Breast cancer is also a risk for transgender men and women says South African non-profit organisation Right To Care.
“Transgender men and women are also at risk of breast cancer due to exposure to the hormones estrogen and progestin which influence the cancer,” says Right to Care programme coordinator for the Global Fund Programme Edward Sibanda.
Right to Care is a non-profit organisation that supports and delivers prevention, care, and treatment services for HIV and TB.
“During national breast cancer awareness month in October we want to reach out to all risk groups, including male-to-female (MTF) and female-to-male (FTM) transsexuals to self-examine monthly,” said Sibanda.
“MTF transsexuals receiving high doses of estrogen develop breast tissue identical to the tissue of a biologically female breast. The risk of breast cancer increases following breast development, and heightens after five or more years of hormone therapy. FTM transsexuals taking testosterone may also be at increased risk because excess testosterone converts to estrogen.
“We find that transgenders may feel uncomfortable with self-exams or medical exams, and therefore do not do them. They also assume that their chances of developing breast cancer are eliminated with surgery. But surgery does not remove all breast tissue.
“This is why self-examination as a detection tool can be life-saving, regardless of a person’s gender.”
Sibanda says that transgender and transsexual people may be less likely to undergo regular screening for breast cancer because they receive lower quality medical care due to stigma and discrimination or lack of knowledge by healthcare workers. Some healthcare professionals refuse to participate in transgender healthcare. Others simply do not have sufficient experience in transgender health.
“The fact is that there is insufficient research on how transgender and transsexual individuals are affected by breast cancer. South Africa doesn’t even have statistics on the size of its trans community.”
Healthcare workers have highlighted some key concerns about trans people and their risks of breast cancer which include:
• High rates of cigarette smoking and alcohol consumption – both key contributors to the incidence of breast cancer
• The lack of trans-inclusive information and medical care resulting in trans people not benefiting from cancer prevention services.
“Trans people who don’t have access to good medical care or who avoid exams used to screen for cancer because of fear or prejudice risk the cancer not being found until it has already spread. The best defence against all cancer is early detection.”
Sibanda says that accepted breast cancer screening guidelines for transgender people are:
• Annual chest/breast examination and regular screening mammography for MTFs who have taken estrogen/progestin, are age 50+, and have other potential risk factors for breast cancer like family history and a high body mass index.
• Annual chest/breast examination and regular screening mammography for FTMs age 50+ who have not had chest surgery.
Risk factors for breast cancer
• Increasing age
• A family history of or genetic susceptibility to breast cancer
• A history of radiation treatment to the chest wall
• A history of breast biopsies
• Never having been pregnant
• Having children after age 30
• Beginning menstruation before 12 years of age
• Undergoing menopause after 55 years of age
• Excessive alcohol consumption and
Right to Care said everyone could limit their breast cancer risk by doing monthly self-examination, stopping smoking, avoiding second-hand smoke, limiting alcohol and following a healthy diet and lifestyle.