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Trans women & breast-cancer screening

Knowing that I’m healthy, or that I don’t have cancer, or that if I do I’ve caught it early enough to be treated — that outweighs the discomfort of getting screened. Debbie

Breast cancer. It’s not something that any of us like to think about, but for many trans women and people on the transfeminine (male-to-female/MtF) spectrum, breast cancer screening can come with particular concerns.

We may have heard different — or conflicting — information about whether or not we’re at risk for developing breast cancer, whether we should be screened and how often, and if taking hormones or having breast implants have any impact on cancer risk or screening.

It can be hard to make breast-cancer screening a priority. Maybe you don’t think you need to be screened. Maybe you’re concerned that you could experience transphobia at the screening facility. Perhaps you’re worried that having a mammogram could be uncomfortable or upsetting. Or, maybe you just don’t want to think about cancer.

Still, it’s important to get screened for breast cancer. This means finding cancer before there are any symptoms. It’s true that we need more good information on breast cancer risk and trans women. But here’s what we do know:

  • Taking gender-affirming hormones (like estrogen) for more than five years increases your risk of developing breast cancer. If you’ve taken hormones for more than five years, and you’re between the ages of 50 and 69, you should get a mammogram (or other screening test) every two years.
  • If you’re a trans woman who has never taken gender-affirming hormones (like estrogen), or if you’ve taken hormones for fewer than five years, then you do not need to be screened regularly for breast cancer.
  • Breast implants do not increase your cancer risk. But if you’ve had implants and you have also taken gender-affirming hormones for more than five years, then you need to be screened regularly between the ages of 50 and 69. You can still have a mammogram with implants, but you’ll need a special type of mammogram, called a diagnostic mammogram.

So, is breast-cancer screening worth the hassle and discomfort? The answer is yes. Because your health is worth it. Because your body is worth it. Because cancer doesn’t discriminate. Because screening saves lives.