No breasts, no need for breast cancer tests. Right? As a man, I'll admit that's been my assumption—even though breast cancer struck my mom when she was 39. But I'm one of many men who might need to reconsider that philosophy in light of intriguing new research published this month. Men whose female relatives have had breast cancer, it suggests, may want to consider genetic testing to evaluate their own—and their children's—cancer risk.
Mary Daly, the founder of the Family Risk Assessment Program at Fox Chase Cancer Center, presented the research at the San Antonio Breast Cancer Symposium. Her message: Some men should consider getting tested for mutations in BRCA1 and BRCA2, two genes associated with breast cancer. Her study, which is part of a large research project that's exploring how families communicate genetic risks, examined how 24 men responded to the news that one of their female relatives had tested positive for one of the BRCA mutations. The analysis included only men whose female relatives report explicitly telling the men of the worrisome test result.
The message didn't always make it through. When asked after the fact, for example, six of the men couldn't recall hearing anything from a female relative about BRCA mutations. And two remembered being told the results had been negative instead of positive. Oops. Maybe those men were busy when they were told. Maybe the TV was on. But it gets worse. Of the 18 men who could recall hearing about BRCA from a relative, seven didn't think the information affected their own chances of developing cancer. Oops again. The reality: All these men have a one-in-two chance of carrying the gene, and those who carry it have a one-in-two chance of passing it on to each of their children, boy or girl.
What does it mean for a man to have one of these cancer-linked mutations? Having the BRCA2 mutation, for example, significantly elevates a man's lifetime risk of getting breast cancer. Though that risk is pretty miniscule to start with—about .01 percent for the average man—it jumps to about 7 percent for a man with the mutation. (In contrast, women with either of the gene mutations have up to an 80 percent lifetime risk of getting breast cancer, according to the American Cancer Society.) Moreover, the same BRCA2 mutation seems to increase a man's lifetime risk of developing prostate cancer from about 14 percent to about 20 percent. That increased risk of prostate cancer is nothing to shrug off: The American Society of Clinical Oncology suggests that men with the gene mutation start getting themselves screened for prostate cancer at age 40 instead of the standard 50.
The BRCA test, which can cost between $300 and $3,000 if insurance doesn't cover it, won't help all men. But for those with a family member who has tested positive for the mutation, the test may well be worth considering. If it reveals that you, too, have a BRCA mutation, your doctor might be extra vigilant for early signs of cancer. Ashkenazi Jews are known to have an especially high risk of carrying the mutations. And a study published in the Journal of the American Medical Association this week shows that Hispanics have a relatively high prevalence as well.
Perhaps more important than yourself, there's your family to think about. BRCA1, for example, doesn't pose much of a risk to men. But any dad would probably want to know if his daughter faced an excess risk of cancer from a gene he had given her. I talked about BRCA testing with David Delaria, a breast cancer survivor from Las Vegas who was treated at the Cancer Treatment Centers of America in Tulsa, Okla. He has never been tested for either BRCA mutation, and prior to our conversation he didn't even realize he could be tested. Now that he knows about the test, he plans to look into it primarily because he thinks his family—including his four granddaughters—should know if they potentially have the gene. "[Families] need to talk about this." he says. "Cancer kills men just like it kills women."
After talking to Delaria, I called my mom to ask her about the BRCA test. It had never occurred to me to ask before, but it turns out that she did get the test shortly after being diagnosed. Thankfully, it came up negative, so I don't even have to consider getting the same test myself. But, for other men who aren't so lucky, Daly's study is a reminder that knowing your genetic predisposition to a disease like cancer could benefit not just you but your family as well.