Posted: Tuesday, October 4, 2022
Only consistent, accurate education will help physicians learn proper protocols for breast cancer screening in transgender individuals, according to an analysis of results of an online 15-question survey presented during the 2022 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 71). Regina Barragan-Carrillo, MD, of Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, and colleagues reported that of 165 physicians surveyed this summer, “only 7.3% felt confident in their knowledge of breast cancer screening in transgender people.”
The baseline of knowledge for breast cancer screening in this population, said the team, is that “hormone-replacement therapy for transgender women requires blockade of androgen production and estrogen supplementation, which increases the risk of breast cancer compared to cisgender males. Also, transgender men [who have not had] gender-affirming mastectomy should undergo breast cancer screening.” However, according to the survey results, 10.9% of respondents recognized that breast cancer risk is different between transgender women and cisgender women.
Regarding specific breast cancer screening strategies, 49.1% of the responding physicians correctly identified the best screening strategies for transgender women, 61.2% correctly answered the recommended age to start screening in transgender women, 40.6% knew the correct periodicity for screening, and 63% identified the correct recommendation for screening for transgender men who had not had a gender-affirming mastectomy.
Although the respondents were relatively young—70.3% were residents and fellows, with a mean age of 30 years—more than half (55.2%) thought they had had inadequate preparation regarding transgender health during medical school. In general, “transgender people experience intersecting forms of marginalization and suffer significant health-care disparities,” stated Dr. Barragan-Carrillo and co-investigators. These barriers can be overcome only when health-care providers receive better information throughout their careers, according to the investigators.
Disclosure: The study authors’ disclosure information can be found at coi.asco.org.