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

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.