What men should know about genetic breast cancer

Breast cancer is not common in men, but it does occur. According to the American Cancer Society an estimated 2,470 new cases of invasive breast cancer will be diagnosed in men in 2017.

Unfortunately, because male breast cancer is rare, researchers don’t have a lot of information on it.

“The entire field of male breast cancer is plagued by a lack of evidence,” says Gabriel Hortobagyi, M.D., clinical professor of breast medical oncology.

But we do know that it is often linked to a family history of the disease.

About 1 in 5 men with breast cancer have a close relative – male or female – with the disease. These men may have a gene mutation, or defect, called BRCA1 or BRCA2, or simply referred to as BRCA.

Just like women, men who are at risk for breast cancer should undergo genetic counseling and genetic testing to determine if they have the disease. We talked with Hortobagyi about what men should know about the BRCA genetic mutation. Here’s what he had to say.

How does a man know if he should receive genetic test for the BRCA genetic mutation?

Men should undergo genetic screening if they:

• Have been diagnosed with breast cancer
• Have a first-degree relative (mother, father, sibling, child) with early onset breast cancer, breast cancer in both breasts or ovarian cancer  

Why should men be tested for the BRCA mutation?

So often men are not tested. Men don’t think they can get breast cancer. Often, even their doctors don’t believe that men can get breast cancer. And while it is rare for men to develop breast cancer, we know it is certainly possible.

The main reason why a man would underdo genetic testing would be so that his doctors could monitor his health. That way, if he does develop breast cancer, it can be treated as quickly as possible. Catching cancer early makes it easier to treat and improves chances for survival.

In addition, if a man carries the BRCA mutation, he can notify the women in his family – sisters or daughters – that they, too, may carry the gene. They can consider if they wish to undergo genetic testing.

What next steps should a man who carried the BRCA mutation take?

Men with the BRCA mutation are more likely than the average man to develop breast cancer, but carrying the gene mutation doesn’t mean they are guaranteed to develop breast cancer. Men with a BRCA mutation have about a 3 to 5% chance of developing breast cancer. (For most men, their lifetime breast cancer risk is about .001%)

In contrast, women with the BRCA mutation are much more likely than men to develop breast cancer. According to the National Cancer Institute, 55 to 65% of women who inherit the BRCA mutation will develop breast cancer before age 70.

But that doesn’t mean men shouldn’t take steps to lower their breast cancer risk. Men who carry the BRCA mutation should seek treatment from an experienced specialist. Because it is so rare, not many doctors have experience treating it.

An experienced doctor can help monitor a man’s symptoms and determine next steps. Often, women with a BRCA mutation will consider a mastectomy to reduce their cancer risk. But there is no evidence that such a surgery would be beneficial in helping men prevent breast cancer.

While there are no specific diet recommendations for preventing male breast cancer, following diet and exercise recommendations can help them maintain a healthy weight and lower their cancer risk.