Does a transsexual need mammograms?
D. BENNETT, MD, of Winnipeg, MB, writes, "I have a patient who will turn 50 soon and is a transgendered individual. After taking estrogens for so many years, should this person have routine mammograms now?"
There are no studies in this particular area that could give you a definitive answer, but I ll do the best I can. I assume this individual is genetically male -- i.e. has an X and a Y chromosome. If there were no other risk factors, e.g. family history, then the lifetime risk of breast cancer would be no more than 1%. He has, however, taken relatively high doses of unopposed estrogen for a long time, so the chance is higher than this, but probably not as high as that of a woman of equivalent age. A mammogram is a noninvasive test that, although not always the most pleasant, has relatively few complications and a low morbidity rate. If this individual has enough breast tissue that the test can be performed, then I say go ahead with it as a screening procedure. If this person walked into a public breast screening clinic, they d likely not know his genetic background and wouldn't hesitate to test him. BC