Integrating breast cancer screening with transmasculine chest reconstruction surgery

Zinnia JonesBreast cancer can occur in both cis women and cis men, and breast health is equally crucial for trans women, who will experience growth of breast tissue during feminizing hormone therapy, and trans men. Biannual mammograms are recommended for trans women on HRT from age 50 onward, and trans women should be aware of their BRCA1/2 status and how this risk factor may come to bear on their hormonal regimen.

Van Renterghem et al. (2018) have recently identified an additional opportunity for breast cancer screening in trans men. Following male chest reconstruction surgery, or top surgery, the removed tissue specimens can be examined by histopathologists for the presence of benign or malignant tumors and lesions, enabling earlier detection of breast cancer. In a study of 344 trans men who underwent top surgery at Ghent University Hospital in Belgium and whose removed tissue was later examined by pathologists, two cases of invasive breast cancer were found:

The value of routine histopathological examination has been illustrated in this cohort, by the finding of an unexpected breast cancer in a 31-year-old transman. The incidence was 0⋅3 per cent in this cohort, similar to the rate of 0⋅5 per cent reported in Japan.

The authors additionally cited previous research indicating the greater sensitivity of histopathological examination for breast cancer detection compared to imaging. In a press release, senior author Dr. Mieke R. Van Bockstal at Ghent University Hospital explained the importance of this routine tissue examination following top surgery:

“The discovery of benign breast lesions will not change a patient’s treatment, but the detection of an unexpected breast cancer will. For some of these patients with breast cancer, chemotherapy and axillary lymph node examination will be necessary. In this way, histopathologists provide essential information for both the patient and his physicians.”

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About Zinnia Jones

My work focuses on insights to be found across transgender healthcare, public health, psychiatry, and history of medicine, integrating these many perspectives and guided by the lived experiences of trans people. I live in Orlando with my family, and work mainly in technical writing.
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