Tuesday, June 18, 2013
Actress Angelina Jolie's announcement in May that she had a double mastectomy to reduce her cancer risk has raised a lot awareness about testing for the BRCA1 and BRCA2 genes in women. But what may have been overlooked in the recent discussion is that men can also have the mutation.
"Men who carry the gene are more likely to get breast cancer, pancreatic cancer, lymphoma and melanoma, and they can pass it along to their children and daughters," said Sherri Soule, an oncologist at Lawrence Memorial Hospital. "If there is a man with a family history of breast and ovarian cancer, they should be aware that they are at risk."
As we celebrate Men's Health Month, it's important to look not only at cancers specific to males — prostate, testicular — but also ones that affect them more rarely. While women are diagnosed with breast cancer at a much higher rate, men can get the disease as well. About 1 percent of all breast cancer cases involve males, with more than 2,000 new diagnoses every year.
Women are more likely to get breast cancer because they have more breast tissue as well as lifelong exposure to estrogen, which can cause the disease. But men also have estrogen-like compounds in their body and generally get the disease because they are sensitive to the hormone.
Male breast cancer is less deadly than in women because the disease tends to be caught earlier, the result of men having less breast tissue.
Male sufferers almost always have mastectomies, and also get the lymph nodes under their armpits removed, which can lead to swelling in that area later in life. Men with breast cancer are usually treated with chemotherapy, radiation and, if necessary, estrogen-blocker pills.
Twenty percent of men with breast cancer have the BRCA gene, though only 1-2 percent of male gene carriers will go on to get that form of cancer, Soule said. But carriers have a 50/50 chance of passing it on to their children. Women with the mutation have a 70-80 percent chance of developing breast cancer in their lifetimes and a 30-40 percent chance of getting ovarian cancer.
Having the gene is not necessarily a reason to put off procreation, though.
"I truly feel that by the time babies who are born now who are BRCA carriers are old enough to start getting cancer, we'll have a way to reverse that gene," Soule said. (The mutation itself was discovered in 1990.)
Men should consider getting tested for BRCA if they have a relative who had breast cancer at a young age or ovarian cancer, or multiple first-degree relatives with breast cancer.
But insurance companies are generally unwilling to pay for the screenings in men because there aren't clear guidelines on what to do with the information, Soule said. It's recommended that males with the BRCA gene get more aggressive screenings for forms of cancer like pancreatic and prostate, and do self-examinations for breast cancer.