Breast Imaging in Transgender Patients: What the Radiologist Should Know

• Published in: Radiographics Vol. 40; no. 1; pp. 13 - 27
• Main Authors: Parikh, Ujas, Mausner, Elizabeth, Chhor, Chloe M, Gao, Yiming, Karrington, Ian, Heller, Samantha L
• Format: Journal Article
• Language: English
• Published: United States 01-01-2020
• Subjects: Adult; Breast Neoplasms - diagnostic imaging; Breast Neoplasms, Male - diagnostic imaging; Early Detection of Cancer; Estradiol - adverse effects; Female; Health Services Accessibility; Humans; Male; Mammography; Neoplasms, Hormone-Dependent - diagnostic imaging; Physician-Patient Relations; Terminology as Topic; Transgender Persons
• ISSN: 0271-5333; 1527-1323
• DOI: 10.1148/rg.2020190044

is the umbrella term for individuals whose gender identity and/or gender expression differs from their assigned sex at birth. With the rise in patients undergoing gender-affirming hormone therapy and gender-affirming surgery, it is increasingly important for radiologists to be aware of breast imaging considerations for this population. While diagnostic imaging protocols for transgender individuals are generally similar to those for cisgender women, screening guidelines are more variable. Currently, several professional and institutional guidelines have been created to address breast cancer screening in the transgender population, specifically screening mammography in transfeminine individuals who undergo hormone therapy. This article defines appropriate terminology with respect to the transgender population, reviews evidence for breast cancer risk and screening in transgender individuals, considers diagnostic breast imaging approaches, and discusses special considerations and challenges with regard to health care access and public education for these individuals.
RSNA, 2019.