N.C. ó Earlier this year, Dr. Jason Dranove had a mastectomy
to prevent breast cancer.
read that right.
rare, but males can develop breast cancer and have surgery to
remove breast tissue.
a pediatric gastroenterologist at Levine Childrenís
Hospital, chose to have the operation after a medical
discovery unfolded in his fatherís family. It began when his
uncle in New Jersey was diagnosed with breast cancer and, a
year later, with pancreatic cancer.
unusual combination of cancers led another uncle in Chicago to
begin asking questions. And that led to the realization that
the cancers could be related to a genetic mutation in the
very odd to see breast cancer in a male," Dranove said,
"but itís pretty weird to see two cancers like that in
the same person."
having a genetic test, the New Jersey uncle learned he was,
indeed, positive for a mutation in the BRCA1 gene that is
known to increase the risk of breast cancer and several other
cancers in both women and men. Because he was positive, it
meant his brothers ó Dranoveís father and the Chicago
uncle ó each had a 50-50 chance of having inherited the
mutation as well.
brothers had to decide whether to be tested. Dranove
encouraged his father to do it by explaining the potential
effects on his children and grandchildren.
have a daughter, and now I have a daughter," Dranove
said. ".ÖIf you get tested and youíre negative, none
of us have to get tested. And we donít have to worry about
this.ÖIf you donít get tested, that means all of us have
to get tested."
fatherís test in 2013 turned out positive for the mutation.
That meant Dranove and his brother and sister each had a 50
percent chance of having the mutation too.
he decided whether to be tested, Dranove met with genetic
counselor Stacy Lenarcic, a colleague at Carolinas HealthCare
System, in February 2015.
her, he learned that the increased risk of cancer due to a
BRCA mutation is low for men, but for a woman, "it can be
catastrophic," he said. He was worried about his
daughter, now 2.
average man, the chance of getting breast cancer is less than
1 percent; with a BRCA mutation, it goes up to 10 percent over
a lifetime. For the average woman, the chance of getting
breast cancer is 12 percent; but with a BRCA mutation, it goes
up to 87 percent.
Dranove and his siblings finally had the test, Dranove was the
only one who turned up positive.
back with his wife to speak with Lenarcic, who explained the
National Comprehensive Cancer Network guidelines. They advise
men with BRCA mutations to be watchful about potential cancer
by performing regular self-breast exams and having breast
exams by a doctor regularly. Lenarcic also recommended that he
visit a cancer surgeon to talk about that option.
being examined by Dr. Richard White, a surgical oncologist
with Carolinas HealthCare, Dranove decided to have a
mammogram, a screening test that is usually associated with
women 40 and over.
was a little bit surprised at how painful it was," said
Dranove, acknowledging what women have known for decades about
the machines that compress breast tissue.
mammogram showed Dranove had more breast tissue on one side
than the other, but didnít show anything suspicious. Still,
partly because of that extra breast tissue, he decided to have
a mastectomy, just to prevent a cancer from growing.
knew that the chances are low that anything bad was ever going
to happen to me," he said. "But it just seemed very
silly to not do it.ÖThereís no reason to take a chance
when you have something that could potentially be close to 100
who performed the surgery on April 22 at Carolinas Medical
Center, praised the Dranove family for communicating about
their medical history and "doing the right thing" by
getting tested and, in Dranoveís case, having the
Dranoveís tissue was tested, White discovered that he had an
very early stage breast cancer, called ductal carcinoma in
situ (DCIS). "If he didnít have the genetic testing and
he didnít come to see me now," White said, "likely
he would have been in my office later, with a breast cancer.
So we avoided all that."
knows the choice to have a mastectomy was less complicated for
a man than a woman "If anything, there are positive
cosmetic effects for a man," he said, referring to his
flatter, trimmer chest. ".ÖFor a woman, itís a major
his experience, Dranove has been passionate about encouraging
other families to talk about their medical histories. Male
breast cancer is not a huge problem, he said, but families
with histories like his need someone, like his Chicago uncle,
who is observant and connecting the dots.
Iíd just ignored this, my daughter (wouldnít know she has)
a 50 percent chance of getting a mutationÖ," Dranove
said. "Now weíll know that she needs to be tested when
the time is right.
need to advocate for themselves," he added. "Your
doctor is not going to pry into your family history. You have
to bring these things up, and you have to have an inkling that
something may be strange.ÖThere are many other inherited
disorders that, if you just know about them, you can prevent
bad things from happening."