What Men Should Know About Hereditary Breast Cancer

Last month in October, we were bombarded with images and information about women’s health, particularly about breast cancer. Pink ribbons. Pink shirts. Pink everything. Even when we tuned in on Sundays to catch all the NFL action, we were reminded of breast cancer awareness by the pink gloves and socks worn by players on the field. If you’re like most men, images of breast cancer awareness might make you think something like “yeah, it is important for women to be screened for breast cancer, but I don’t need to worry about any of that stuff”. You might even have a relative or a close friend who has battled breast cancer, and therefore have a deeper emotional connection to breast cancer awareness, but still feel that as a man, it has no relevance to your health.

Yes, breast cancer awareness is appropriately focused primarily on women’s health. But if you think that it is only about women’s health, you’re dead wrong bro, and let me tell you why that is.

While it is relatively rare, breast cancer does happen to men, too. About 1 in 1,000 men will develop breast cancer at some point in their lives. However, some men have a genetic predisposition that substantially increases this risk- I’ll discuss this in more detail later on in this post.

You may have heard about genes related to breast cancer risk before. Do the terms BRCA1 and BRCA2 ring a bell? They’re the two genes that we know are most associated with an increased risk of breast cancer, but they’re also associated with an increased risk for other types of cancer, such as ovarian and prostate cancer. BRCA1 and BRCA2 are cancer protection genes, meaning that when they are working as they should, they help protect us from cancer.

A common misconception about the BRCA1 and BRCA2 genes is that only women have them and therefore, that they can only be passed down to women from their mothers. But in fact, everyone, men and women alike, has two copies of both of these genes. And when someone says that they “have the gene”, what they really mean to say is that one of their two copies of either BRCA1 or BRCA2 has a mutation (think of it as a genetic “spelling mistake”) which causes that copy to not work properly. Therefore, men with a BRCA1 or BRCA2 mutation—not just women—can pass it on to both their sons and daughters.

Now that you’re aware that everyone (including you!) has these genes, it’s important for you to know a little bit more about them. So here are some facts:

  • About 1 in 500 people in the U.S. has a mutation in either BRCA1 or BRCA2. However, this number varies considerably between different ethnic groups. For example, the percentage of people of Ashkenazi Jewish descent who have a BRCA1 or BRCA2 mutation is about 1 in 40, a rate much higher than in the general population.

  • Men with a BRCA mutation have about a 1-10% lifetime risk of developing breast cancer. While this risk is much lower than the lifetime risk of breast cancer for female BRCA mutation carriers (which is between 40-60%), it is much higher than the general population risk for men (0.1%, or 1 in 1000).

  •  Men with a BRCA mutation have a 30-39% lifetime risk of developing prostate cancer. Not only is this risk significantly higher than the general population risk, the type of prostate cancer seen in BRCA mutation carriers (especially in BRCA2) often occurs at a younger age and is more aggressive and potentially life-threatening compared to prostate cancer in non-BRCA mutation carriers.

  • BRCA1 and BRCA2 are not the only genes associated with increased breast and prostate cancer risks for men. So even if someone in your family has had genetic testing for BRCA1 and BRCA2 which was negative (meaning no mutation was found), it could be that a mutation in another gene exists which predisposes to cancer.

  • Men with a BRCA mutation can take action to reduce their cancer risks, such as having annual clinical breast exams to detect any suspicious changes in breast tissue, and blood tests to check PSA (prostate-specific antigen) levels in combination with digital rectal exams.

  • BRCA1 and BRCA2 are typically not associated with colorectal cancer risks (although some recent research has linked mutations in BRCA1 to increased colorectal cancer risks); risks for this type of cancer are associated with mutations in a different set of genes.

So, fellas, if you have a strong family history of breast, ovarian, prostate, or any other type of cancer, consider reaching out to a genetic counselor to discuss your family history of cancer and possible genetic testing. Who knows, it could potentially save your life. And in the meantime, in recognition of No Shave November, let’s do our part to raise awareness about cancer and put that razor down and let that beard grow wild the rest of the month. And pass this information on to your fellow bros. It’s our month and our turn to spread the word.