medRxiv : the preprint server for health sciences · 2026
Mammography utilization and male breast cancer in BRCA1/2 carriers.
СтатьяПрепринтНазвание и аннотация: Перевод в очереди
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Davies Meredith Y, Tayeb Maliha, Scarrow Emily, Phun Jasmine, Milavsky Evelyn, Orr Caitlin, Sore Roukiatou, Lu David Y, Symecko Heather, Ehsan Sarah, Desai Heena, Hausler Ryan, Wubbenhorst Bradley, Doucette Abigail, Gabriel Peter E, Nathanson Katherine L, Edmonds Christine E, Robinson Kyle W, Kelley Michael J, Garraway Isla P, Zullig Leah L, Bayley Erin M, Moss Haley A, Schoen Martin W, McCarthy Anne Marie, Domchek Susan M, Zhang Jennifer Q, Maxwell Kara N
Аннотация
PURPOSE: Men 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.
METHODS: We 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.
RESULTS: Among 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.
CONCLUSION: Screening 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.
METHODS: We 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.
RESULTS: Among 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.
CONCLUSION: Screening 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.