Abstract
Because of a lack of uniform collection of gender identity data, population-level
breast cancer statistics in the transgender community are unknown. With recent estimates
that at least 0.6% (1 in every 167 people) of the U.S. population is transgender,
guidance on breast cancer risk, screening, and management in this population is needed.
Such guidance should examine modifications, if any, to recommendations in cisgender
populations, taking into consideration any history of hormone therapy exposure or
breast surgery. This article describes existing evidence on breast cancer incidence
in transgender women and men, and attempts to make rational recommendations regarding
the screening for and approach to managing breast cancer in transgender populations.
Current data are mostly limited to case reports which are reviewed here. More prospective,
population-level research is needed to better understand the risks and predictors
of breast cancer in this population, as well as to better inform the most appropriate
screening modality, age of starting screening, and interval. Ultimately, a risk score
calculator similar to existing risk models such as the Gail score, as well as an approach
to shared decision making that involves patient-centered perspectives, is needed to
best guide practices in this area.
Keywords
transgender - breast cancer - screening - treatment