There is a common misconception that BRCA1 and BRCA2 mutations only impact women because of their association with increased breast cancer risk. Everyone has BRCA1 and BRCA2 genes, and some people are born with a mutation in one of these genes. Men and women with a gene mutation in either BRCA1 or BRCA2 are at heightened risk for certain cancers, including breast cancer in both men and women, as well as ovarian, prostate, and pancreatic cancers. These gene mutations can be passed on to male and female children by either men or women.

BRCA in Men

Men with BRCA mutations can be at increased risk for certain cancers, namely breast, prostate, and pancreatic cancer, as well as melanoma. While cancer risks in male BRCA mutation carriers are not as dramatically elevated as those of female BRCA mutation carriers, and screening typically begins later in life, genetic testing, cancer risk management, and early detection can be life-saving.

The average man has a 0.1% breast cancer risk, while male BRCA1 mutation carriers have a 1-5% increased risk and male BRCA2 carriers have an increased risk of 5-10%. The average man has a 16% chance of developing prostate cancer, while BRCA2 mutation carriers have an increased risk of up to 25%. Men with BRCA1 mutations may also develop prostate cancer at a younger age than men in the general population. If the average man has a 1% pancreatic cancer risk, BRCA1 mutation carriers have a 2-3% risk and BRCA2 mutation carriers have a 3-5% risk; likewise, there is a slightly increased risk of melanoma, particularly in BRCA2 mutation carriers.

Genetic Counseling and Testing

Men should consider genetic counseling and testing for BRCA1 or BRCA2 mutations if:

  • They have been diagnosed with male breast cancer
  • There is a known history of a BRCA mutation in the family
  • There is a known history of male breast cancer, prostate or pancreatic cancer in the family
  • There is a history of early breast cancer (under age 50) and/or a history of ovarian cancer in close female relatives 
  • The family is of Ashkenazi Jewish ancestry (Central and Eastern European)

If you are considering genetic testing, it is important to consult with a genetic counselor. Find a genetic counselor in your area or via telehealth. To help your healthcare provider assess your individual risk, family history should be collected from blood relatives on both your mother and father’s sides of the family. This includes your first degree relatives (parents, siblings, children), second degree relatives (half-siblings, grandparents, aunts, uncles), and third degree relatives (cousins, great grandparents, great-aunts, great-uncles). It is important to remember that men can inherit BRCA mutations from their mothers, so while collecting information about female breast and ovarian cancer may not seem related to male cancer risk, it is essential in the case of BRCA mutations.

Cancer Screening and Medical Management

A personalized cancer risk management program can be developed for individuals known to be at increased cancer risk due to a mutation in  BRCA1  or  BRCA2. You and your doctors will ultimately decide what plan makes the most sense for you. Cancer risk management generally includes the following categories:

  • Intensive screening to increase the chances of early detection, should cancer develop.
  • Prophylactic or risk reducing surgical removal of breast tissue.
  • Chemoprevention, which is taking a medicine shown to lower the chances of developing cancer.

For men with BRCA1 or BRCA2 mutations, medical management typically begins at age 35. Your oncologist or primary care physician can help shape your specific screening plan.

How is breast cancer screening done for male BRCA carriers?

Starting at age 35, male BRCA carriers should begin self-breast exams and undergo clinical breast exams every 12 months with a physician. A mammogram may be recommended on an individual basis. Mammograms are done the same way in men as they are done in women.

What is a mammogram?

A mammogram is a low-dose X-ray procedure that produces images of the inside of the breasts. Mammography can detect some suspicious breast changes that are too small or too deep to be felt on breast examination.

A newer technology, called 3-dimensional (3D) mammography, or breast tomosynthesis, can be done as part of mammography screening. Although some studies have suggested that breast tomosynthesis may find more breast cancers and have fewer false positives than standard mammography, it remains unclear whether this is a better approach. All men should discuss this screening option in more detail with their doctor.

Typically beginning at 35 to 40, male BRCA mutation carriers should begin yearly clinical breast exams with a physician.

Prostate Screening

At age 40, prostate cancer screenings are recommended for BRCA2 mutation carriers and considered for BRCA1 mutation carriers. Prostate cancer screenings may include prostate-specific antigen (PSA) blood tests and digital rectal exams.

Additional Screening

Melanoma screening plans can be impacted by your family’s personal health history and should be guided by your dermatologist. While there are currently limited options for pancreatic cancer screening, there are ongoing clinical trials available, particularly for those with a family history of pancreatic cancer.

Learn more about managing cancer risk

Screening for Men with Mutations in BRCA1 or BRCA2

Type of Cancer

Screening Procedure

Starting Age

Frequency

Breast

Physician breast exams

35 years

Every 12 months

Prostate

Prostate exam and PSA blood test

45 years 3

Every 12 months

3 Recommended prostate cancer screening for BRCA2 carriers starts at age 40. This could be considered for BRCA1 mutation carriers.