General Health

Are Transgender Females at Risk for Breast Cancer?

Transgender people have faced discrimination for a long time, and any kind of data related to them was not collected or recorded appropriately. Discrimination and barriers to care still exist mainly in the transgender community, but there have been substantial steps forward. Nevertheless, there are several instances in which the transgender community have been discriminated against. One such example is that for years or was assumed that transgender women have the same risk of breast cancer as cisgender men, but recently a few reports showed that it was not the case.

Researchers now believe that transgender women are more likely to develop breast cancer than cisgender men and why they should follow breast cancer screening guidelines. Till now, not much information is available about the risk of breast cancer in transgender women. However, the results of a 2019 study in Dutch provided some valuable information.

The study looked for breast cancer cases among transgender people taking hormone therapy who received care at the gender clinic. It was concluded that transgender women receiving hormone therapy have a higher risk of breast cancer than cisgender men. The data also shows that the risk increased after being treated with gender-affirming hormones for only a short time. It was also noticed that transgender women who developed breast cancer often developed it younger than cisgender women.

The median age of breast cancer diagnosis for transgender women in the study was 52. The average age of breast cancer diagnosis for cisgender women is 61 years. More studies and information is needed. However, this study shows that hormone therapy increases the risk of breast cancer for transgender women. Although the risk is considered below the risk of cisgender women, it is a significant enough risk that screening and breast cancer education for transgender women is essential.

What are the breast cancer screening recommendations for transgender women?

The Dutch study proved that breast cancer screening for transgender women is essential. The exact screening recommendations depend on specific circumstances. Some of the general recommendations are:-

  • If you have had feminizing hormones for at least five years, breast cancer screening recommendations for cisgender women should be followed.
  • If you are 50 or above, follow the breast cancer screening recommendations for cisgender women should be followed. Screening should be done every two years. This screening does not depend on how long you have had hormones.
  • If you have a family history of breast cancer or mutations in the genes BRCA1 or BRAC2, screening instructions for high-risk cisgender women should be followed.

What are the symptoms of breast cancer?

Some of the signs of breast cancer are:-

  • A lump in breast tissue
  • An area of breast tissue that feels different from others.
  • Breast pain
  • Breast swelling
  • Inverted nipple
  • Discolored skin on the breast
  • Bloody nipple discharge
  • Change in size or appearance of the breasts
  • Lump in the armpit

What is the risk of breast cancer in transgender men?

Male hormones decrease the risk of breast cancer. Transgender men are at less risk for breast cancer than cisgender women. However, unless they have had a mastectomy, it is recommended that transgender men continue to follow breast cancer screening recommendations for cisgender women in their age group.

Transgender men who take male hormones and have had a mastectomy do not need to continue having breast cancer screening.

Not only that, feminizing hormones result in the growth of breast tissue. Therefore, feminizing hormones can increase the risk of breast cancer. However, the risk is small.

Conclusion

Transgender women have a higher risk of breast cancer than cisgender men do. The increase in risk is slight, and the risk is lower than cisgender women’s. However, the risk is considered significant enough to receive breast cancer screening.

It is recommended to start screening transgender women who are in hormonal therapy for five years or when one turns 50 years old. At either point, screening recommendations for cisgender women should be followed.

Author

Tuhina Mishra

Dr. Tuhina Mishra completed her MBBS from Grant Government Medical College in the year 2021. She has published several research papers in Indian and international journals. Tuhina is a recipient of the ICMR-STS award in the year 2019. She is a staunch believer in making research an integral part of the medical curriculum. She has volunteered in several NGOs, healthcare startups, and awareness programs.

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