Transgender Issues Related To Male Breast Cancer

Although everyone has a risk of developing cancer in their lifetime, not everyone has access to supportive and informed healthcare. Many transgender people face discrimination in healthcare settings that causes trans patients to feel unwelcome or fearful of medical care. Beyond the lack of gender-affirming care, there are often overlooked or misconceived factors regarding transgender cancer risk. We hope to provide some useful information for the transgender community to understand better their risk of cancer, specifically of the breast.

Cancer-related genetic mutations, such as BRCA1/2, are hereditary and passed down through families. As a hereditary mutation, any parent that is positive for a BRCA1/2 mutation has a 50% chance of passing the mutation onto their biological children, regardless of gender identity. BRCA1/2 mutations specifically predispose people to many different types of cancer, including breast, prostate, ovarian, and pancreatic cancer. If you have a family history of these types of cancers, consider getting genetic testing to know if you are at increased risk of cancer development. 

Regardless of gender identity and genetic predisposition, anyone with breast tissue is at risk for breast cancer. While knowing BRCA status and family history is an important first step to assessing risk, many physicians and patients do not consider the effects of hormone treatment. Transgender women who undergo hormone therapy with estrogen have a relatively increased risk of breast cancer due to the hormonally sensitive nature of some breast cancers. Some, such as estrogen-receptor-positive breast cancers, are in part driven by estrogen in the human body, therefore the increased presence of estrogen via hormone replacement therapy could contribute to an increased risk of cancer development. While on the other hand, transgender men often aim to lower estrogen levels through testosterone treatment, typical estrogen levels are still relatively higher than cisgender men and therefore there is an increased risk of breast cancer. However, even in cases where transgender men and women do not participate in hormone replacement therapy, one fact remains true: if you have any breast tissue at all, you can develop breast cancer.