Men in the women’s world of hereditary breast and ovarian cancer—a systematic review

Abstract

Little is known about men seeking genetic counseling for hereditary breast and ovarian cancer (HBOC). We review the sparse literature on men attending such genetic consultations. Two main themes are identified: the women's influence on the genetic counseling process, and the psychological impact on men. The women in the HBOC families have an influence on the men's decision to request genetic testing, and they take the leading role in communicating genetic information. With respect to psychological impact, the men suffer from grief and fear of developing cancer, and they seem to use avoidance as a coping strategy. Carrier males experience feelings of guilt because they might have passed on a mutation to their children. Non-carriers experience test-related stress if their siblings tested positive. Mutation status may have an impact on reproductive issues. These findings are discussed in light of gender issues and literature concerning men's health behavior. Further studies are needed to provide optimal care for men seeking genetic counseling for hereditary breast and ovarian cancer.

BRCA carriers' thoughts on risk management in relation to preimplantation genetic diagnosis and childbearing: when too many choices are just as difficult as none

“…Consistent with previous literature, all respondents reported feelings of guilt about transmitting the mutation to future children (19). In a survey of 213 women of reproductive age affected by hereditary breastovarian cancer, 90% were concerned about passing the mutation on to their children (20).…”

“…Respondents expressed concern that men with a BRCA mutation were less concerned with hereditary transmission. Despite this, some studies have shown men do experience similar feelings of guilt about the possibility of passing on a mutation to their children (23) and in difficulty sharing test results with family members (19). …”

Cancer worry among Norwegian male BRCA1/2 mutation carriers

“…Little is known about BRCA1/2-positive males, and the few available studies regarding men in HBOC families have reported low rates of male participation among mutation carriers [8]. Two studies have reported that the motivation for genetic testing among men in HBOC families was fear of cancer or worries about their own health [15, 16], and only one study has focused solely on BRCA1/2 mutation-positive men [10].…”

“…Little research attention has been paid to male experiences in HBOC families [8]. The sparse literature available describes men as mainly seeking genetic testing out of an obligation to their children [9–13], and it is reported that women have a strong influence upon male decision-making regarding genetic testing [11].…”

“…The available studies regarding male experiences in HBOC families report low rates of mutation carriers [8, 9, 11, 14]. As such, limited knowledge regarding the experiences of BRCA1/2 mutation-positive men is available.…”