BRCA Mutations in Men: Three Things to Know

The Basser Center for BRCA at Penn Medicine is the first comprehensive center for the research, treatment, and prevention of BRCA-related cancers.

Many people associate BRCA with women and breast cancer. That’s understandable — after all, BRCA stands for “BReast CAncer gene” — but BRCA gene mutations are associated with multiple cancer types and aren’t limited to females. Men should also consider reaching out to the Basser Center for both learning about and being screened for BRCA-related cancers.

“We realize there is a knowledge gap about how BRCA affects men because most research and awareness efforts for BRCA have focused on women,” said Kara Maxwell, MD, PhD, an assistant professor of Medicine and Genetics at the University of Pennsylvania Perelman School of Medicine. Maxwell also serves as director of the Men & BRCA Program at the Basser Center. “The Men & BRCA Program was designed to help fill this education gap, meet the need for clinical care, and drive research to answer important questions about BRCA-related cancers in men.”

We spoke with Maxwell to learn more about what men should know about BRCA.

1. BRCA mutations put men at higher risk for cancer too.

Everyone has BRCA1 and BRCA2 genes, which are tumor suppressor genes that are important to fighting cancer. But, anyone can be born with a mutation in one of these genes that prevent them from working normally. When that happens, it raises a person’s risk for breast, ovarian and other cancers. Men who have a BRCA1 or BRCA2 gene mutation have a higher risk of developing certain cancers, including prostate, pancreatic, and even breast cancers.

While breast cancer is rare in men, it can happen. The average male has a 0.1 percent lifetime risk of developing breast cancer, but in men with BRCA mutations, the risk is much higher: 1 to 5 percent lifetime risk for men with BRCA1 mutations and 5 to 10 percent lifetime risk for men with BRCA2 mutations.

However, most men are probably more worried about prostate cancer than breast cancer, with good reason: the lifetime risk for prostate cancer for an average male is 14 percent. For men with BRCA1/2 mutations, the risk is much higher — ranging from 25-50 percent — and if prostate cancer does develop, it may be more aggressive. The average prostate cancer patient is in his mid-60s when he’s diagnosed, but particularly men with BRCA2 mutations may be diagnosed at a younger age.

Men with BRCA mutations are also at increased risk for pancreatic cancer: 2 to 3 percent lifetime risk for those with BRCA1 mutations and 3 to 5 percent lifetime risk for those with BRCA2 mutations, compared to just 1 percent lifetime risk in the general population.

Finally, BRCA2 mutations are also associated with a higher risk of melanoma in males.

2. Consider the women in your family.

It’s important to remember that men can inherit a BRCA mutation from their father or their mother, so when thinking about your family history of cancer, take note of any close female relatives who were diagnosed with breast cancer before age 50 or who had ovarian cancer, as these diagnoses could be related to BRCA mutations. While these cancers may not seem related to male cancer risk, if they’re part of your family history, it may be sign that BRCA mutations run in your family.

In addition to a close family history of early breast cancer or ovarian cancer, men may want to consider genetic counseling and testing for BRCA1 or BRCA2 mutations, if they:

  • Have been diagnosed with male breast cancer
  • Know of a family history of BRCA mutations
  • Know of a family history of male breast cancer, prostate cancer, or pancreatic cancer
  • Are from a family of Ashkenazi Jewish ancestry (Central and Eastern European)

If you’re a father, consider the generations that come after you too. Even men who are never personally diagnosed with cancer can pass down BRCA mutations to their children.

3. There are resources to help men with BRCA mutations manage their cancer risk.

The Men & BRCA program at the Basser Center for BRCA was designed to advance research and provide education for men with BRCA mutations. The program offers events and free resources to help men understand their cancer risk and make informed decisions about their health. The Basser Center’s research aims to better understand the biology of BRCA mutations and BRCA-related cancers, and to bring discoveries made in the lab to patients in the clinic as quickly as possible, including clinical trials for new prostate cancer treatments.

For anyone with a personal or family history of cancer who is considering genetic testing to find out if they carry a BRCA1 or BRCA2 mutation, know that you don’t have to figure it out on your own. The first step is consulting with a genetic counselor, who can help assess your individual risk and, if you decide to move forward with genetic testing, help explain the results and recommended next steps. Genetic counseling appointments can often be scheduled as telehealth visits.

If you have a BRCA1 or BRCA2 mutation, your doctor can work with you to develop a personalized cancer risk management program that may include additional or earlier cancer screenings. For male BRCA mutation carriers, screening typically begins at age 35.

“Genetic testing and cancer risk management can be life-saving,” Maxwell said. “We’re committed to providing men with BRCA mutations the education and resources they need to make informed decisions about their health — for themselves and their loved ones.”

To schedule an appointment for genetic risk evaluation or management of hereditary cancer risks at Penn Medicine’s Abramson Cancer Center, please contact the MacDonald Cancer Risk Evaluation Center at 215.349.9093 or [email protected].

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