It is fairly common practice for those diagnosed with breast cancer to have genetic testing. Genetic testing is almost unheard of when men are diagnosed with prostate cancer. Current research shows that genetic testing for men with prostate cancer could provide important information about both potential treatment efficacy and prognosis.

A recent look at the role of a germ-line BRCA2 mutation in the development of prostate cancer moved forward our understanding of the clinical presentation and how it links to possible outcomes.

A total of 148 men from 1,423 families were ascertained from the kConFab consortium. Each participant met the following criteria: (i) a verified case of prostate cancer; (ii) confirmed as either a carrier or non-carrier of a family-specific BRCA pathogenic mutation; (iii) comprehensive clinical and treatment data were available. Clinical data were linked to treatment received and overall survival was analyzed by Kaplan–Meier.

We do know that prostate cancer in men whose families are breast cancer-prone have a high risk of disease progression, irrespective of their mutation status. However, we now know that men with a BRCA2 mutation carriers an increased risk of death and prostate cancer-related death

[HR (95% CI) 4.5 (2.12–9.52), P = 8.9 × 10?5] by comparison with non-carriers.

Serum PSA readings, even when age adjusted, taken prior to diagnosis in 90% of all men were above clinical significance. Following D’Amico risk stratification, 77.5% of BRCA2 mutation carriers and 58.7% of non-carriers had high-risk disease. BRCA2 mutation status also proved to be a good independent prognostic indicator of overall survival. Even more important, there was a poor overall survival outcome for both the BRCA2 mutation carriers and non-carriers given curative-intent treatment in men from breast cancer prone families.
All men in breast cancer-prone families are at risk of developing aggressive prostate cancer. This information is significant and should be included in discussions with genetic counselors and medical professionals when discussing prostate cancer treatment options for men in these families, irrespective of mutation status.

Cancer Prev Res; 4(7); 1002–10. ©2011 AACR., Heather Thorne, kConFab, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia,

Joel T. Nowak, M.A., M.S.W.