Mammography utilization and male breast cancer in BRCA1/2 carriers
- 1Corporal Michael J Crescenz VA Medical Center
Abstract
PurposeMen with pathogenic BRCA1 and BRCA2 variants (BRCA+) have an elevated lifetime risk of male breast cancer (MBC) yet data regarding mammography in this population remain limited.
MethodsWe performed a retrospective cohort study of BRCA+ assigned male at birth individuals (males) at Penn (1/1/2008-5/1/2024) and the Veterans Administration (VA, 10/1/2002-1/1/2026) for mammography uptake. Mammography results and MBC characteristics were compared between BRCA+ and BRCA-males.
ResultsAmong 810 BRCA+ males, 19% had a documented mammogram for screening or symptoms. Among 562 BRCA+ males age-eligible for mammogram without prior MBC, most (63%) had documentation of a mammography-related discussion and 16% completed mammogram, of whom 25% were BRCA1+ and 75% were BRCA2+. Among mammograms obtained for screening of 97 BRCA+ males, there were few BI-RADS 4/5 (N=1, 1%) and no MBC was detected. Symptom-indicated mammograms in 59 BRCA+ compared to 228 BRCA-males yielded BI-RADS 4/5 findings in 35% versus 25%, p<0.0001, and MBC diagnoses in 29% versus 21%, p=0.219. The positive predictive value (PPV) of BI-RADS 4/5 lesions was similar in BRCA+ vs BRCA-males (71% vs 74% and 100% vs 93%, respectively). Among 22 BRCA+ and 57 BRCA-MBC, 55% and 42% were node positive and 82% and 86% were ER+Her2-, respectively.
ConclusionScreening mammography utilization among BRCA+ males was low despite elevated hereditary risk. Regardless of BRCA status, nearly all MBC were diagnosed based on symptoms, and a high proportion of MBC were diagnosed at advanced stages. Our findings identify a critical need for both improved identification of males at high risk for breast cancer and improved screening practices of high-risk men.
Related
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BibTeX
@misc{davies2026mammography,
title = {{Mammography utilization and male breast cancer in BRCA1/2 carriers}},
author = {M. Y. Davies and M. Tayeb and E. Scarrow and J. Phun and E. Milavsky and C. Orr and R. Sore and D. Lu and H. Symecko and S. Ehsan and H. Desai and R. Hausler and B. Wubbenhorst and A. Doucette and P. Gabriel and K. L. Nathanson and C. Edmonds and K. W. Robinson and M. J. Kelley and I. P. Garraway and L. L. Zullig and E. M. Bayley and H. A. Moss and M. W. Schoen and A. M. McCarthy and S. M. Domchek and J. Q. Zhang and K. N. Maxwell},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.22.26363613},
url = {https://www.medrxiv.org/content/10.64898/2026.09.22.26363613v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Mammography utilization and male breast cancer in BRCA1/2 carriers
AU - M. Y. Davies
AU - M. Tayeb
AU - E. Scarrow
AU - J. Phun
AU - E. Milavsky
AU - C. Orr
AU - R. Sore
AU - D. Lu
AU - H. Symecko
AU - S. Ehsan
AU - H. Desai
AU - R. Hausler
AU - B. Wubbenhorst
AU - A. Doucette
AU - P. Gabriel
AU - K. L. Nathanson
AU - C. Edmonds
AU - K. W. Robinson
AU - M. J. Kelley
AU - I. P. Garraway
AU - L. L. Zullig
AU - E. M. Bayley
AU - H. A. Moss
AU - M. W. Schoen
AU - A. M. McCarthy
AU - S. M. Domchek
AU - J. Q. Zhang
AU - K. N. Maxwell
PY - 2026
DA - 2026/09/22
PB - medRxiv
DO - 10.64898/2026.09.22.26363613
UR - https://www.medrxiv.org/content/10.64898/2026.09.22.26363613v1
AB - PurposeMen with pathogenic BRCA1 and BRCA2 variants (BRCA+) have an elevated lifetime risk of male breast cancer (MBC) yet data regarding mammography in this population remain limited. MethodsWe performed a retrospective cohort study of BRCA+ assigned male at birth individuals (males) at Penn (1/1/2008-5/1/2024) and the Veterans Administration (VA, 10/1/2002-1/1/2026) for mammography uptake. Mammography results and MBC characteristics were compared between BRCA+ and BRCA-males. ResultsAmong 810 BRCA+ males, 19% had a documented mammogram for screening or symptoms. Among 562 BRCA+ males age-eligible for mammogram without prior MBC, most (63%) had documentation of a mammography-related discussion and 16% completed mammogram, of whom 25% were BRCA1+ and 75% were BRCA2+. Among mammograms obtained for screening of 97 BRCA+ males, there were few BI-RADS 4/5 (N=1, 1%) and no MBC was detected. Symptom-indicated mammograms in 59 BRCA+ compared to 228 BRCA-males yielded BI-RADS 4/5 findings in 35% versus 25%, p<0.0001, and MBC diagnoses in 29% versus 21%, p=0.219. The positive predictive value (PPV) of BI-RADS 4/5 lesions was similar in BRCA+ vs BRCA-males (71% vs 74% and 100% vs 93%, respectively). Among 22 BRCA+ and 57 BRCA-MBC, 55% and 42% were node positive and 82% and 86% were ER+Her2-, respectively. ConclusionScreening mammography utilization among BRCA+ males was low despite elevated hereditary risk. Regardless of BRCA status, nearly all MBC were diagnosed based on symptoms, and a high proportion of MBC were diagnosed at advanced stages. Our findings identify a critical need for both improved identification of males at high risk for breast cancer and improved screening practices of high-risk men.
ER -