{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:19:21Z","timestamp":1792790361553,"version":"4.5.0"},"posted":{"date-parts":[[2026,9,23]]},"group-title":"Oncology","reference-count":29,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"United States Department of Veterans Affairs","award":["1I50CU000193"],"award-info":[{"award-number":["1I50CU000193"]}],"id":[{"id":"https:\/\/ror.org\/05rsv9s98","id-type":"ROR","asserted-by":"crossref"}]},{"name":"United States Department of Veterans Affairs","award":["1I01CX002710"],"award-info":[{"award-number":["1I01CX002710"]}],"id":[{"id":"https:\/\/ror.org\/05rsv9s98","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Cancer Institute","award":["P30CA016520"],"award-info":[{"award-number":["P30CA016520"]}]},{"name":"Prostate Cancer Foundation","award":["18VALO08"],"award-info":[{"award-number":["18VALO08"]}],"id":[{"id":"https:\/\/ror.org\/01npwtv09","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Prostate Cancer Foundation","award":["22CHAL02"],"award-info":[{"award-number":["22CHAL02"]}],"id":[{"id":"https:\/\/ror.org\/01npwtv09","id-type":"ROR","asserted-by":"crossref"}]},{"name":"American Cancer Society","award":["RSG-23-1038098-01-HOPS"],"award-info":[{"award-number":["RSG-23-1038098-01-HOPS"]}],"id":[{"id":"https:\/\/ror.org\/02e463172","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>\n                    Men with pathogenic\n                    <jats:italic>BRCA1<\/jats:italic>\n                    and\n                    <jats:italic>BRCA2<\/jats:italic>\n                    variants (\n                    <jats:italic>BRCA+<\/jats:italic>\n                    ) have an elevated lifetime risk of male breast cancer (MBC) yet data regarding mammography in this population remain limited.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We performed a retrospective cohort study of\n                    <jats:italic>BRCA<\/jats:italic>\n                    + 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\n                    <jats:italic>BRCA<\/jats:italic>\n                    + and\n                    <jats:italic>BRCA<\/jats:italic>\n                    -males.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Among 810\n                    <jats:italic>BRCA+<\/jats:italic>\n                    males, 19% had a documented mammogram for screening or symptoms. Among 562\n                    <jats:italic>BRCA<\/jats:italic>\n                    + 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\n                    <jats:italic>BRCA1<\/jats:italic>\n                    + and 75% were\n                    <jats:italic>BRCA2+<\/jats:italic>\n                    . Among mammograms obtained for screening of 97\n                    <jats:italic>BRCA+<\/jats:italic>\n                    males, there were few BI-RADS 4\/5 (N=1, 1%) and no MBC was detected. Symptom-indicated mammograms in 59\n                    <jats:italic>BRCA<\/jats:italic>\n                    + compared to 228\n                    <jats:italic>BRCA<\/jats:italic>\n                    -males yielded BI-RADS 4\/5 findings in 35% versus 25%, p&lt;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\n                    <jats:italic>BRCA+<\/jats:italic>\n                    vs\n                    <jats:italic>BRCA-<\/jats:italic>\n                    males (71% vs 74% and 100% vs 93%, respectively). Among 22\n                    <jats:italic>BRCA<\/jats:italic>\n                    + and 57\n                    <jats:italic>BRCA<\/jats:italic>\n                    -MBC, 55% and 42% were node positive and 82% and 86% were ER+Her2-, respectively.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>\n                    Screening mammography utilization among\n                    <jats:italic>BRCA<\/jats:italic>\n                    + males was low despite elevated hereditary risk. Regardless of\n                    <jats:italic>BRCA<\/jats:italic>\n                    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.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.22.26363613","type":"posted-content","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:15:19Z","timestamp":1790219719000},"source":"Crossref","is-referenced-by-count":0,"title":["Mammography utilization and male breast cancer in\n                  <i>BRCA1\/2<\/i>\n                  carriers"],"prefix":"10.64898","author":[{"given":"Meredith Y.","family":"Davies","sequence":"first","affiliation":[{"name":"Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliha","family":"Tayeb","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Scarrow","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Phun","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Milavsky","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Orr","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roukiatou","family":"Sore","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Y.","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Symecko","sequence":"additional","affiliation":[{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ehsan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heena","family":"Desai","sequence":"additional","affiliation":[{"name":"Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA"},{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Hausler","sequence":"additional","affiliation":[{"name":"Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA"},{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Wubbenhorst","sequence":"additional","affiliation":[{"name":"Division of Translational Medicine & Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Doucette","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter E.","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Nathanson","sequence":"additional","affiliation":[{"name":"Division of Translational Medicine & Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine E.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, Department of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle W.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA"},{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Kelley","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, National Oncology Program, Washington, DC"},{"name":"Durham Veterans Affairs Health Care System, Durham, NC"},{"name":"Division of Medical Oncology and Duke Cancer Institute, Duke University Medical Center, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isla P.","family":"Garraway","sequence":"additional","affiliation":[{"name":"Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles, CA"},{"name":"Department of Urology and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah L.","family":"Zullig","sequence":"additional","affiliation":[{"name":"Durham Veterans Affairs Health Care System, Durham, NC"},{"name":"Department of Population Health Sciences, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M.","family":"Bayley","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System, Pittsburgh, PA"},{"name":"Department of Surgery, University of Pittsburgh, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley A.","family":"Moss","sequence":"additional","affiliation":[{"name":"Durham Veterans Affairs Health Care System, Durham, NC"},{"name":"Department of Obstetrics and Gynecology, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-5553","authenticated-orcid":false,"given":"Martin W.","family":"Schoen","sequence":"additional","affiliation":[{"name":"Veterans Affairs St. Louis Healthcare System, St. Louis, MO"},{"name":"Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Domchek","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Q.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-4202","authenticated-orcid":false,"given":"Kara N.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA"},{"name":"Division of Hematology\/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026092603300540000_2026.09.22.26363613v1.1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14082006"},{"key":"2026092603300540000_2026.09.22.26363613v1.2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14133175"},{"key":"2026092603300540000_2026.09.22.26363613v1.3","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910530403"},{"key":"2026092603300540000_2026.09.22.26363613v1.4","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1707939"},{"key":"2026092603300540000_2026.09.22.26363613v1.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00299"},{"key":"2026092603300540000_2026.09.22.26363613v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(98)00028-8"},{"key":"2026092603300540000_2026.09.22.26363613v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00633-7"},{"key":"2026092603300540000_2026.09.22.26363613v1.8","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14133292"},{"key":"2026092603300540000_2026.09.22.26363613v1.9","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13143535"},{"issue":"2","key":"2026092603300540000_2026.09.22.26363613v1.10","first-page":"313","article-title":"Mutation analysis of BRCA1 and BRCA2 in a male breast cancer population","volume":"60","year":"1997","journal-title":"Am J Hum Genet"},{"key":"2026092603300540000_2026.09.22.26363613v1.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-4085-4"},{"key":"2026092603300540000_2026.09.22.26363613v1.12","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4098-y"},{"key":"2026092603300540000_2026.09.22.26363613v1.13","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-016-0671-y"},{"key":"2026092603300540000_2026.09.22.26363613v1.14","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djm203"},{"key":"2026092603300540000_2026.09.22.26363613v1.15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02112"},{"key":"2026092603300540000_2026.09.22.26363613v1.16","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2009.075176"},{"key":"2026092603300540000_2026.09.22.26363613v1.17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.18486"},{"key":"2026092603300540000_2026.09.22.26363613v1.18","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30891-4"},{"key":"2026092603300540000_2026.09.22.26363613v1.19","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.2185"},{"key":"2026092603300540000_2026.09.22.26363613v1.20","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2026.0007"},{"key":"2026092603300540000_2026.09.22.26363613v1.21","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0053"},{"key":"2026092603300540000_2026.09.22.26363613v1.22","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019190971"},{"key":"2026092603300540000_2026.09.22.26363613v1.23","doi-asserted-by":"publisher","DOI":"10.4236\/ss.2014.57054"},{"key":"2026092603300540000_2026.09.22.26363613v1.24","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05338-1"},{"key":"2026092603300540000_2026.09.22.26363613v1.25","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-020-01274-5"},{"key":"2026092603300540000_2026.09.22.26363613v1.26","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017170770"},{"key":"2026092603300540000_2026.09.22.26363613v1.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.sopen.2025.08.005"},{"key":"2026092603300540000_2026.09.22.26363613v1.28","doi-asserted-by":"publisher","DOI":"10.1159\/000226284"},{"key":"2026092603300540000_2026.09.22.26363613v1.29","doi-asserted-by":"publisher","DOI":"10.1177\/1557988317753241"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.09.22.26363613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:30:15Z","timestamp":1790418615000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.09.22.26363613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":29,"URL":"https:\/\/doi.org\/10.64898\/2026.09.22.26363613","relation":{},"subject":[],"published":{"date-parts":[[2026,9,23]]},"subtype":"preprint"}}