If you’re simply asking the absolute risk of a man with breast cancer’s offspring developing breast cancer versus a woman’ s offspring, then the man is more likely to be a carrier of a gene such as BRCA1 or BRCA2 and thus his children are at higher risk.

The criteria used to screen patients for referral for genetic testing for breast cancer include the following: occurring at age < 50, multiple first-degree relatives, generational drift (occurring at younger ages in subsequent generations), bilateral breast cancer, male breast cancer, associated syndromes such as breast and ovarian cancers (in men with BRCA1 or 2 they may have an increased incidence of prostate cancer) or high risk specific populations such as the Ashkenazi (Eastern European) Jewish background.

The risk of a father who has had breast cancer handing the gene down to his son or daughter is the same as a mother; however, the gene carries a relative risk as the penetrance is different in different people. I believe — although I’ve never seen this written down — that a son of a male carrier would have a different penetrance of breast cancer then a daughter of a female carrier. This gene is also associated with elevated risk of other cancers including ovarian, prostate, stomach, lymphoma, pancreas and bile duct cancers. Bruce Colwell, MD

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