Data is limited about breast cancer risk in the transgender community and recommendations are guided by sex assigned at birth, use and duration of hormone treatment, and surgical history.
What is your risk?
Your risk is based on your sex assigned at birth, use and duration of hormone treatment, and surgical history.
Risks in transgender individuals are estimates from limited data about breast cancer risk in the transgender community. Transgender men (female-to-male) who receive gender affirming hormone treatment as estimated to develop breast cancer 1 in 300 (4 out of 1229) . Transgender women (male-to-female) who receive gender affirming hormone treatment are estimated in 1 in 150 (15 out of 2260) . Cisgender women develop cancer at at rate of 1 in 8 . Cisgender men develop breast cancer at a rate of 1 in 833 .
The American College of Radiology has published breast cancer screening recommendations for transgender and gender nonconforming individuals.
In average-risk transfeminine (male-to-female) individuals, 40 years of age or older, and with 5 or more years of hormone use, breast cancer screening with mammography is appropriate.
In transfeminine individuals at higher-than-average risk, 25 to 30 years of age or older, and with 5 or more years of hormone use, breast cancer screening is usually appropriate. Individuals in this ‘higher-than-average’ risk category have:
- Personal history of breast cancer or radiation to the chest at 10 to 30 years of age
- Genetic predisposition to breast cancer, a family history of breast or ovarian cancer
- An untested patient with a first-degree relative with a genetic predisposition to breast cancer.
In average-risk transfeminine individuals with little to no hormone use (less than 5 years), no screening is currently recommended.
In transfeminine individuals at higher than average risk 25 to 30 years of age or older with little to no hormone use, screening may be appropriate.
For transmasculine (female-to-male) individuals with bilateral mastectomies (removal of both breasts) (“top surgery”) of any age or risk, there is no screening is currently recommended.
In average-risk transmasculine individuals who are 40 years of age or older with breast reduction or no chest surgery, a screening mammogram is appropriate.
In intermediate-risk transmasculine individuals 30 years of age or older with breast reduction or no chest surgery, screening mammogram is appropriate, and breast ultrasound or breast MRI with and without intravenous contrast may be appropriate.
Patients in this ‘intermediate’ risk category have any of the following:
- Personal history of breast cancer, lobular neoplasia, atypical ductal hyperplasia
- A 15% to 20% lifetime risk of breast cancer.
Information as of April 2022, courtesy of American College of Radiology
These links are being provided as a convenience and for informational purposes only.
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