The Risk of Breast Cancer Among Male-to-Female Transgenders: A Systematic Review

Publication Date

2025

Document Type

Article

Publication Title

Phillippine Journal of Internal Medicine

Abstract

Background. The health needs of the transgender population have not been well understood and have been an interest when it comes to research. There were several reported cases of breast cancer, specifically in male-to-female (MtF) transgenders or those who were born genotypic male but addressed themselves psychosocially as females. The characteristics, risk factors, and recommendations for breast cancer in this population have not been established, and thus the need to develop further research.

Methods. In this study, three independent reviewers conducted literature searches using various online databases for all types of studies in relation to breast cancer occurrences in MtF transgenders in adult patients during the publication timeline of 2016–2022. Studies were excluded if there were no confirmed histologic studies nor breast cancer screening recommendations on the said population.

Results. A total of 14 articles were included and categorized in which quality assessment for risk of bias was done accordingly. Most of the studies were case reports, case series, and literature reviews making the overall quality poor. Most of the MtF transgenders were diagnosed with breast cancer at a median age of 58.9 years. The use of cross-sex hormones for at least 5 years by a transgender women may contribute the most to the risk of developing breast cancer. Other possible risk factors include a family history of breast cancer and obesity with body mass index (BMI) >35. The level of risk of developing breast cancer is still uncertain, but chronic hormonal use may increase one’s risk.

Conclusion. Due to the poor quality of the studies included, it is not possible at this time to quantify the risk of breast cancer among MtF transgenders. However, long-term use of cross-sex hormones (estrogen and/or progesterone) may be a contributing factor, but more large-scale studies are needed to establish the relationship. Most studies recommend mammography as the screening diagnostic modality at the age of 50 and older, with significant risk factors as identified annually or biennially. These recommendations still vary and are not yet well established by strong evidence due to various limitations, one of which is the uncertainty of the size of the MtF transgender population. Hence, further investigations are warranted and this study aims to uplift the recognition of breast cancer risk among the MtF transgenders.

First Page

82

Last Page

92

Link to Full Text

Share

COinS