Breast Cancer Screening for Transgender People
The terms below may be helpful in understanding breast cancer screening recommendations for transgender people:
- Transmasculine people (transgender men) – female sex assigned at birth, male gender identity
- Transfeminine people (transgender women) – male sex assigned at birth, female gender identity
- Cisgender men – male sex assigned at birth, male gender identity
- Cisgender women – female sex assigned at birth, female gender identity
Breast cancer and transgender people
Data on breast cancer among transmasculine and transfeminine people are limited.
One small study compared breast cancer rates among transgender people who had hormone treatments (with or without surgery as part of their transition) to breast cancer rates in the general population [76]. These early findings suggested [76]:
- Transmasculine people had a much lower risk of breast cancer than women in the general population, but a higher risk than men in the general population.
- Transfeminine people had a much lower risk of breast cancer than women in the general population, but a higher risk than men in the general population.
There’s still much to learn about the risk of breast cancer in transgender people. If you’re transgender, talk with your health care provider about your risk of breast cancer.
Resources for finding a health care provider
One step you can take is to find a health care provider who is sensitive to your needs. Getting a referral from a trusted friend may help. The National LGBT Cancer Network has a directory of LGBT-welcoming cancer screening centers that may also be helpful.
Regular visits to a health care provider offer the chance to discuss your risk of breast cancer and get breast cancer screening and other needed health care.
Learn more about finding a health care provider.
Breast cancer screening recommendations for transgender people
The American College of Radiology (ACR) has breast cancer screening guidelines for transgender people. These guidelines are tailored by [77-78]:
- Sex assigned at birth
- Age
- Personal risk of breast cancer
- Breast development
- Breast surgery, for transmasculine people
- Whether a person has used gender-affirming hormone treatment (and for how long), for transfeminine people
Learn about factors that greatly increase breast cancer risk and affect breast cancer screening and risk reduction options.
Breast cancer screening for transgender people at average risk of breast cancer
If you’re transmasculine and have had bilateral mastectomy, your risk of breast cancer is low. Bilateral mastectomy is the removal of both breasts (“top surgery”). Although bilateral mastectomy does not completely protect you from breast cancer, even in people at high risk of breast cancer, it lowers the risk of breast cancer by at least 90 percent [70,79-81].
If you’re transmasculine and have not had top surgery, your breast cancer risk is similar to women in the general population (cisgender women). If you’re at average risk of breast cancer, it’s recommended you follow screening recommendations for women at average risk of breast cancer [77-78].
If you’re transfeminine and at average risk of breast cancer, breast cancer screening recommendations depend on your use of gender-assigning hormone treatments (see table below) [77-78].
Breast cancer screening recommendations from the ACR are shown in the tables below. Talk with your health care provider about the breast cancer screening plan that’s right for you.
Breast cancer screening for transgender people at higher risk of breast cancer
If you’re at higher risk of breast cancer, you may need to be screened earlier and more often than others.
For example, people with a BRCA1 or BRCA2 (BRCA1/2) inherited gene mutation have a higher risk of breast cancer. Breast cancer screening recommendations for transgender people with a BRCA1/2 inherited gene mutation are similar to recommendations for others with a BRCA1/2 mutation [77-78].
Breast cancer screening recommendations from the ACR are shown in the tables below. Talk with your health care provider about the breast cancer screening plan that’s right for you.
ACR breast cancer screening recommendations for |
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Age, surgery and breast cancer risk |
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Any age with bilateral mastectomy (“top surgery”) and any level of breast cancer risk |
Not recommended |
Not recommended |
Ages 40 and older with breast reduction or no chest surgery and at average risk of breast cancer* |
Usually appropriate |
Not recommended |
Ages 30 and older with breast reduction or no chest surgery and a personal history of breast cancer, lobular carcinoma in situ (LCIS), atypical hyperplasia or a 15-20% lifetime risk of breast cancer |
Usually appropriate |
Breast MRI may be appropriate Breast ultrasound may be appropriate |
Ages 25-30 with breast reduction or no chest surgery and a BRCA1 or BRCA2 inherited gene mutation |
Usually appropriate |
Breast MRI usually appropriate Breast ultrasound may be appropriate |
Adapted from American College of Radiology materials [77-78]. |
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* Less than a 15% lifetime risk of breast cancer
ACR breast cancer screening recommendations for |
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Age, use of gender-affirming hormone treatment and breast cancer risk |
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Ages 40 and older, with past or current hormone use for 5 years or more and at average risk of breast cancer |
May be appropriate |
Not recommended |
Any age, with no hormone use or less than 5 years of hormone use and at average risk of breast cancer |
Not recommended |
Not recommended |
Ages 25-30, with past or current hormone use for 5 years or more and at higher risk of breast cancer |
Usually appropriate |
Not recommended |
Ages 25-30 with no hormone use or less than 5 years of hormone use and at higher risk of breast cancer |
May be appropriate |
Not recommended |
Adapted from American College of Radiology materials [77-78]. |
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Susan G. Komen® Support Resources |
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Updated 12/19/22
