Table 5:

Existing breast screening recommendations for trans men (review 3)

Organization, year; population	Document type	Screening recommendations
Organization, year; population	Document type	Additional eligibility criteria	Modality	Interval	Additional recommendations
Without chest reconstruction^*
CCS, 201724	Position statement	40–49 yr, at average risk	NR	NR	Discuss individual risk of breast cancer and benefits and risks of mammography
		50–69 yr, at average risk	Mammography	Every 2 yr	NR
		≥ 70 yr, at average risk	NR	NR	Discuss whether and how client should be screened according to individual risk factors
CETH, 201626	Guideline	NR	NR	NR	Follow guidelines for cisgender women
SHC, 201528	Guideline	NR	Clinical breast examination	Annual	Follow guidelines for cisgender women
SHC, 201528	Guideline	50–71 yr	Mammography	Every 2 yr	Follow guidelines for cisgender women
ACOG, 201131	Position statement	NR	NR	NR	Age-appropriate^† screening
VCH, TTSES & CRHC, 20064	Guideline	With or without history of CSH use,^‡^§ with or without oophorectomy	Breast examination^¶	Annual	NR
VCH, TTSES & CRHC, 20064	Guideline		Mammography	NR	Follow guidelines for natal females
With partial chest reconstruction^*
CCS, 201724	Position statement	NR	Ultrasonography or MRI^**	NR	Discuss individual risk factors^†† for breast cancer
CETH, 201626	Guideline	NR	Ultrasonography or MRI	NR	NR
SHC, 201528	Guideline	NR	Mammography	NR	Not required following chest reconstruction
VCH, TTSES & CRHC, 20064	Guideline	With or without history of CSH use,^‡^§ with or without oophorectomy	Mammography	NR	Not necessary following chest reconstruction, but should be considered if only a reduction is performed
Trans men in general (i.e., chest reconstruction status not specified)
CCS, 201724	Position statement	High risk^‡‡	NR	NR	May need to be screened at earlier age or more frequently than trans men at average risk, or both
IPPF, 201527	Position statement	With history of CSH use^‡^§	NR	Periodic	Periodic cancer screening for those who retain their breast tissue
SHC, 201528	Guideline	Strong family history of breast cancer	Mammography	NR	Follow the same guidelines as for cisgender women regarding indications for referral to high-risk screening program/ genetic assessment
NHS, 201330	Guideline	With developed breast tissue	NR	NR	Breast screening

Note: ACOG = American College of Obstetricians and Gynecologists, CBE = clinical breast examination, CCS = Canadian Cancer Society, CETH = Center of Excellence for Transgender Health, CRHC = Canadian Rainbow Health Coalition, CSH = cross-sex hormone, IPPF = International Planned Parenthood Federation, MRI = magnetic resonance imaging, NHS = National Health Service, NR = not reported, SHC = Sherbourne Health Centre, TTSES = Transcend Transgender Support & Education Society, VCH = Vancouver Coastal Health.
↵* Chest reconstruction was variably termed as mastectomy, gender-affirming chest surgery or chest surgery.
↵† Age range not specified.
↵‡ Cross-sex hormone use was variably termed as hormone use or testosterone.
↵§ Duration not specified.
↵¶ Document did not specify whether clinical breast examinations, breast self-examinations or both were recommended.
↵** Specific breast screening recommendations for trans men who have had partial chest reconstruction were not provided. However, it was noted that, in some cases, mammography may not be possible following chest reconstruction surgery, and breast ultrasonography or magnetic resonance imaging may be a preferable screening method.
↵†† Risk factors include the amount of breast tissue removed, personal risk factors and history, whether the client has had oophorectomy, and whether the client is taking testosterone and other hormones.
↵‡‡ Defined as a genetic mutation in oneself, or having a parent, sibling or child who has a genetic mutation that puts them at higher risk for breast cancer; a family history that indicates a lifetime risk of breast cancer of 25% or greater, confirmed through genetic assessment; or having received radiation therapy to the chest before 30 years of age as treatment for another cancer or condition.