Men and BRCA Testing: What You Need To Know

Sarah Ruppert, MS, CGC, is a certified genetic counselor and genetics program supervisor at the Inova Translational Medicine Institute. Read Sarah Ruppert’s profile.

If you’re familiar with the BRCA1 and BRCA2 genes, odds are good you think of them as “breast cancer genes.” Indeed, mutations in these two genes are associated with a significantly increased risk of breast and ovarian cancers in women. But what about men?

Many people are surprised to learn that mutations in the BRCA1 or BRCA2 genes pose a risk for men, too, as the Washington Post described in a recent article. In Inova’s Cancer Genetic Counseling Program, my fellow genetic counselors and I help men as well as women understand their options and how genetic tests might fit into their overall health goals.

BRCA Genes: Risks For Men

Mutations in the BRCA2 gene increase the risk of pancreatic cancer and melanoma in both men and women. Risks specific to men include male breast cancer and prostate cancer. What’s more, recent research indicates that BRCA2 mutations boost the risk of developing a more aggressive, deadly form of prostate cancer. (The cancer risks in men with BRCA1 mutations are less clear.)

Men who test positive for a BRCA2 mutation can choose to start screening for prostate cancer at earlier ages than typically recommended in the general population. They might also choose to participate in research to find the best screening methods. Being aware of your risk can help you catch the disease at earlier – more treatable – stages.

Knowing one’s BRCA status is also relevant for family members, including children who might have inherited the dangerous mutations.

Should You Be Tested?

Some men struggle with whether they want to know the information that a genetic test can provide. Rest assured, that’s a common concern for both men and women. Genetic counselors can help you understand the pros and cons of getting tested.

Men are likely to be good candidates for BRCA1 and BRCA2 genetic testing if they have:

• A relative who has a known BRCA mutation
• A personal or family history of male breast cancer
• A personal or family history of three or more cancers, including aggressive prostate cancer, pancreatic cancer and/or breast cancer, especially if any of the cancers were diagnosed at or before age 50.
• A family history of ovarian cancer in a close female relative (sister, daughter, mother, niece, aunt, grandmother, first cousin or great aunt)
• A family history of breast cancer diagnosed at or before age 45 in a close female relative
• A family history of more than one separate breast cancer in a single close female relative
• A family history of breast cancer in two or more close female relatives on the same side of the family, with at least one relative diagnosed at or before age 50
• Ashkenazi Jewish descent with a personal history of pancreatic cancer and/or aggressive prostate cancer, or a family history of breast, ovarian or pancreatic cancer at any age

Genetic Testing: A Personal Decision

At Inova, we have many male patients who choose to undergo BRCA testing. Some make the decision because they have relatives who have tested positive or who have been diagnosed with related cancers. Others are referred by their doctors after being diagnosed with cancer themselves.

The decision to be tested is a personal one, and there is no single right time to pursue it. Some get tested right away after learning of a mutation in their family. Others wait years.

One of our patients decided to have the test in his 20s because he was interested in what his genetic status meant for any future children he might have. Another patient assumed he must be positive after having been diagnosed with prostate cancer but was relieved when testing revealed he did not, in fact, share the known BRCA2 mutation that his sister has.

Our genetic counselors can walk you through the ways that genetic testing can help define your risk for cancer and how you can use that information to stay healthy. Learn more about Inova’s Cancer Genetic Counseling Program.