Having a mother or daughter who carries a mutation on the BRCA1 or 2 genes puts women at an increased risk of developing breast and ovarian cancer. The same is true for men, although few men undergo genetic testing.
“Men are equally as likely as women to inherit a BRCA mutation,” said Dr. Christopher Childers, a resident physician in the department of surgery at the David Geffen School of Medicine, University of California-Los Angeles.
“If a male has a BRCA mutation, his risk of breast cancer increases a hundredfold.”
A study published in JAMA Oncology in April found that few men are screened for BRCA genetic mutations. Analyzing data from the 2015 National Health Interview Survey, researchers found that men underwent testing for breast/ovarian cancer genes at one-tenth the rate of women.
“Men who carry BRCA mutations are at higher risk for a variety of cancers including breast, prostate, pancreatic and melanoma. In particular, males who carry BRCA2 mutations are at increased risk of often early and more aggressive prostate cancers,” Childers said.
Check family history
Previous studies have shown that men believe breast cancer is a female issue, but this couldn’t be further from the truth, said genetic counselor Kimberly Childers, study co-author and regional manager at the Center for Clinical Genetics and Genomics at Providence Health & Services Southern California.
The study by the husband-wife pair, may be the first national study analyzing the rates of genetic cancer testing for both men and women, Christopher Childers said.
“The strongest risk factor for carrying a BRCA mutation is having a family member with a BRCA mutation. If your mother, father, sister, brother or child has a BRCA mutation, you have a 50 percent chance of having the mutation as well,” Kimberly Childers said.
Other factors that may indicate a high probability of carrying a mutation include a personal history of male breast cancer, pancreatic cancer or high-grade or metastatic prostate cancer, Kimberly Childers said.
“Men without a history of cancer may also be at risk of carrying a mutation if there is a strong history of these cancers in their family,” she said. “It’s important for men to know that if their female relatives have ovarian or early breast cancers, that this may translate into a higher cancer risk for them, too.”
Course of action
Men with a BRCA mutation are recommended to undergo clinical breast exams every year starting at age 35, Christopher Childers said.
“Once a BRCA mutation is identified, it is important that they ask their doctor to show them how to perform a self-exam of their chest, learning what abnormal tissue might feel like and what could be of concern,” he said.
Most but not all breast cancers in BRCA positive men occur after age 50. Beginning at age 45, men with BRCA mutations should undergo prostate cancer screening (prostate-specific antigen and digital rectal exams), Christopher Childers said. If men are concerned about their risk, they should discuss it with a primary care provider or genetic counselor. To find a local genetic counselor, visit nsgc.org/findageneticcounselor.
Diagnosis for men
Brad Sidlo, director of radiology for Wilson N. Jones Regional Medical said cancer is personal to him.
His mother is a breast cancer survivor, and he has been fighting breast cancer through radiology for 25 years.
He said breast cancer in men is rare, only 1 in every 1000 men will develop breast cancer.
“It starts with a lump a man could feel. Not necessary painless but are often painless. Some males will feel a knot on their breast area. Most breast cancers who happen to men between ages of 60 to 70. It could be more likely for a male if breast cancer falls to a close relative, like a mother or grandmother, it increases the chances.”
He said diagnosis for a man isn’t that different from a woman. He said a man would get a mammogram the same as a woman.
“When someone presents a lesion on a breast, the starting point for detection is a mammogram,”Sidlo said. Usually, “the man discovers a lump on his chest. Sometimes the nipple would be inverted or have some discharge. At that time you would want to seek a physician.”
He said it is rare for men under the age of 35 to develop breast cancer.
He also said men who are diagnosed with early-stage breast cancer are more likely to die than women.
“Statistically men die from breast cancer when it is found early,” Sidlo said.
He recommends talking to a physician regularly. He said physicians can talk from a more clinical perspective. Patients are more receptive to information coming from a doctor they know.