We still don’t have a lot of information about transgender women’s exact risk for breast cancer. However, the results of a 2019 Dutch studyTrusted Source provided a few valuable pieces of data.
The study looked for cases of breast cancer among transgender people taking hormone therapy who received care at the gender clinic of the VU University Medical Centre Amsterdam in the Netherlands between 1972 and 2016. The Centre was chosen because it is a major public health facility, where more than 95 percent of transgender people in the Netherlands receive care.
Researchers found that transgender women who receive hormone therapy have an increased risk of breast cancer when compared with cisgender men. Data from the study also shows that the risk increased after being treated with gender affirming hormones for only a short time.
Additionally, data from the study indicated that transgender women who developed breast cancer often got it at a younger age 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 in the Netherlands is 61.
More studies and information are still needed. However, this study shows that hormone therapy increases the risk of breast cancer for transgender women. Although the risk is considered to be below the risk for cisgender women, it is a significant enough risk that screening and breast cancer education for transgender women is very important.
Additional risk factors for breast cancer
A number of 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.
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 common, and the breast growth that transgender women experience as a result of hormonal therapy can be dense breast tissue.
Previous breast cancer. Having breast cancer once increases your risk of getting it again.
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What are the breast cancer screening recommendations for transgender women?
The Dutch study proved that breast cancer screening for transgender women is important. The exact screening recommendations for transgender women depend on your specific circumstances. Here are three general recommendations:
If you’ve been on feminizing hormones for at least 5 years, follow the breast cancer screening recommendations for cisgender women in your age group.
If you are age 50 or above, follow the breast cancer screening recommendations for cisgender women in your age group and have a screen at least every 2 years. This applies no matter how long you’ve been on hormones.
If you have a family history of breast cancer or know you 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.
The doctor or clinic that prescribes your hormones might be able to advise you if you’re not sure exactly when to begin screenings. You can talk with them about any family history of breast cancer or any other concerns you might have. They can help you develop a timeline and screening plan.
They might also be able to recommend healthcare professionals and locations to access a breast cancer screening.
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