveillance model identifies emerging microcirculatory compromise and neuropathic stress earlier in recovery. Positioned within oncology survivorship care, PodiatryScan supports preventive foot monitoring, rehabilitation planning, protective strategies, and timely referral—elevating post-cancer care from reactive management to function-preserving, anticipatory medicine.

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1) Chemotherapy-Induced Peripheral Neuropathy (CIPN) and the Feet

CIPN is among the most prevalent and functionally limiting toxicities of cancer therapy. Agents such as taxanes, platinum compounds, vinca alkaloids, and proteasome inhibitors damage sensory axons and small fibers that innervate the feet, producing numbness, paresthesia, burning pain, and proprioceptive loss. The feet—being distal—are affected earliest and often most severely. Sensory loss increases fall risk, impairs balance, and predisposes to unnoticed trauma. Persistent neuropathy can outlast treatment by years, reshaping gait mechanics and loading patterns across the foot and ankle. Surveillance that tracks sensory thresholds, skin integrity, and functional stability helps clinicians intervene with protective footwear, balance training, and timely referrals to neurology or rehab before secondary injuries accrue.

 

2) Microvascular Injury and Ischemic Stress

Many cytotoxic agents injure endothelial cells and disrupt nitric-oxide–mediated vasodilation, diminishing capillary perfusion in distal tissues. Reduced microcirculation compromises oxygen delivery to the toes and plantar skin, delaying healing after minor cuts or pressure points. In patients with pre-existing vascular disease, diabetes, or smoking history, treatment-related microangiopathy compounds ischemic risk. The feet, as terminal vascular territories, often reveal early signs of perfusion stress—color changes, temperature asymmetry, and delayed capillary refill—making them an ideal surveillance target for circulatory compromise during survivorship.

 

3) Radiation Effects on Vascular Regulation and Autonomic Control

Radiation therapy can induce long-lasting endothelial injury, fibrosis, and autonomic dysregulation within treated fields and along neurovascular pathways. Although the feet are rarely irradiated directly, autonomic disturbances and systemic inflammatory responses can alter distal vascular tone and sweat gland function. Patients may report cold intolerance, color changes, edema, or brittle skin and nails in the lower extremities. These changes increase susceptibility to fissures, infection, and pressure injury—particularly in older adults or those with limited mobility. Monitoring distal tissue resilience becomes part of comprehensive survivorship care.

 

4) Hand–Foot Syndrome (Palmar-Plantar Erythrodysesthesia)

Certain chemotherapies and targeted agents precipitate hand–foot syndrome, characterized by erythema, pain, swelling, desquamation, and blistering on palms and soles. Plantar involvement threatens ambulation and adherence to therapy. Early identification of plantar skin stress enables dose adjustments, topical protection, and offloading strategies that preserve function and reduce treatment interruptions.

 

5) Lymphedema, Edema, and Tissue Vulnerability

Cancer-related lymphatic injury—whether from surgery, radiation, or systemic inflammation—can manifest as lower-extremity edema. Chronic swelling increases skin tension, reduces microcirculatory exchange, and raises infection risk. The feet, constrained by footwear and dependent positioning, are particularly vulnerable to maceration and fissuring. Longitudinal surveillance guides compression strategies, footwear modification, skin care, and referral to lymphedema therapy to prevent recurrent cellulitis and mobility decline.

 

6) Immunotherapy and Inflammatory Dermatoses

Checkpoint inhibitors and other immunotherapies introduce novel inflammatory toxicities affecting skin and small vessels. Acral dermatitis, vasculitic changes, and microvascular inflammation may present on the feet as painful erythema, purpura, or ulceration. Differentiating immune-mediated dermatoses from ischemic or infectious etiologies is critical to avoid mismanagement and unnecessary treatment interruptions. Structured foot surveillance supports earlier triage and targeted management.

 

7) Nail and Skin Barrier Disruption

Onycholysis, brittle nails, paronychia, xerosis, and fissuring are common during systemic therapy. On the feet, nail dystrophy alters pressure distribution in footwear, while skin barrier breakdown invites fungal and bacterial infection. Preventive foot care—routine inspection, nail management, moisturization, and footwear assessment—reduces secondary complications that disproportionately burden survivors with neuropathy or edema.

 

8) Musculoskeletal Deconditioning and Gait Changes

Pain, fatigue, and neuropathy alter loading patterns across the forefoot and heel, precipitating callus formation, plantar fasciopathy, and stress reactions. Deconditioning compounds these biomechanical shifts, increasing fall risk. Integrating podiatric assessment with rehabilitation planning preserves mobility and helps survivors return to activity safely.

 

9) Infection Risk in an Immunocompromised Host

Neutropenia and mucocutaneous barrier injury elevate the risk of tinea pedis, cellulitis, and wound infection in the feet. Minor interdigital fissures can escalate rapidly in immunocompromised patients. Proactive surveillance, patient education on daily foot checks, and rapid response pathways for early infection signs are essential.

 

10) Why the Feet Are a Sentinel in Survivorship

The feet concentrate the downstream effects of vascular, neurologic, inflammatory, and mechanical stressors introduced by cancer therapies. Because they are distal, load-bearing, and richly innervated, early dysfunction becomes clinically apparent there first. PodiatryScan operationalizes this insight through structured, longitudinal foot monitoring—integrating perfusion cues, sensory status, skin integrity, and functional mobility into survivorship workflows. The result is earlier detection, smarter referrals, targeted protection, and function-preserving care that keeps survivors mobile and independent.

 

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Clinical Takeaways

·        Screen early and often for sensory loss, perfusion stress, and skin barrier compromise in the feet during and after therapy.

·        Act preventively with footwear optimization, offloading, skin care, balance training, and timely specialty referral.

·        Coordinate care across oncology, podiatry, neurology, rehab, and wound services to prevent small problems from becoming disabling sequelae.

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References

1.       American Cancer Society. (2023). Hand–foot syndrome (palmar-plantar erythrodysesthesia).

2.       Argyriou, A. A., Bruna, J., Marmiroli, P., & Cavaletti, G. (2012). Chemotherapy-induced peripheral neurotoxicity (CIPN): An update. Critical Reviews in Oncology/Hematology, 82(1), 51–77.

3.       Cavaletti, G., & Marmiroli, P. (2010). Chemotherapy-induced peripheral neurotoxicity. Nature Reviews Neurology, 6(12), 657–666.

4.       Hershman, D. L., et al. (2014). Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers. Journal of Clinical Oncology, 32(18), 1941–1967.

5.       Lacouture, M. E., et al. (2011). Clinical practice guidelines for the prevention and treatment of EGFR inhibitor–associated dermatologic toxicities. Supportive Care in Cancer, 19(8), 1079–1095.

6.       National Cancer Institute. (2024). Peripheral neuropathy (PDQ®)–Health professional version.

7.       Rockson, S. G. (2018). Lymphedema. American Journal of Medicine, 131(3), 276–280.

8.       Siegel, R. L., Miller, K. D., & Jemal, A. (2024). Cancer statistics. CA: A Cancer Journal for Clinicians, 74(1), 17–48.

9.       Smith, E. M. L., et al. (2013). The reliability and validity of a modified Total Neuropathy Score in patients with CIPN. Journal of the Peripheral Nervous System, 18(1), 45–51.

10.     Sonis, S. T. (2013). Pathobiology of mucositis. Nature Reviews Cancer, 4(4), 277–284.

Inside the Resounding Success of the 2025 MBCGA Medical Summit (DRAFT ONLY)

 DRAFT- NOT FOR PUBLISHING YET

A Record-Breaking Convergence and a New Global Standard

The Male Breast Cancer Global Alliance (MBCGA) 2025 Medical Summit has now firmly established itself as one of the most influential global forums dedicated to male breast cancer education, advocacy, and clinical advancement. Held October 24–25, 2025, the Summit exceeded expectations on every front—attendance, reach, scientific depth, and emotional resonance—surpassing participation records from previous years and signaling a new era of momentum for the Alliance

Under the visionary leadership of Cheri Ambrose, Founder and CEO of MBCGA, the Summit convened an extraordinary roster of international clinicians, researchers, survivors, caregivers, and advocates. What unfolded over two days was not simply a conference, but a living demonstration of how education, collaboration, and human connection can accelerate progress in a disease long overshadowed by gender bias.

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Where Science Met Humanity

The 2025 Summit featured a meticulously curated agenda addressing the most urgent and emerging frontiers in male breast cancer—from early access and precision diagnostics to survivorship, rehabilitation, mental health, and global equity

Opening sessions set a decisive tone. Naomi Litchfield of Bionical Emas underscored why early access to therapies is not a luxury but a lifeline. That message was carried forward by Jose Pablo Leone, who delivered critical updates on the ETHAN Clinical Trial, one of the most important research efforts focused exclusively on breast cancer in men.

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Innovation at the Clinical Frontier

Among the Summit’s most talked-about sessions was Robert Bard, whose presentation on image-guided tumor treatment showcased how advanced imaging is reshaping precision oncology. His emphasis on targeting disease while preserving healthy tissue reinforced a central Summit theme: smarter care, not more aggressive care

The future of precision monitoring took center stage with Ben Park, whose presentation on circulating tumor DNA (ctDNA) was widely regarded as a cornerstone of the Summit. “Our ability now to de-escalate therapies based upon knowing who really has microscopic cancer cells left—and who doesn’t—is going to be game-changing,” Dr. Park stated, highlighting a paradigm shift that could spare patients unnecessary toxicity while accelerating cures

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Care Beyond Treatment

The Summit’s power lay equally in its attention to life beyond protocols. Charlotte Bayala delivered a deeply moving session on grounding oneself amid uncertainty—drawing from her lived experience as a caregiver. Her message echoed a sentiment that resonated across chat feeds and post-event feedback: science heals bodies, but presence heals families .

Physical recovery and long-term resilience were masterfully addressed by Leslie Waltke, whose evidence-based rehabilitation strategies reframed survivorship as an active, lifelong process rather than a passive aftermath.

Equally impactful was Barbara Bartlik, who confronted the often-ignored emotional and psychological toll of male breast cancer. Her call to integrate psychiatric care into oncology settings was both sobering and galvanizing

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A Global Perspective, A Shared Mission

Day two expanded the Summit’s lens internationally. Fatima Cardoso delivered a landmark address on advanced and metastatic male breast cancer, blending scientific rigor with a global advocacy perspective. Her remarks underscored the urgent need for equity in research funding, diagnostics, and access to care worldwide

Mentorship, survivorship, and palliative care were powerfully explored by leaders including Keeshia Jones and Don Dizon, whose reframing of palliative care as a pathway to thriving challenged long-standing misconceptions.

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Sponsors, Partners, and a Growing Movement

The success of the 2025 Summit was amplified by the engagement of sponsors and institutional partners—including Pfizer, whose participation highlighted the role of real-world evidence in expanding treatment access for men with breast cancer.

While final attendance figures are pending, organizers confirm that participation exceeded all prior MBCGA summits—an unmistakable indicator of growing global engagement and trust in the Alliance’s mission.

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A Defining Moment for MBCGA

As the final sessions closed, one truth was unmistakable: the 2025 MBCGA Medical Summit was not just successful—it was transformational. It validated years of advocacy, elevated underrepresented voices, and forged new pathways for collaboration across disciplines and borders.

In the words echoed throughout the Summit, education is not optional—it is survival. And in 2025, MBCGA proved that when the world comes together with purpose, progress follows.

SPECIAL EVENT ANNOUNCEMENT: Global 2026 Quarterly Webinar Series

MBCGA Launches a Global 2026 Quarterly Webinar Series—Education, Empowerment, and the Future of Male Breast Cancer Care

In 2026, the Male Breast Cancer Global Alliance (MBCGA) is taking a decisive step forward in its educational mission with the launch of a Quarterly Global Webinar Series—a curated, high-impact program designed to bring timely science, lived experience, and clinical insight directly to patients, caregivers, clinicians, and advocates around the world.

This new series builds on years of MBCGA’s commitment to visibility, equity, and clarity in male breast cancer. From its earliest educational forums and digital town halls to international collaborations with clinicians and survivor-leaders, MBCGA has consistently used education as a catalyst for empowerment. The 2026 webinar series formalizes that mission into a structured, seasonal platform—each quarter focused on a topic that directly affects quality of life, decision-making, and long-term survivorship.

A Legacy of Education, Now Elevated

Historically, MBCGA webinars have served as safe spaces where complex topics—often overlooked in male breast cancer—could be explored openly. These sessions connected survivors with surgeons, geneticists, exercise physiologists, and integrative health experts, fostering dialogue that transcended borders. As the Alliance’s global reach expanded, so did the need for a more intentional educational arc—one that follows the patient journey from diagnosis through recovery and beyond.

The 2026 Quarterly Webinar Series answers that call. Each session is strategically timed, thoughtfully themed, and anchored by respected voices across medicine and advocacy. Together, they form a year-long narrative of care.

The 2026 Webinar Lineup

Spring | March 19 – Breast Reconstruction
Reconstruction is often framed through a female lens, leaving male patients navigating unanswered questions. This session addresses surgical options, physical outcomes, and the psychological dimensions of reconstruction—bringing clarity to an often under-discussed aspect of male breast cancer care.

Summer | June 17 – Exercise Oncology
Movement is medicine—but how, when, and why matters. The summer session explores the science of exercise oncology, examining how tailored physical activity supports recovery, reduces recurrence risk, and restores confidence after treatment.

Fall | September 24 – Genetics
Genetic testing and inherited risk are central to male breast cancer awareness. This webinar delves into genetic counseling, family implications, and emerging research—equipping patients and families with knowledge that informs prevention and vigilance.

Winter | December 9 – Detoxification
Closing the year, MBCGA turns its focus to detoxification and environmental health—an area of growing concern among survivors. This session examines toxic burden, post-treatment resilience, and practical strategies for supporting long-term health.

Voices That Matter

The strength of the series lies in its speakers—leaders who bridge science and lived experience. Featured guests include Dr. Leslie Montoya and Dan Root, representing Detox of Cancer and offering insight into recovery-focused detoxification strategies. Genetic expertise and clinical perspective are brought by Dr. Sarah Pearson and Dr. Leslie Waltke, while survivor-advocate Harvey Singer grounds each discussion in real-world experience.

Education That Serves the Community

Topic selection for the 2026 series was guided by one principle: relevance. Each theme reflects recurring questions from the MBCGA community—questions about identity after surgery, strength after treatment, inherited risk, and environmental exposures. By aligning expert knowledge with survivor priorities, the Alliance ensures that education remains practical, compassionate, and actionable.

Looking Ahead

The MBCGA Quarterly Webinar Series is more than a calendar of events—it is a declaration. A declaration that male breast cancer education deserves depth, continuity, and global reach. As 2026 unfolds, these webinars will not only inform but also connect, inspire, and empower a worldwide community committed to better outcomes and brighter futures.

"Education changes lives. In 2026, MBCGA is making sure it reaches everyone who needs it."

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The 2025 MBCGA Medical Summit marked a defining moment in global male breast cancer education—breaking attendance records and raising the bar for clinical, survivor, and advocacy-driven collaboration.

Held October 24–25, the Summit convened an extraordinary international faculty of oncologists, researchers, rehabilitation specialists, caregivers, survivors, and industry leaders, all united by one mission: advancing equity and outcomes for men with breast cancer. From groundbreaking discussions on circulating tumor DNA, image-guided tumor treatment, and advanced metastatic care, to powerful sessions on survivorship, mental health, caregiving, and rehabilitation, the program delivered depth, relevance, and humanity in equal measure.

Hosted by MBCGA Founder and CEO Cheri Ambrose, the event showcased why education is not optional—it is lifesaving. With global participation surpassing all previous years and strong engagement from institutional partners and sponsors, the 2025 Summit affirmed MBCGA’s role as a trusted convener and catalyst for progress. This was not just a conference—it was a turning point.

SEE COMPLETE FEATURE REVIEW ON THE 2025 MBCGA SUMMIT

Speaker 1: Dr Jose Pablo Leone- MBCGA 2025 Health Summit (October 24-26)

Redefining Endocrine Therapy for Men: Inside Dr. Jose Pablo Leone’s ETHAN Trial

For decades, the treatment of male breast cancer has remained largely unchanged—quietly borrowing from protocols designed for women while rarely being questioned, tested, or refined for men themselves. At the Dana-Farber Cancer Institute, Dr. Jose Pablo Leone has spent much of his career confronting this imbalance. Through the ETHAN clinical trial, now actively underway at Dana-Farber and collaborating academic centers, he is leading one of the most consequential efforts to modernize endocrine therapy for men with breast cancer—not through extrapolation or assumption, but through direct, carefully designed clinical investigation.

Dr. Leone’s work sits at the intersection of clinical urgency and scientific discipline. Male breast cancer is rare, accounting for a small fraction of overall breast cancer diagnoses, yet rarity has come at a cost. While endocrine therapies for women have advanced rapidly—incorporating aromatase inhibitors, ovarian suppression strategies, and targeted agents such as CDK4/6 inhibitors—men have remained tethered to tamoxifen, a drug that has served as the default standard for decades.

“We’re still treating men the way we did 30 or 40 years ago,” Dr. Leone has observed. “Not because it’s the best option, but because we’ve never definitively tested anything else.”

That gap is precisely why ETHAN exists.

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Why ETHAN Had to Be Built

Hormone receptor–positive disease represents approximately 90–95% of male breast cancer cases in the United States. In women, this subtype has been the focus of relentless innovation. Large trials reshaped care by demonstrating that aromatase inhibitors—alone or combined with ovarian suppression—could outperform tamoxifen in key settings. More recently, CDK4/6 inhibitors such as abemaciclib and ribociclib have extended disease-free survival even further.

For men, however, these advances created an uncomfortable paradox: better therapies exist, but clinicians lack the evidence to confidently apply them. “We’re stuck,” Dr. Leone explains, “because without male-specific data, every decision feels like a leap of faith.”

ETHAN was designed to replace that uncertainty with clarity.

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A Trial That Watches Tumors Respond in Real Time

Rather than attempting to replicate massive, multi-thousand-patient trials—an unrealistic goal in a rare cancer—ETHAN uses a powerful alternative approach: a pre-surgical “window of opportunity” design.

Men with newly diagnosed, operable, ER/PR-positive, HER2-negative breast cancer are enrolled before any treatment begins. Participants are randomized to one of three initial endocrine strategies: tamoxifen alone, an aromatase inhibitor alone, or an aromatase inhibitor combined with gonadotropin-releasing hormone (GnRH) suppression. After just three weeks of therapy, a research biopsy is performed.

“The advantage of this design,” Dr. Leone explains, “is that we don’t have to guess. We can actually see what the tumor is doing.”

Following this window phase, patients continue endocrine therapy—with or without the addition of the CDK4/6 inhibitor abemaciclib—before proceeding to surgery. This two-by-two structure allows the study to answer several critical questions simultaneously: which endocrine backbone works best, whether CDK4/6 inhibition adds benefit, and which combinations make the most sense for men.

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Measuring What Matters Most

ETHAN’s dual primary endpoints reflect its dual mission. The first is reduction in Ki-67, a marker of tumor proliferation, measured between diagnosis and the research biopsy. The second is the Residual Cancer Burden (RCB) index, assessed at surgery to quantify how much tumor remains after treatment.

“These aren’t redundant measures,” Dr. Leone emphasizes. “They tell us different things at different moments.”

Ki-67 captures early biological response—how aggressively the cancer slows when therapy begins. RCB reflects cumulative effect, translating treatment response into surgical reality.

Secondary endpoints broaden the lens further. Hormone levels, including estradiol and testosterone, are tracked to understand how each therapy reshapes male physiology. Safety, feasibility, and quality of life are monitored throughout, recognizing that effectiveness without tolerability is not a true solution.

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A Translational Engine, Not Just a Clinical Trial

ETHAN is also notable for its depth of biological exploration. Tissue from diagnostic biopsies, window biopsies, and surgical specimens is collected alongside serial blood samples. Through collaborations with national research leaders, the study examines tumor genomics, germline mutations, circulating tumor DNA, and mechanisms of tumor cell death.

One focus is apoptosis—the programmed death of cancer cells—which may differ among CDK4/6 inhibitors. “There’s a hypothesis that abemaciclib may induce more tumor cell death than other agents,” Dr. Leone notes. “Believe it or not, this hasn’t been definitively studied even in women.”

The trial also seeks to identify endocrine response signatures—genetic patterns that predict which tumors will respond best to specific therapies. While women benefit from tools like Oncotype DX, no equivalent exists for men. ETHAN aims to change that.

“This is about understanding why endocrine therapy works beautifully in some men and not in others,” Dr. Leone says. “Once we understand that, everything changes.”

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The Human Cost of Having Only One Option

Beyond efficacy, ETHAN confronts a hard truth: men often struggle to complete endocrine therapy. European studies suggest that only 40–50% of men finish five years of tamoxifen, compared with roughly 70% of women completing endocrine therapy overall.

Tamoxifen’s side-effect profile can be particularly challenging for men, including elevated blood-clot risk, sexual dysfunction, fatigue, and muscle pain. “If you only have one option,” Dr. Leone explains, “and that option causes significant side effects, the likelihood of stopping early is high.”

Aromatase inhibitors offer a different experience for men. With testosterone levels preserved, risks such as osteoporosis are minimal, and hot flashes are uncommon. “Even if these drugs work equally well,” he adds, “having another option is a huge win—for adherence, for quality of life, and for peace of mind.”

ETHAN allows clinicians to observe not only tumor response, but how men tolerate each approach—information that directly informs post-surgical treatment decisions.

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Momentum, Collaboration, and Urgency

Enrollment in ETHAN is ongoing across major academic centers in the United States, with additional sites opening to expand geographic access. Progress has been steady, though slower than initially hoped—a reality Dr. Leone acknowledges candidly.

“This is still a success,” he says. “Eighteen men enrolled in a male-specific breast cancer trial is not trivial. But the community needs answers, and we want to get there as fast as possible.”

The trial’s momentum reflects extraordinary collaboration among academic institutions, patient advocates, and national organizations. Support from the male breast cancer advocacy community has been instrumental in expanding access and awareness.

“This work doesn’t happen in isolation,” Dr. Leone emphasizes. “It happens because patients, advocates, and researchers align around a shared goal.”

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A Turning Point in Male Breast Cancer Care

ETHAN is not simply a study of drugs—it is a statement. It challenges the notion that men must accept hand-me-down standards of care. It insists that evidence matters, even in rare diseases. And it demonstrates that with thoughtful design, small trials can answer big questions.

“If all we learn is that these therapies work just as well as tamoxifen,” Dr. Jose Pablo Leone reflects, “that alone changes everything.”

For men facing a diagnosis that has long lived in the shadows of breast cancer research, ETHAN represents something profoundly overdue: clarity, choice, and progress grounded in evidence rather than assumption.