Table 5:

Existing breast screening recommendations for trans men (review 3)

Organization, year; populationDocument typeScreening recommendations
Additional eligibility criteriaModalityIntervalAdditional recommendations
Without chest reconstruction*
CCS, 201724Position statement40–49 yr, at average riskNRNRDiscuss individual risk of breast cancer and benefits and risks of mammography
50–69 yr, at average riskMammographyEvery 2 yrNR
≥ 70 yr, at average riskNRNRDiscuss whether and how client should be screened according to individual risk factors
CETH, 201626GuidelineNRNRNRFollow guidelines for cisgender women
SHC, 201528GuidelineNRClinical breast examinationAnnualFollow guidelines for cisgender women
50–71 yrMammographyEvery 2 yr
ACOG, 201131Position statementNRNRNRAge-appropriate screening
VCH, TTSES & CRHC, 20064GuidelineWith or without history of CSH use,§ with or without oophorectomyBreast examinationAnnualNR
MammographyNRFollow guidelines for natal females
With partial chest reconstruction*
CCS, 201724Position statementNRUltrasonography or MRI**NRDiscuss individual risk factors†† for breast cancer
CETH, 201626GuidelineNRUltrasonography or MRINRNR
SHC, 201528GuidelineNRMammographyNRNot required following chest reconstruction
VCH, TTSES & CRHC, 20064GuidelineWith or without history of CSH use,§ with or without oophorectomyMammographyNRNot 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, 201724Position statementHigh risk‡‡NRNRMay need to be screened at earlier age or more frequently than trans men at average risk, or both
IPPF, 201527Position statementWith history of CSH use§NRPeriodicPeriodic cancer screening for those who retain their breast tissue
SHC, 201528GuidelineStrong family history of breast cancerMammographyNRFollow the same guidelines as for cisgender women regarding indications for referral to high-risk screening program/ genetic assessment
NHS, 201330GuidelineWith developed breast tissueNRNRBreast 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.