Breast cancer rates in the transgender community were unknown until recently due to discrimination and inadequate data recording. Although discrimination and barriers to care still exist, progress has been made. Previously, it was believed that transgender women had the same breast cancer risk as cisgender men, but new data has proven otherwise. Research shows that transgender women face a higher risk of breast cancer and should follow screening guidelines. This article will explore breast cancer risk factors for transgender women and recommend screening methods.
What is the breast cancer risk in transgender women?
The exact risk for breast cancer in transgender women is still not fully understood. However, a Dutch study conducted in 2019 provided some valuable insights. This study examined breast cancer cases among transgender individuals who received hormone therapy at the VU University Medical Centre Amsterdam between 1972 and 2016. The Centre was chosen because it is a significant public health facility where over 95 percent of transgender people in the Netherlands receive care.
The study found that transgender women who receive hormone therapy have a higher risk of breast cancer than cisgender men. Furthermore, the risk increased after a short time of being treated with gender-affirming hormones. Additionally, the study indicated that transgender women who developed breast cancer were diagnosed younger than cisgender women. The median age of breast cancer diagnosis for transgender women was 52, while for cisgender women in the Netherlands, it was 61.
Although more studies are required to gather more information, this study highlights the heightened risk of breast cancer in transgender women receiving hormone therapy. While the risk is lower than that of cisgender women, it is still significant enough to warrant screening and breast cancer education for transgender women.
Read more: Understanding the Stages of Breast Cancer
Additional risk factors for breast cancer
Several other factors increase your risk of breast cancer. Many of these risks affect both transgender and cisgender women. Those risk factors include:
- Genetics. Having mutations on the BRCA1 or BRCA2 gene increases your risk for breast cancer. Transgender women can inherit these gene mutations.
- Family history. A family history of breast cancer puts you at a higher risk for breast cancer.
- Age. Your risk for breast cancer goes up as you age.
- Obesity. Obesity can change levels of hormones in your body and is linked to an increased risk of breast cancer.
- I have limited physical activity. Having a non-active lifestyle can increase your risk for breast cancer.
- Alcohol. There’s a known link between drinking alcohol and an increased risk for breast cancer.
- Dense breast tissue. Dense breast tissue is more fibrous and harder to read on a mammogram. It can increase your risk for breast cancer. Dense breast tissue is joint, and the breast growth that transgender women experience due to hormonal therapy can be dense breast tissue.
- Previous breast cancer. Having breast cancer once increases your risk of getting it again.
What are the breast cancer screening recommendations for transgender women?
The Dutch study proved that breast cancer screening for transgender women is essential. The detailed screening recommendations for transgender women depend on your specific circumstances. Here are three general offers:
- If you’ve been on feminizing hormones for at least five years, follow the breast cancer screening recommendations for cisgender women in your age group.
- If you are 50 or above, follow the breast cancer screening recommendations for cisgender women in your age group and have a screen at least every two years. This applies no matter how long you’ve been on hormones.
- If you have a family history of breast cancer or have genetic mutations on the BRCA1 or BRCA2 gene, follow the screening instructions for high-risk cisgender women in your age group. This applies no matter how long you’ve been on hormones.
If you’re uncertain when to start breast cancer screenings, your prescribing doctor or clinic may offer helpful advice. Discuss with them any family history of breast cancer or other concerns you may have. They can assist you in creating a screening plan and timeline. Additionally, they may suggest healthcare providers and sites for accessing breast cancer screenings.
Read more: A Comprehensive Guide to Breast Cancer
Addressing Barriers to Healthcare
Unfortunately, transgender women frequently encounter hindrances in obtaining healthcare, as indicated by research conducted in 2017, and experience prejudice while attempting to avail of medical services. This problem is compounded when accessing gender-specific medical services such as breast cancer screenings.
Not all medical professionals are educated on inclusive care or the medical needs of transgender women. Here are a few tips that can help you get the care you deserve and need:
- Research LGBT-friendly medical professionals in your area and read reviews. If you have transportation and your insurance allows it, it’s sometimes worth traveling 45 minutes or so to get to a location that will provide better care.
- Bring a friend or family member. You have the right to bring someone with you to medical appointments. Having someone you trust with you can help prevent discrimination.
- Come prepared with information. Don’t be afraid to come to appointments with notes and research. It can help you feel more confident when talking with your doctor.
What are the symptoms of breast cancer?
Early detection is crucial for effectively treating breast cancer. Therefore, it is vital to undergo regular screenings and educate oneself about the symptoms associated with breast cancer. While these symptoms may not always signify cancer, seeking medical attention promptly if any of them are observed is advisable.
Here are the signs to know:
- a new lump in breast tissue
- an area of breast tissue that feels different from the tissue around it
- breast pain
- breast swelling
- an inverted nipple
- red or discolored skin on the breast
- flaking or peeling skin on the breast
- nipple discharge
- bloody nipple discharge
- a sudden change to the size or appearance of the breasts
- a painful lump or swelling in the armpit
Breast cancer resources for transgender women
A breast cancer diagnosis can be overwhelming, frightening, and isolating. It’s essential to have support and resources you can turn to. Fortunately, there are many helpful organizations for transgender women, including:
- Live Through This. Live Through This is an organization by and for LGBTQI+ people with all types of cancer. You can listen to their podcast, get recipes, read informative blogs, find resources, and more.
- Inclusive Community for Breast Health (ICBH). ICBH provides breast cancer support groups, resources, and information for LGBT people and their families.
- CancerCare. CancerCare offers online support groups led by an oncology social worker. Groups are specific to types of cancer and run in 15-week sessions.
- BreastCancerNow. You can call the free BreastCancerNow helpline for support anytime by dialing 808-800-6000.
Frequently asked questions about breast cancer in transgender people
What’s the breast cancer risk for transgender men?
It has been observed that the intake of masculinizing hormones can reduce the likelihood of breast cancer. As a result, transgender men are less prone to breast cancer than cisgender women. However, it is advisable for transgender men who haven’t undergone a mastectomy to follow the breast cancer screening guidelines for cisgender women in their age group. Breast cancer screening may not be necessary for those who have experienced a mastectomy and are taking masculinizing hormones.
Read more: When Should You Go to the ER for Migraine?
Should you stop taking feminizing hormones if you have other risk factors for breast cancer?
It is essential to discuss with your doctor your risk of breast cancer. Generally, discontinuing feminizing hormones is not typically necessary. While feminizing hormones may elevate the risk of breast cancer compared to cisgender men, it remains lower than that of cisgender women.
This implies that although breast cancer concerns transgender women, the increased risk, even when considering other factors, usually does not warrant the recommendation to discontinue hormone therapy.
However, ultimately, whether to accept the higher risk for breast cancer is a personal decision. If you have concerns, seeking support from a transgender-friendly healthcare professional can be beneficial in gaining a better understanding of your specific risk profile.
Read more: Can Estrogen Increase Your Risk of Breast Cancer?
Are there other types of feminizing hormones that don’t increase the risk of breast cancer?
It is important to note that any feminizing hormone that produces gender-affirming results will likely come with some risk. Specifically, breast tissue growth is a common outcome of taking feminizing hormones, which can increase your risk of developing breast cancer. However, it’s essential to remember that this risk increase is generally tiny.
Can transgender women, without changing their legal gender, get breast cancer screening?
As a recipient of healthcare services, you are entitled to equal treatment without discrimination. To safeguard your access to vital services, including breast cancer screenings, national and state laws, and insurance regulations offer protection regardless of any legal document changes you may have made. The National Center for Transgender Equality provides a comprehensive list of your rights and additional resources to help you navigate the healthcare system.
Takeaway
Individuals who identify as transgender women and undergo feminizing hormone therapy may face a slightly higher risk of developing breast cancer than cisgender men. However, this risk is still lower than that of cisgender women. Despite the relatively low risk, transgender women must receive regular breast cancer screenings.
It is recommended that screenings begin after five years of hormone therapy or at 50, following the same guidelines as cisgender women. For transgender women with a higher risk, such as those with the BRCA1 or BRCA2 gene mutation, more frequent screenings are advised. Discussing personal risk factors and screening timelines with the healthcare provider who prescribes hormone therapy is recommended.