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Published: July, 2016; Vol 13, Num 2

 

What Men Need to Know about Breast Cancer Genes

Angelina Jolie Pitt has a family history of breast and ovarian cancer, and her decision to have surgery to reduce her chances of being the next victim has encouraged many women to talk to their health care providers about their own risks for these and other cancers.

Men should do the same thing.

The same genetic defect that led Jolie Pitt to have her breasts and ovaries preemptively removed can also be a health threat in men. It is also something they can pass on to their children.

Cancer and Genetics

The BRCA1 and BRCA2 genes are the most well-known genes linked to hereditary breast and ovarian cancers and to overall hereditary cancer risk in women and in men. (Jolie Pitt has a BRCA1 mutation.) BRCA stands for breast cancer, but there are other cancers that defective BRCA genes increase risk for. In women, these include certain ovarian cancers. In men, these include prostate cancer and melanoma. In women and men, BRCA mutations also increase risk for lymphoma and cancers of the pancreas, gallbladder, bile duct and stomach.

What Are BRCA Genes?

Everyone has BRCA1 and BRCA2 genes. Their purpose is to repair DNA within cells.

When functioning properly, BRCA genes help protect against cancer. They are often referred to as “tumor suppressors,” as the proteins they produce help maintain cell growth.

Mutations in the BRCA genes can cause runaway cell division. This is what causes cancer.

Whether they develop these cancers or not, women and men can pass BRCA mutations down to their daughters and to their sons. Each child has a 50 percent chance of inheriting a defective gene. Jolie Pitt’s family is a tragic example of how this elevated risk can continue for generations. Various cancers have claimed numerous female and male relatives on the maternal side of her family. These include her mother, grandmother and aunt who died from breast and ovarian cancers and an uncle who died from prostate cancer.

Should Men Consider Genetic Counseling and Testing?

As it is for women, genetic testing is the only way for men to know if they carry BRCA gene mutations. Genetic counseling should be considered by:

  • Men in a family with a known BRCA mutation
  • Men with a personal history of male breast cancer
  • Men with a personal history of prostate or pancreatic cancer with at least one close relative with breast cancer under age 50 or ovarian or pancreatic or prostate cancer at any age
  • Men with a personal history of pancreatic cancer and of Ashkenazi Jewish ancestry
  • Men with a family history of breast cancer under age 50 or cancer in both breasts or ovarian cancer
  • Men with unknown family history (for example, they were adopted at birth) who are diagnosed with breast cancer

Genetic counseling and testing for BRCA mutation for people considered to be at high risk is covered by the Affordable Care Act according to the National Cancer Institute. Your health care provider can provide guidance but it is important to confirm your insurance coverage before having any test(s). Sometimes these tests are offered at no charge to patients who meet specific financial and medical criteria.

Most instances of cancer have little to do with heredity. However, awareness that heredity sometimes is a factor may help you and your loved ones stay healthy. Taking steps when you know you are predisposed to certain cancers can often help reduce your risk and the likelihood of passing that risk to another generation.

[Janet Lubman Rathner]