Researchers from Memorial Sloan-Kettering Cancer Center in New York City and the Ochsner Clinic in New Orleans reviewed medical records of 142 male breast cancer patients treated between 1973 and 1994. They found 15 percent of the men had a family history of the disease. The results of the study were published in the journal Cancer (Vol. 86, No. 5).

"For men with breast carcinoma the presence of a family history did not affect the age at presentation, the duration of the symptoms, the stage of disease at presentation, the overall survival," the study authors wrote.

Although male breast cancer is rare, a higher percentage of men with breast cancer die compared to women with breast cancer. It was once thought that breast cancer was a more aggressive disease in men than in women, said study co-author Patrick I. Borgen, MD, chief of the breast service in the department of surgery at Memorial Sloan-Kettering Cancer Center.

The study highlighted what many have learned over the past few years: Breast cancer is not more aggressive in men. But the disease is often allowed to progress untreated, decreasing the odds of survival. In fact, the study also concluded that the strongest predictor of survival was whether or not the breast cancer has spread to the axillary lymph nodes when a man is first treated for the disease.

"The point here is neither men nor their doctors are looking for breast cancer. Male breast cancer is just as curable as female breast cancer," Dr. Borgen said. "The lesson is that men get breast cancer. If you find a lump and a doctor doesn’t suspect breast cancer, get a second opinion. If you find a painless lump below the nipple or notice a bloody nipple discharge get it checked out right away."
 
Dr. Borgen concluded that because prognosis was essentially the same for men with a family history of breast cancer and those without a family history, treatment should not be changed based on family history. He also said pre-treatment testing for the BRCA2 gene is not necessary.

But the presence of the gene mutation in men does have importance for female first-degree relatives. While BRCA2 in men does not significantly increase the risk of male breast cancer in sons, it does increase the risk of breast cancer for a man’s sisters and daughters, Dr. Borgen said. "Unfortunately for women, it’s exactly the same as having a mother with breast cancer."

For that reason, Dr. Borgen said, testing for the BRCA2 gene in men with breast cancer can be valuable to the patient’s relatives. Women concerned about family history of breast cancer often overlook the father’s side of the family. In fact, having a father with a history of breast cancer is a strong indicator of a hereditary syndrome, said Tom S. Frank, MD, medical director for Myriad Genetic Laboratories.

It makes sense for female relatives of men with breast cancer to be tested, Dr. Frank said. "A male relative with breast cancer is a red flag for the rest of the family."

The ACS strongly recommends that any person considering genetic testing talk to a genetic counselor, nurse, or doctor qualified to interpret and explain the results before they proceed with testing.

It is very important for people to understand and carefully weigh the benefits and risks of genetic testing before the tests are done. Testing is expensive and is not covered by some health plans. In addition, there is concern that people with abnormal genetic test results will not be able to get insurance, or may have to pay much more for coverage.