When people think of breast cancer they usually think of women. But of course, breast cancer also affects men – just not nearly as often. While American women have a 13 percent chance of developing breast cancer in their lifetime, men only have a 1 percent chance – unless they have a BRCA gene mutation that dramatically increases their risk of contracting the disease.
Dr. Jason Radecke, a bariatric and minimally invasive surgeon with HCA Florida Lawnwood Hospital, knows first-hand about the risks and occurrences of breast cancer in men with the BRCA gene.
“My uncle had it and fought breast cancer for 11 years before he passed,” Dr. Radecke said.
“My father had it and died of pancreatic cancer which is also associated with the BRCA gene mutation. My nephew has it, and my fraternal twin brother and cousin have it and both had a preventative bilateral mastectomy.
“My sister does not have it and preliminary genetic testing indicates I do not have it,” he continued. “So, it appears that breast cancer gene mutation is passed on through the males in my family. If a man develops breast cancer, he should alert his family to get genetic testing done.”
What exactly is this BRCA gene? The name BRCA is an abbreviation for ‘Breast Cancer’ gene. BRCA1 and BRCA2 are two different genes that can affect a person’s chances of developing breast cancer. Every human has both the BRCA1 and BRCA2 genes and these genes actually play a big role in preventing breast cancer, most of the time. They help repair DNA breaks that can lead to cancer and uncontrolled growth of tumors. Because of this, the BRCA genes are known as tumor suppressor genes.
When a gene becomes altered and doesn’t function correctly it’s called a gene mutation, and a small percentage of people (about 1 in 400) carry mutated BRCA genes. The mutation renders the gene ineffective at repairing broken DNA and helping prevent breast cancer. These people are more likely to develop breast cancer and the carrier of the mutated gene can pass on the gene mutation to his or her offspring.
“There are several breast cancer risk assessment tools available online that can calculate a woman’s risk of developing breast cancer,” Dr. Radecke said. “The Breast Cancer Risk Assessment Tool, also known as the Gail Model, can estimate your risk of developing breast cancer based on your answers to a few questions about your medical and reproductive history and the history of breast cancer among your first-degree relatives. If you are at high risk, your insurance company may pay for genetic testing.”
While a full panel of genetic testing can run into the thousands, there are basic at-home tests from companies like 23andMe and Quest that can be done for under $200. These tests will only test for the most common variants of the BRCA genes but are affordable enough to give you some peace of mind if you are negative, or the ability to talk to your insurance company about more testing if you are positive.
“Many women and men who test positive for the BRCA gene mutation choose to take preventative measures by removing all the breast tissue with a bilateral mastectomy and implant reconstruction,” Dr. Radecke said. “Fortunately, insurance will pay for this procedure 100 percent if you have the BRCA gene mutation. Movie stars Angelina Jolie and Christina Applegate were probably the first to bring awareness to this life-saving procedure. Because the gene mutation is also linked to ovarian cancer, we will often take out the ovaries during the same procedure.
“Men with the BRCA gene mutation are also getting double mastectomies and reconstructive surgeries as a preventative measure,” Dr. Radecke said. “They have pectoral implants for men which may even look better that the pecks they were striving for when working out at the gym. There seems to be a stigma to men getting implants for some reason, but at the very least they should be diligent about getting annual checkups including mammograms and ultrasounds.”
“I advise anyone who tests positive for the BRCA gene mutation to consider getting the mastectomy and reconstruction,” Dr. Radecke continued. “Based on which BRCA gene mutation you have, you carry a 40-to-92 percent chance of having breast cancer by the age of 50. Even if you are 65 it’s not too late. You don’t have breast cancer yet, but by the time you are 80 you most likely will. You don’t get a glimpse into the future and have the opportunity to do something about it very often. Of course, all options should be discussed with your healthcare professional to determine what procedure and treatment is right for you.”
While breast cancer in men remains rare, more and younger women are being diagnosed every year. Fortunately, the cancer is being diagnosed in much early stages when it is more curable much of the time. Genetic testing is one part of the equation. Women have also become more diligent about scheduling yearly surveillance and screenings with 3D mammograms and ultrasounds. The end result is that more cancer is being caught and cured and survival rates are increasing.
“The five-year relative survival rate for women in the United States with non-metastatic invasive breast cancer has increased to 91 percent and the 10-year relative survival rate for women with non-metastatic invasive breast cancer is 85 percent,” according to cancer.net.
“If the invasive breast cancer is located only in the breast, the five-year relative survival rate of women with this disease is 99 percent and about 66 percent of women with breast cancer are diagnosed at this stage.”
“Being proactive is always a good thing for both men and women,” Dr. Radecke said.
“Genetic testing is changing the face of medicine and breast cancer in particular. We have now identified the BRCA gene mutation as a major contributor to the disease and knowing you have it will empower you to make important decisions about your health. It’s like giving you a window to the future. Only you can decide what to do with that information.”
Dr. Jason Radecke received his medical degree from the Medical University of South Carolina in Charleston, completed his surgical residency in General Surgery at Union Memorial Hospital in Baltimore, and completed his fellowship at the University of South Florida in Tampa. He is accepting new patients in his office located at 2402 Frist Blvd., STE 202, Fort Pierce. Call 772-241-6800.
