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.

Watch Dr. Kara Maxwell's presentation on the latest research developments on BRCA mutations in men from the Annual Male Breast Cancer Global Alliance Conference in 2023.

Frequently Asked Questions About Men & BRCA

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.

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.

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.

At What Age Should a Male BRCA Carrier Begin Screening for Cancer?

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.  

Pancreatic Screening

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. Watch informational videos created by our team on pancreatic cancer commonly asked questions.

Additional Screening

Melanoma screening plans can be impacted by your family’s personal health history and should be guided by your dermatologist. 

• Learn more on fertility preservation, egg freezing, and pre-implantation genetic testing (PGT)
  Find a fertility clinic near you with the CDC's "Find a Clinic" tool
• Genetic Testing Advocates: The Wolf Family Navigates Life with a BRCA Mutation
• Ask a Genetic Counselor: BRCA & Men video
• Learn more about Male Breast Cancer and Hereditary Cancers by visiting the HIS Breast Cancer website
• Bryson Katona, MD, PhD answers common questions on pancreatic cancer awareness
• Ask Dr. Domchek: Men and BRCA Mutations video
• Prostate Cancer Screening with a BRCA Mutation blog post
• BRCA Mutations in Men: What You Need to Know webinar