Both men and women have breast tissue, and while men don’t have the ability to produce milk, their breast cells can still develop into cancer. About 1 in 5 men with breast cancer have a close relative —male or female—who also had the disease. Research indicates that biological males make up half of the U.S. population carrying a BRCA1 or BRCA2 mutation, genes commonly linked to breast cancer in women.
Men with a BRCA mutation have up to an 8% lifetime risk of developing breast cancer, compared to 0.1% for the general male population. Additionally, men with BRCA mutations are at an increased risk of developing prostate, pancreatic, and other cancers throughout their lives. This makes it important for men with a family history of breast cancer to consider genetic testing. If a man carries the BRCA mutation, it’s important to inform family members, such as sisters or daughters, as they may also carry the gene mutation. This gives them the option to also undergo genetic testing, which can lead to personalized screening protocols that detect cancers early and improve treatment outcomes.
Men are typically diagnosed after the age of 60 and may exhibit many of the same symptoms as women with breast cancer, such as:
- A lump in the breasts (usually painless to the touch)
- Nipple discharge
- Swollen and/or sore breasts
- Nipple retraction or an inverted nipple
- Rash on or near the nipple
- Lumps under the arm
- Redness of the nipple or of skin near the breasts
However, due to a lower awareness of breast cancer in men, they often delay seeing their healthcare provider. Treatment for male breast cancer is similar to treatment for women as well, which may involve surgery to remove breast tissue, chemotherapy and radiation therapy. This delay can result in a diagnosis at a more advanced stage, leading to poorer health outcomes.
While men with the BRCA mutation are at a higher risk of developing breast cancer compared to the average man, carrying the gene mutation does not guarantee that they will develop the disease. There are other risk factors that, when combined with the BRCA mutation, can increase the likelihood of developing breast cancer. These include elevated estrogen levels, which may occur if you:
- Have long-term liver damage, such as cirrhosis
- Are overweight or obese
- Have Klinefelter syndrome, a condition where a genetic male has an extra X chromosome
- Were assigned male at birth and have received estrogen hormone therapy for more than 2 years as part of gender-affirming care
Despite the heightened cancer risk for men carrying the BRCA1 or BRCA2 mutations, progress for guidelines for genetic testing and cancer screening for this group has been slow. Men often face barriers such as stigma, lack of awareness, and difficulty accessing care. Healthcare providers can play a crucial role in addressing this gap by encouraging male patients to explore their family history of cancer. This proactive approach can help identify potential risk factors and prompt recommendations for genetic testing.
Genetic testing should be performed with access to appropriate genetic counselling services delivered by a certified professional genetic counselor, so that patients understand the test’s findings and implications for their health. If you have a family history of breast cancer, talk to your healthcare provider about whether genetic testing might be right for you.
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