Navigating Breast and Chest Health Can Be Challenging

Guidelines do exist specifically for transgender people, but because the data backing them is scarce, the recommendations are not well known — even among doctors — and differ dramatically between sources. The screening guidelines for transgender men and non-binary people who are assigned female at birth (afab) are largely based on the guidelines for cisgender women, but  the impact of top surgery on the need for breast cancer screening is debated among physicians.

For amab non-binary and trans women, the American College of Radiology recommends the following:

• If less than 5 years of hormone use and average risk, no testing

• If less than 5 years of hormone use, 25 to 30 years or older, and higher-than-average risk, annual digital breast tomosynthesis (DBT, also called a 3D mammogram) or mammogram “may be appropriate” 

• If 5 or more years of hormone use, 25 to 30 years or older, and higher-than-average risk, annual DBT or mammogram is “usually appropriate” 

• If 5 or more years of hormone use, 40 years or older, and average risk, annual DBT or mammogram “may be appropriate”

For afab non-binary people and trans men, the ACR recommends the following:

• If you have had top surgery, no testing (However, other organizations do not recommend skipping testing for trans people who have had top surgery.)

• If you have not had top surgery or you’ve had only a reduction, are 40 years or older, and have average risk, DBT or mammogram is “usually appropriate”

• If you have not had top surgery or you’ve had only a reduction, are 30 years or older, and have intermediate risk, DBT or mammogram is “usually appropriate,” and breast MRI with and without intravenous contrast “may be appropriate”

• If you have not had top surgery or you’ve had only a reduction, are 25 to 30 years or older, and have high risk, DBT, mammogram, and breast MRI with and without intravenous contrast “is usually appropriate”

This information is provided by Breastcancer.org.