Men, Breast Cancer, and the BRCA Gene Mutation

We generally think of breast cancer as being only a problem for women; but breast cancer can also occur in men, although far less often than in women. On average, breast cancer occurs in less than 1 in 1,000 American men and accounts for less than 0.5 percent of all cancer deaths in men.

If a man carries a BRCA2 mutation, however, he has a much greater lifetime risk (about 7 percent) of developing breast cancer. He also faces an increased risk of prostate cancer. BRCA1 mutations are less likely than BRCA2 mutations to predispose men to breast cancer.

A man should ask his doctor about a screening test for mutations in his BRCA genes if:

several close female relatives have a history of breast or ovarian cancer
a first-degree relative — mother, sister, brother, or offspring — develops breast cancer before age 50, or has had a positive test for a BRCA gene mutation
The median age of onset of breast cancer in men is about 65, approximately 5 to 10 years later than the age of onset among women. In men with a BRCA mutation, breast cancer occurs at an earlier age and is more aggressive than other types of male breast cancer.

The decision to obtain genetic tests for BRCA mutations must be weighed carefully because the most complete test costs about $3,200, and insurance companies may not pay for any or all of these costs unless your doctor provides convincing reasons for obtaining the test.

Even if a man has already developed breast cancer, he should still get a test for a BRCA mutation, for two reasons: First, finding a BRCA2 mutation increases the likelihood of breast cancer in his apparently normal breast and, second, this information may prove valuable for other members of his family.

There is little information on what steps a man might take to detect breast cancer at an early stage, when it is most treatable. He should, however, be alert to the appearance of a painless, firm mass beneath or around the nipple.

Mammography, which is abnormal in more than 80 percent of men with breast cancer, can distinguish cancer from the more common problem of gynecomastia (breast enlargement in men).