Effects of Gender-affirming Medical and Surgical Therapy on Breast Imaging Findings and Breast Cancer Risk: Practical Considerations

Dahlia L Guerrero, MD; John Sowinski, MD; Kavita M Patel, MD


Appl Radiol. 2022;51(3):24-32. 

In This Article

Abstract and Introduction


Transgender individuals experience a self-concept of gender that differs from their sex assigned at birth.[1] A transgender female self identifies as female and has been assigned male sex at birth (male-to-female). A transgender male self identifies as male and has been assigned female sex at birth (female-to-male). An estimated 1.3–2.0 million people in the United States identify as transgender; this is possibly underestimated given the lack of national census surveillance of gender identity.[2,3] Some transgender individuals may choose to undergo gender-affirming hormone (GAH) therapy or gender-affirming surgery (GAS) to align their external appearance with their inner experience of gender.

This narrative aims to introduce readers to breast-related gender-affirmation therapy, review the most recent recommendations for breast cancer screening in the transgender population, and depict some of the expected breast imaging findings in the transgender population.