Should transgender women and men be concerned about breast cancer?

Research has come a long way in developing tools to assess the risk, detect and treat breast cancer, but for transgender (trans) men and women, many questions remain.

There is an absence of research about breast cancer in transgender individuals, according to the American Cancer Society. A lack of information can leave trans men and trans women wondering if and when they should be screened.

“There is definitely a need for more research around the risk of breast cancer in transgender people for the benefit of both the individuals and physicians,” says Dr. Rosalinda Alvarado, a breast surgeon at Advocate Illinois Masonic Medical Center in Chicago. “We do know hormone therapy use may increase the risk of breast cancer.”

She recommends that people using hormone therapy should be especially diligent in scheduling mammograms and clinical examinations as recommended by the National Comprehensive Cancer Network guidelines.”

In a resource for transgender men and women, The Fenway Institute suggests transgender individuals receive screening “based on physical structure and what is known about the risks of taking estrogen.” The Institute suggests that trans women taking estrogen for at least five years should follow the screening recommendations for women.

The American Cancer Society recommends women receive an annual mammogram starting at age 45.

“It is possible for both men and women to develop breast cancer,” says Dr. Alvarado. “Patients should talk with a physician openly and honestly about their gender identity and health history to determine the best course of prevention and screening for each individual.”

Transgender men and women often face additional obstacles when seeking care. Many transgender people delay or avoid medical treatment for fear of discrimination, and many insurance plans do not provide coverage for transition-related care, according to the National Center of Transgender Equality. The organization encourages health care providers and staff to learn more about transgender care and how to communicate sensitively to transgender patients.

“As a health care provider, it is of utmost importance to earn and keep the trust of your patient by treating them with dignity and respect regardless of gender identity or sexual orientation and staying informed of the best practices available,” says Dr. Alvarado.