BRCA Gene Mutation and What It Means For Men

Everyone knows that Angelina Jolie had a double mastectomy as a prophylaxis against developing breast cancer. I think every woman can appreciate how brave she was to undergo the surgery but also how she put this issue on the map and increased the awareness of the BRCA gene. Since Angelina had the mastectomy she has reduced her risk of breast cancer from a dismal 87% to a manageable 5%. But what does the BRCA gene mean if a man carries the gene?

Men and women can inherit and pass on a BRCA mutation. Men with a BRCA mutation have a lower chance overall of developing cancer than do women with a mutation, but their chances of breast cancer, prostate cancer, and a few other specific cancers are increased.
Men with a BRCA gene mutation have a higher risk of developing breast cancer, prostate cancer and skin cancer (melanoma). In some men (and women), BRCA2 gene mutations have been associated with an increased risk of lymphoma, melanoma, and cancers of the pancreas, gallbladder, bile duct, and stomach. Furthermore, these cancers are more likely to develop at a younger age in men with a BRCA mutation. Men with a BRCA mutation have a lower chance overall of developing cancer than do women with a mutation

Both men and women carry the BRCA gene mutation and it is possible for men to inherit the mutated gene from a man’s father.

Men from families with a history of breast and ovarian cancer in the women in the family should consider testing for a BRCA gene mutation particularly if any of the breast cancers occurred before age 50 (in either female or male relatives). Men with breast cancer themselves are highly likely to have a BRCA mutation and should consider testing. Men who have prostate cancer and a family history of breast cancer should also think about testing for the mutated gene.

Men who know they carry a BRCA gene mutation can take proactive steps such as getting screened regularly for some of the cancers associated with the mutation, such as annual prostate cancer screening with a PSA test and annual skin examinations for melanoma. Men with a BRCA mutation should also seek medical advice about any changes in their breasts such as breast tenderness, discharge from the nipple or a breast mass or lump. Even more so, it is important to share this result with your family when you deem appropriate, as it may be life saving information to your sisters, mother and daughters.

Bottom Line: BRCA gene is certainly an important issue for women but it is also important for men as well. If you have a family member with breast or ovarian cancer especially if they have the cancer detected before age 50, then they should have a test for the BRCA gene.

Dr. Neil Baum is physician and the author of What’s Going On Down There, The Complete Guide To Women’s Pelvic Heath and is available from Amazon.com

What’s Going On Down There-Improve Your Pelvic Health (amazon.com)

Breast Cancer In Men-Not Just a Woman’s Problem

Breast cancer is not as common in men as in women and there are 2400 cases diagnosed each year compared to 232,000 new cases of breast cancer diagnosed in women each year. Unfortunately, most men with a breast lump, bump, or discharge from the nipple will ignore the problem. As a result many men do not seek medical care and are diagnosed when the cancer is at a more advanced stage and is more difficult to treat.
The cause of breast cancer in men is not known. However, there appears to be a relationship between male breast cancer and an increase in estrogen in men. Estorgen is the hormone that is responsible for a woman’s breast development. Since men produce very little estrogen, men rarely get breast cancer. It is thought that the extra estrogen in men may be responsible for breast cancer. Also, breast cancer occurs in older men usually at the time that testosterone, the male hormone produced in the testicle, production is in decline.
It is rare for a man under age 35 to get breast cancer. The likelihood of a man developing breast cancer increases with age. But breast cancer is less common in men because their breast duct cells are less developed than those of women and because they normally have lower levels of female hormones that affect the growth of breast cells.
Most male breast cancers are detected between the ages of 60 to 70 years. Other risk factors of male breast cancer include: a family history of breast cancer in a close female relative, a history of radiation exposure of the chest, enlargement of the breasts following hormone treatment, a rare genetic condition called Klinefelter’s syndrome. severe liver disease. diseases of the testicles such as mumps orchitis, a testicular injury, or an undescended testicle. Another newly identified risk factor is an inherited mutated gene or the BRCA2 gene.
Most breast cancer starts in the lining of the milk ducts in the breast and then if undetected or not treated will spread to the lymph nodes under the arm.
The diagnosis is made by the physical examination of the lump or mass noted in the breast tissue. The diagnosis is made by a mammogram which is the same test used for women with a breast mass and is confirmed with a breast biopsy where a small piece of tissue is removed and examined under a microscope.
The treatment of breast cancer in men is based on the tumor stage which is determined by the size and a determination of how far the cancer has spread. A grade 1 tumor is not very fast growing whereas a grade 3 tumor is more like to grow and spread to the lymph nodes and other organs.

The breast cancer found in men is very receptive to an oral drug tamoxifen, which inhibits the action estrogen on the breast tissue. Tamoxifen works like key blocking a keyhole and stops breast cancer cells from multiplying or growing. The side effects of tamoxifen include hot flashes, decreased sex drive, weight gain, and changes in moods. These are the same symptoms that women experience during menopause.

Bottom Line: Breast cancer in men is not very common. However, if detected early it is curable. If you are a man or a woman and experience a new lump or bump in your breast, make an appointment and see your physician.

Dr. Neil Baum is a physician in New Orleans and the author of What’s Going On Down There-the Complete Guide To Women’s Pelvic Health. The book is available on Amazon.com.

New book on women’s health

Preventive Healthcare For Women – What You Need To Know

Women have had an interaction with the healthcare profession from birth to old age. They have achieved good health as a result of frequent visits to their doctors and practiced good health habits. This blog is written for the purpose of providing women with suggestions for continuing the process of maintaining good health.

Why Screening Tests Are Important
Remember that old saying, “An ounce of prevention is worth a pound of cure”? Getting checked early can help you stop diseases like cancer, diabetes, and osteoporosis in the very beginning, when they’re easier to treat. Screening tests can spot illnesses even before you have symptoms. Which screening tests you need depends on your age, family history, your own health history, and other risk factors.

Breast Cancer
The earlier you find breast cancer, the better your chance of a cure. Small breast-cancers are less likely to spread to lymph nodes and vital organs like the lungs and brain. If you’re in your 20s or 30s, your health care provider should perform a breast exam as part of your regular check-up every one to three years. You may need more frequent screenings if you have any extra risk factors.

Screening With Mammography
Mammograms are low-dose X-rays that can often find a lump before you ever feel it, though normal results don’t completely rule out cancer. While you’re in your 40s, you should have a mammogram every year. Then between ages 50 and 74, switch to every other year. Of course, your doctor may recommend more frequent screenings if you’re at higher risk.
Cervical Cancer
With regular Pap smears, cervical cancer (pictured) is easy to prevent. The cervix is a narrow passageway between the uterus (where a baby grows) and the vagina (the birth canal). Pap smears find abnormal cells on the cervix, which can be removed before they ever turn into cancer. The main cause of cervical cancer is the human papillomavirus (HPV), a type of STD.
Screening for Cervical Cancer
During a Pap smear, your doctor scrapes some cells off your cervix and sends them to a lab for analysis. A common recommendation is that you should get your first Pap smear by age 21, and every two years after that. If you’re 30 or older, you can get HPV tests, too, and wait a little longer between Pap smears. Both screenings are very effective in finding cervical cancer early enough to cure it.
Vaccines for Cervical Cancer
Two vaccines, Gardasil and Cervarix, can protect women under 26 from several strains of HPV. The vaccines don’t protect against all the cancer-causing strains of HPV, however. So routine Pap smears are still important. What’s more, not all cervical cancers start with HPV.
Osteoporosis and Fractured Bones
Osteoporosis is a state when a person’s bones are weak and fragile. After menopause, women start to lose more bone mass, but men get osteoporosis, too. The first symptom is often a painful break after even a minor fall, blow, or sudden twist. In Americans age 50 and over, the disease contributes to about half the breaks in women and 1 in 4 among men. Fortunately, you can prevent and treat osteoporosis.
Osteoporosis Screening Tests
A special type of X-ray called dual energy X-ray absorptiometry (DXA) can measure bone strength and find osteoporosis before breaks happen. It can also help predict the risk of future breaks. This screening is recommended for all women age 65 and above. If you have risk factors for osteoporosis, you may need to start sooner.
Skin Cancer
There are several kinds of skin cancer, and early treatment can be effective for them all. The most dangerous is melanoma (shown here), which affects the cells that produce a person’s skin coloring. Sometimes people have an inherited risk for this type of cancer, which may increase with overexposure to the sun. Basal cell and squamous cell are common non-melanoma skin cancers.
Screening for Skin Cancer
Watch for any changes in your skin markings, including moles and freckles. Pay attention to changes in their shape, color, and size. You should also get your skin checked by a dermatologist or other health professional during your regular physicals.
High Blood Pressure
As you get older, your risk of high blood pressure increases, especially if you are overweight or have certain bad health habits. High blood pressure can cause life-threatening heart attacks or strokes without any warning. So working with your doctor to control it can save your life. Lowering your blood pressure can also prevent long-term dangers like heart disease and kidney failure.
Screening for High Blood Pressure
Blood pressure readings include two numbers. The first (systolic) is the pressure of your blood when your heart beats. The second (diastolic) is the pressure between beats. Normal adult blood pressure is below 120/80. High blood pressure, also called hypertension, is 140/90 or above. In between is prehypertension, a sort of early warning stage. Ask your doctor how often to have your blood pressure checked.
Cholesterol Levels
High cholesterol can cause plaque to clog your arteries (seen here in orange). Plaque can build up for many years without symptoms, eventually causing a heart attack or stroke. High blood pressure, diabetes, and smoking can all cause plaque to build up, too. It’s a condition called hardening of the arteries or atherosclerosis. Lifestyle changes and medications can lower your risk.
Checking Your Cholesterol
To get your cholesterol checked, you’ll need to fast for 12 hours. Then you’ll take a blood test that measures total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglycerides (blood fat). If you’re 20 or older, you should get this test at least every five years.
Type 2 Diabetes
One-third of Americans with diabetes don’t know they have it. Diabetes can cause heart or kidney disease, stroke, blindness from damage to the blood vessels of the retina (shown here), and other serious problems. You can control diabetes with diet, exercise, weight loss, and medication, especially when you find it early. Type 2 diabetes is the most common form of the disease. Type 1 diabetes is usually diagnosed in children and young adults.
Screening for Diabetes
You’ll probably have to fast for eight hours or so before having your blood tested for diabetes. A blood sugar level of 100-125 may show prediabetes; 126 or higher may mean diabetes. Other tests include the A1C test and the oral glucose tolerance test. If you’re healthy and have a normal diabetes risk, you should be screened every three years starting at age 45. Talk to your doctor about getting tested earlier if you have a higher risk, like a family history of diabetes.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s spread through sharing blood or body fluids with an infected person, such as through unprotected sex or dirty needles. Pregnant women with HIV can pass the infection to their babies. There is still no cure or vaccine, but early treatment with anti-HIV medications can help the immune system fight the virus.
HIV Screening Tests
HIV can be symptom-free for many years. The only way to find out if you have the virus is with blood tests. The ELISA or EIA test looks for antibodies to HIV. If you get a positive result, you’ll need a second test to confirm the results. Still, you can test negative even if you’re infected, so you may need to repeat the test. Everyone should get tested at least once between ages 13-64.
Preventing the Spread of HIV
Most newly infected people test positive around two months after being exposed to the virus. But in rare cases it may take up to six months to develop HIV antibodies. Use a condom during sex to avoid getting or passing on HIV or other STDs. If you have HIV and are pregnant, talk with your doctor about reducing the risk to your unborn child.
Colorectal Cancer
Colorectal cancer is the second most common cause of cancer death after lung cancer. Most colon cancers come from polyps (abnormal masses) that grow on the inner lining of the large intestine. The polyps may or may not be cancerous. If they are, the cancer can spread to other parts of the body. Removing polyps early, before they become cancerous, can prevent it completely.
Screening for Colorectal Cancer
A colonoscopy is a common screening test for colorectal cancer. While you’re mildly sedated, a doctor inserts a small flexible tube equipped with a camera into your colon. If she finds a polyp, she can often remove it right then. Another type of test is a flexible sigmoidoscopy, which looks into the lower part of the colon. If you’re at average risk, screening usually starts at age 50.
Glaucoma
Glaucoma happens when pressure builds up inside your eye. Without treatment, it can damage the optic nerve and cause blindness. Often, it produces no symptoms until your vision has already been damaged.
Glaucoma Screening
How often you should get your eyes checked depends on your age and risk factors. They include being African-American or Hispanic, being over 60, eye injury, steroid use, and a family history of glaucoma. People without risk factors or symptoms of eye disease should get a baseline eye exam, including a test for glaucoma, at age 40.
Bottom Line: It’s good health sense to talk with your doctor about screening tests. Some tests, such as a Pap test or breast exam, should be a routine part of every woman’s health care. Other tests might be necessary based on your risk factors. Proper screening won’t always prevent a disease, but it can often find a disease early enough to give you the best chance of overcoming it.

Breast Cancer-Not Just A Problem for Women

Breast cancer is one of the most common cancers in women. However, men are not immune to this problem although it is far more common in women. Many people do not realize that men have breast tissue and that they can develop breast cancer. Breast cancer is about 100 times less common among men than among women.
The prognosis (outlook) for men with breast cancer was once thought to be worse than that for women, but recent studies have not found this to be true. In fact, men and women with the same stage of breast cancer have a fairly similar outlook for survival.

The most obvious difference between the male and female breast is size. Because men have very little breast tissue, it is easier for men and their health care professionals to feel small masses (tumors). On the other hand, because men have so little breast tissue, cancers do not need to grow very far to reach the nipple, the skin covering the breast, or the muscles underneath the breast. So even though breast cancers in men tend to be slightly smaller than in women when they are first found, they have more often already spread to nearby tissues or lymph nodes. The extent of spread is one of the most important factors in the prognosis (outlook) of a breast cancer.

Another difference is that breast cancer is common among women and rare among men. Women tend to be aware of this disease and its possible warning signs. Women perform self exams on a regular basis and also obtain mammograms every year. However, most men do not realize they have even a small risk of being affected. Some men ignore breast lumps or think they are caused by an infection or some other reason, and they do not get medical treatment until the mass has had a chance to grow. Because breast cancer is so uncommon in men, there is unlikely to be any benefit in screening men in the general population for breast cancer.

Men need to know that breast cancer is not limited to only women. Possible signs of breast cancer to watch for include: A lump or swelling, which is usually (but not always) painless, skin dimpling or puckering, nipple retraction (turning inward), redness or scaling of the nipple or breast skin, or discharge from the nipple
These changes aren’t always caused by cancer. For example, most breast lumps in men are due to gynecomastia (a harmless enlargement of breast tissue). Still, if you notice any breast changes, you should see your health care professional as soon as possible.
Treatment

Most of the information about treating male breast cancer comes from doctors’ experience with treating female breast cancer. Because so few men have breast cancer, it is hard for doctors to study the treatment of male breast cancer patients separately in clinical trials.
Local therapy is intended to treat a tumor at the site without affecting the rest of the body. Surgery and radiation therapy are examples of local therapies. Systemic therapy refers to drugs, which can be given by mouth or directly into the bloodstream to reach cancer cells anywhere in the body. Chemotherapy, hormone therapy, and targeted therapy are systemic therapies.

The prognosis (outlook) for men with breast cancer was once thought to be worse than that for women, but recent studies have not found this to be true. In fact, men and women with the same stage of breast cancer have a fairly similar outlook for survival.

Bottom Line: Breast cancer can occur in men as well as women. While not as common in men as in women, men need to know that any lumps, swelling or discharge from the nipple should be examined by a physician.