What Transgender Women Should Know About Breast Cancer Risks

Breast cancer is a risk for all women, but if you’re a transgender woman, breast cancer risk, detection and treatment aren’t topics that are widely discussed. While the risks for breast cancer are lower in transgender women than non-transgender women, there are still some important risks to consider.

Some of the unique challenges you may face include:

• You may have dense breasts, which is an independent risk factor for breast cancer and can lead to false negative mammography results.
• While you may have a lower lifetime exposure to estrogen (a hormone produced in the ovaries that can increase the risk of cancer post-menopause), taking gender-affirming hormones, such as estrogen, for more than five years can increase your breast-cancer risk. 
• Recommendations for breast cancer screening for transgender women are not well known by physicians, making it difficult to get a clear understanding of when screening should take place.
• You may be reluctant to go to the doctor, wondering if you’ll be treated with the respect you deserve.

Based on these risks and limitations, it is essential that transgender women be informed and take an active role in their health care.

Breast Screening Recommendations for Transgender Women

The University of California Center of Excellence for Transgender Health recommends that if you’re age 50 or over and have taken feminizing hormones for five or more years, you should get a mammogram every two years. Your doctor may suggest more frequent screenings, depending on the number of years you’ve taken hormones or if you have a family history of breast cancer.

In addition to screenings, you should perform a breast self-exam monthly.

Breast Cancer Symptoms

• Lump or mass that can be painless or painful
• Swelling of all or part of the breast
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction

These symptoms do not always indicate cancer. Particularly if you are taking hormones, you may experience breast pain, tenderness and nodules. However, if you have concerns, you should talk with your doctor.

Reducing Breast Cancer Risks

Some factors, such as getting older, having certain genes or a family history of breast cancer are risks that are hard to change. However, you can reduce your odds of developing breast cancer by making lifestyle changes such as:

• Maintaining a healthy weight
• Being physically active with moderate or vigorous activity
• Limiting or avoiding alcohol
• Eating a diet rich in vegetables, fruit, lean meats and low-fat dairy

Look for gender-affirming medical professionals who will treat you with respect and sensitivity, and be sure you understand your breast-cancer risks and prioritize your breast health.