Explained: Are Transgender Women At A Greater Risk Of Breast Cancer?

The incidence of breast cancer is on the rise among women residing in urban areas. It is a complex disease that can affect anyone with breast tissue, regardless of their gender identity. Though, most common in women but can also be seen in men who have hormonal imbalances.

Transgender women (individuals assigned a male sex at birth, but identifying with the female sex) may opt for a gender transition procedure and undergo hormone therapy as a part of their transition.

What studies say

Hormone therapy for transgender women often involves the use of estrogen and antiandrogen hormones, which can impact breast tissue. Estrogen can stimulate the growth of breast tissue, potentially increasing the risk of breast cancer. Studies have shown that, while the therapy stimulates breast development, it may increase also put them at increased risk of breast cancer for a relatively short duration during the course of the therapy. Moreover, transgender women who have undergone hormone therapy may still carry some residual risk.

Having said that, it's crucial to highlight that the increased risk is generally considered to be relatively small and is comparable to the risk faced by any women of similar age and hormone exposure.

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There is a lack of extensive research on the exact risk of breast cancer in transgender women, highlighting the need for further studies to obtain accurate estimates. However, current evidence indicates that transgender women who undergo hormone therapy may experience a slightly elevated risk in comparison to cisgender men, yet a lower, risk when compared to cisgender women. Nonetheless, additional research is necessary to gain a more comprehensive understanding of breast cancer risk within the transgender population.

What are the risks

The risk of breast cancer in transgender women is influenced by various factors, such as age, duration of hormone therapy, and individual genetic and lifestyle characteristics. Estrogen exposure, which is commonly part of hormone therapy for transgender women, is believed to potentially contribute to a higher risk of breast cancer. However, the exact magnitude of this risk is still being investigated, as additional research is needed to provide a more comprehensive understanding.

It's important for transgender women to be aware of their individual risk factors and to undergo regular breast cancer screenings as recommended by their doctor. Given the limited research in this area, there are currently no widely accepted guidelines for breast cancer screening in transgender women. However, many healthcare providers recommend that they take certain standard precautions that could promote breast health and also reduce the risk of them developing breast cancer.

The standard general recommendations include

Regular breast self-examinations

Transgender women are advised to perform regular breast self-examination to get familiar with the look and the feel of their breasts. This practice helps them stay vigilant and detect any potential changes or abnormalities that may arise. In the event of noticing any changes, it is crucial for transgender women to promptly seek guidance from their healthcare provider.

Clinical breast examinations

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While conducting regular breast self-examinations is vital, transgender women should also prioritize receiving regular clinical examinations performed by healthcare professionals, especially those with expertise in transgender healthcare. These clinical examinations play a crucial role in comprehensive breast health assessment and can aid in the early detection of any potential concerns. It is recommended that transgender women establish a relationship with healthcare providers knowledgeable about transgender healthcare to ensure optimal care and monitoring.

Screening and mammograms

There are fixed standard guidelines for breast cancer screening and mammograms in cisgender women. But, currently, there are no standard guidelines for transgender women. Hence, it is important for them to discuss with their healthcare provider about their individual risk factors and medical history if they require mammograms.

Management of hormone therapy

It is important for transgender women who have undergone hormone therapy to regularly consult their healthcare provider to monitor their hormone therapy regimen and ensure that the hormone levels are at appropriate ranges. Early detection of any hormonal impairment is helpful in managing the potential risks.

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Lifestyle modification

Engaging in a healthy lifestyle such as regular exercises, maintaining a healthy weight, consuming a balanced and nutritious diet, limiting alcohol, and quitting smoking can reduce the potential risk of breast cancer and other health conditions.

Awareness is the key

It is recommended to stay abreast about the latest research and guidelines about transgender healthcare in general and about breast cancer as well. Being aware and informed is helpful in making informed decisions about their health.

Take home message

For any transgender woman, it is necessary to be aware that any amount of precautions may vary depending on individual factors such as age, personal risk factors, medical history, and family history. It is always advisable to discuss their personal risk factors and appropriate screening strategies with a knowledgeable healthcare provider who can provide tailored recommendations based on their unique situation.

About the author: Dr. Rahul S Kanaka is a Consultant ¨C Surgical Oncology, Manipal Hospital Yeshwanthpur, Sarjapur, and Hebbal. All views/opinions expressed in the article are of the author.