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Do Transgender Females Need Screening Mammograms?
Patients who have undergone gender-affirming hormone therapy and/or gender-affirming surgery do, in fact, need to have breast cancer screenings. While there is currently a lack of firm data, hormone therapy may increase the risk of breast cancer in transgender patients, similar to that of post-menopausal cisgender women who take long-term hormone replacement therapy.
Breast Cancer Screening Guidelines for Transgender Females
Current screening recommendations in the transgender female population vary according to the age of the individual and other risk factors including the duration of hormone therapy. Generally, advocates recommend annual or biennial screening starting at age 50 years for individuals who have taken hormone therapy for a minimum of 5 years.
The American College of Radiology recommends that transgender women with risk factors who have been receiving hormone therapy for more than 5 years follow the breast cancer screening guidelines for natal females. In addition, transgender women with a family history of breast or ovarian cancer should also begin screenings earlier and more frequently.
Breast Cancer Screening Guidelines for Transgender Men
Transgender men with preserved breast tissue (ie, reduction mammoplasty or no breast surgery) should undergo the same risk assessment as natal females, as the same risk factors apply – including BRCA mutations, chest irradiation, and family history of breast cancer. Thus, it is proposed that pre-surgical transgender men follow the established breast cancer screening guidelines for natal females.
Breast cancer risk is markedly diminished in transgender men who undergo bilateral subcutaneous mastectomy, as supported by studies showing an almost 90% risk reduction in natal females with risk factors. However, the residual risk remains higher than that of natal males. Current guidelines recommend an annual clinical and physical examination and/or discussion with your provider.
Screening Tools for Transgender Patients
Connecticut Breast Imaging offers expert breast imaging evaluation and the highest quality breast cancer screening for all patients, including the use of 3D mammography, breast ultrasound, and breast biopsies, when necessary.
If transgender patients have dense or very dense breast tissue, mammography may need to be accompanied by breast ultrasound to provide the most accurate results, as dense tissue can make viewing possible cancerous growths difficult (in both transgender and cisgender patients).
Why Connecticut Breast Imaging?
At Connecticut Breast Imaging, we respect all patients, and aim to provide the most accurate, considerate and comprehensive care possible. In addition, we have experience working with transgender patients and the specific challenges of breast cancer screenings for this community.
Call or contact us online today to schedule a breast cancer screening and to discuss your specific needs and breast cancer risk.