Breast Cancer Screening Guidelines for Transgender Women and Men

Transgender people have a different gender identity than the sex they were assigned at birth. It is believed that 0.5 percent of the population is transgender. The word transgender is sometimes abbreviated to “trans.” A transgender man is someone with a male gender identity but a female sex assigned at birth (female-to-male). A transgender woman is someone with a female gender identity but a male sex assigned at birth (male-to-female).

Transgender women and men can develop breast cancer. Therefore, each patient should talk with their health care provider about their breast cancer screening options. Below are current screening recommendations for transgender women and men.

Transgender Women

Transgender women may have a greater chance of getting breast cancer due to the medicines they take to boost female hormones and lower male hormones. A person’s family history and genetic makeup can also increase their chances of breast cancer. For instance, a transgender man is genetically female. If he carries a breast cancer gene, such as BRCA, and does not have a mastectomy, he stays at risk for breast cancer.

Current screening recommendations come from the Center of Excellence for Transgender Health at the University of California San Francisco and Fenway Health in Boston. Since over half of transgender women (male-to-female) have dense breasts, screening mammography may be useful for finding breast cancer.

Breast Cancer Screening Guidelines for Transgender Women (male-to-female)

  • If you are 50 years of age or older and you had at least 5 years of hormonal therapy, you should have a screening mammogram every 2 years.
  • Your health care provider should talk to you about the risks of too much breast cancer screening. They should also assess your breast cancer risk factors such as family history of cancer and a body mass index more than 35. Find out your BMI.

*This information is current as of 10/3/18 but is subject to change.

Transgender Men

Mastectomy (breast removal) and taking male hormones are generally protective and lower the chances of breast cancer in transgender men. While rare, there have been cases of breast cancer in men who had a mastectomy and received hormones. This is likely due to small amounts of breast tissue that remain after surgery.

Transgender men who have not had both breasts removed (bilateral mastectomy) or who have only had breast reduction should be screened for breast cancer based on current guidelines for non-transgender women. There is no reliable proof to guide the screening of transgender men who have had a mastectomy. When the breast tissue is removed during a mastectomy, a mammogram may not be possible. Instead, an ultrasound or MRI may be needed. If you’re a transgender man who has undergone bilateral mastectomy, talk with your health care provider about your best options for breast cancer screening.

Breast Cancer Screening Guidelines for Transgender Men (female-to-male)

  • If you did not have a mastectomy, you should be screened based on breast cancer screening guidelines for non-transgender women.
  • If you only had a breast reduction, you should be screened based on current breast cancer screening guidelines for non-transgender women.
  • If you have changes in the way your breasts look or feel, see your health care provider and ask about having a clinical breast exam.

*This information is current as of 10/3/18 but is subject to change.