ICARE Newsletter Spring 2023
Breast Cancer Screening in Male BRCA1/2 Carriers

Generally, males with breast cancer present with advanced stage disease, thought to be due to a lack of screening. While data to determine performance of breast screening through mammograms for males at inherited risk is limited, recent studies suggest that the detection rate is similar or better than for females at general population risk.1,2,3 In one study, the cancer detection rate (CDR) in males with screening mammograms due to a personal or family history of breast cancer or genetic predisposition was 18 per 1000 exams, with detection of five node negative cancers.1 In comparison, the CDR among symptomatic males was 20 per 1000 exams, of which 2/3 measured 2.1 cm on average and most had nodal metastases. Mammographic screening sensitivity, specificity, and positive predictive value (PPV) of biopsy were 100%, 95% and 50% respectively. In another cohort of males at increased risk for breast cancer based on a personal and/or family history of breast cancer or genetic predisposition with screening mammograms, the CDR was reported as 4.9 per 1000, which is similar to screening mammography in females (5.4 per 1000).2 Collectively, these studies suggest that screening mammography may be useful to detect breast cancer among males at increased risk. Of note, gynecomastia may be common in males (particularly at certain ages) and is not a risk factor for breast cancer, thus should not impact the decision to screen.

1Gao et al. Radiology. 2019;293(2):282-291. PMID: 31526252.

2Marino et al. Breast Cancer Res Treat. 2019;177(3):705-711. PMID: 31280425.

3Campos et al. Cancers (Basel). 2021;13(14):3535. PMID: 34298749.

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