When Men Get Breast Cancer

We Pay Too Little Attention to Male BRCA Mutations

Protect the Pecs: Alan Blassberg, who carries a BRCA mutation, regularly undergoes mammograms, and produced a documentary called “Pink and Blue” to raise awareness for male breast cancer.
Courtesy of Alan Blassberg
Protect the Pecs: Alan Blassberg, who carries a BRCA mutation, regularly undergoes mammograms, and produced a documentary called “Pink and Blue” to raise awareness for male breast cancer.

By Anne Cohen

Published August 12, 2014.

When a friend pulled Harvey Singer in for a bear hug one weekend in Chicago in 2008, a shooting pain went through Singer’s chest.

A couple weeks earlier, Singer had noticed a change on the side of his left nipple but had shrugged it off as the result of being “old and a little out of shape.” His sister Vicki told him to get checked out. She’d recently been diagnosed with her third breast cancer.

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“It took 10 seconds before the doctor said ‘Okay, I’m sending you for a mammogram,’” Singer, who is now 60 years old and lives in Rochester, New York, said.

Two days after the procedure, Singer’s doctor called: He had breast cancer. Singer opted for a full mastectomy.

Eighteen months later, he was diagnosed with prostate cancer.

Singer wasn’t just unlucky. Like 1 in 40 Ashkenazi Jews, he and his sister are carriers of a BRCA mutation, which puts them at higher risk for certain hereditary cancers. (His sister Vicki and his mother were diagnosed with breast cancer one month apart in 1995.)

Since May 2013, when actress Angelina Jolie revealed, in an op-ed for the New York Times, that she had tested positive for a BRCA-1 mutation and decided to undergo a prophylactic double-mastectomy, general awareness of the risks of BRCA mutations causing female hereditary cancers has been on the rise. But that is not the case for men: Many people don’t realize that men have the same chance of inheriting the mutation as women, and that male breast cancer, although less common than the female kind, poses a real threat. According to data provided by the Basser Research Center for BRCA at the University of Pennsylvania, men with a BRCA mutation have between 5 and 10% lifetime risk of breast cancer, compared to 0.1% lifetime risk for men in the general population. For women with a BRCA mutation, the risks run up to 80%, as they have more breast tissue. A BRCA mutation also puts men at higher risk for prostate cancer (16%), pancreatic cancer (2-5%) and melanoma (3-5%). Because of the lack of knowledge about male breast cancer as well as the stigma against “a woman’s disease,” men are often diagnosed dangerously late.

For Mary Ann Wasil, a 10-year breast cancer survivor, there’s an easy solution: early information — for girls and boys.

When she was diagnosed, Wasil remembers thinking aloud about what this would mean for her daughters. Her doctor immediately stepped in. “You do understand that your son is at much at risk as your daughters?”

Wasil’s doctor was partly right: Female BRCA carriers have a higher risk of developing cancer than male carriers. But the mutation can be passed down equally from a father or mother. If one parent is a carrier, each child — male or female — has a 50% chance of inheriting the mutation. “Just because men don’t have ovaries doesn’t mean they can’t carry BRCA mutations,” said Chani Wiesman, a genetic counselor at the Montefiore Medical Center’s Program for Jewish Genetic Health. “We have to convince them that testing is valuable to them. BRCA mutations are common in Ashkenazi Jews. These are family issues. Not just women issues.” Emphasizing the risk of breast cancer for men can be tricky, she added, because 95% of patients are women. Regardless, an effort must be made.

Wasil is the founder of the Get In Touch Foundation, which partners with schools in all 50 states and 26 countries to teach basic breast health to middle and high school kids. Her doctor’s words lingered in the back of her mind, and last year, the board of Get In Touch decided to extend the outreach to boys. The organization’s Daisy Wheel app, which teaches kids in middle and high school how to perform breast self-examinations, has been downloaded in 80 countries.

“I want to include in the mission statement that we teach girls and guys how to take care of their bodies,” Wasil said. “Men have breast tissue.”

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