Breast Cancer in Transgender

Breast Cancer Screening Recommendations

A. For Trans Women

The screening recommendations for transgender women typically depend on factors like age, family history, and any hormone therapy that they might be undergoing. Generally, it is recommended to discuss screening options with a healthcare provider, including mammograms, breast examination, and self-examination.

• For those who take estrogen as part of hormone therapy

Should get a mammogram every 2 years after they have taken hormones for at least 5 to 10 years. This is because any breast tissue can develop breast cancer, and estrogen which is a part of this therapy does increase the risk of breast cancer.

• For those with a strong family history of breast cancer

It’s important that you discuss with your doctor how to manage this risk such as with screenings or other preventive care. It may also need you to start getting mammograms earlier, and even more often. Also, trans women with the BRCA1 or BRCA2 genes are at an increased risk of breast cancer, hence there are talks about testing trans women for BRCA before starting gender-affirming hormones. If you do have a doctor and want to get tested for the BRCA genes – and other genes linked to breast cancer – your doctor can help you find out about what’s involved.

• For those who don’t take hormones

It is advised that you see your doctor in case you notice any breast lumps or changes.

• For those who got breast augmentation

Though studies don’t show that it increases the risk of breast cancer, as per researchers it is a rare but serious complication. Hence, it is recommended being aware of the risk and keeping up with the follow-up care after getting the breast implants.

B. For Trans Men

For transgender men, breast cancer screening recommendations can also vary depending on individual factors such as whether you have had top surgery to change the appearance of your chest, age, family history, and hormone therapy.

• For those who have not had top surgery or who have only had breast reduction

It is advised to get a mammogram every 1 or 2 year, starting at the age of 40 years.

• For those who have had top surgery

The doctor may recommend self-exams & breast exams conducted by the doctor himself. This is mostly because you may not have enough breast tissue to put in a mammogram machine. Though top surgery lowers the risk of breast cancer, it is not as much as mastectomy through which you can prevent or treat breast cancer.

• For those who have the BRCA gene mutation and have had top surgery

You may need annual breast screenings. It’s important that your doctor knows that you are BRCA+ so they can accordingly prepare a preventive screening plan.

• For those who take hormone therapy with testosterone

Your breast cancer chances are likely to be lower as testosterone suppresses estrogen, but only if it is taken consistently over time. However, if you don’t take testosterone or if you take a low dose or take it intermittently then you won’t have the protective benefit.