Breast Health and Screening Mammograms

by Erin Tully and PHN staff

From PHN Issue 34, Fall 2017

            Breast Cancer is the most common cancer in the United States. While breast cancer is most likely to affect cisgender women, it affects people of all genders. (Cisgender means people whose gender identity matches the sex that they were assigned at birth.) Mammograms are recommended for people over the age of 40 who have breasts.

What is breast cancer?

Breast cancer is the uncontrolled growth of cancer cells in the breast tissue. These cells can grow in the lobes and ducts that produce and carry breast milk, and in the lymph nodes, which cluster under the arm and above the collarbone. Breast cancer cells are malignant, and it is possible for them to spread to other areas of the chest and body.

What are risk factors for developing breast cancer?

The strongest risk factor is age. Other important risk factors that can increase a person’s chance of having breast cancer include:

  • Family History – Increased risk if a mother, sister, daughter, or male relative has been diagnosed with breast cancer
  • Personal History – Increased risk of developing breast cancer again if diagnosed in the past
  • Genetics – Some genetic mutations increase the risk of developing breast cancer
  • Alcohol Consumption – The more a person drinks, the more their risk for breast cancer
  • Radiation Exposure – Increased risk for those who have had radiation therapy to the chest before age 30
  • Reproductive and Menstrual Experiences – Increased risk for those who had their first menstrual period before age 12, first full-term pregnancy after age 30 or no full-term pregnancy, and menopause after age 55
  • Activity Level – Those who are less physically active throughout life may be at increased risk

Why should people with breasts get screened?

            Screening for breast cancer can help find it before it shows any signs or symptoms. Cancer is much easier to treat before it grows too large or begins to spread. During clinical breast exams, the health provider touches the breasts and under the arms to make sure there are no lumps or anything else that seems unusual. It is also important to do self-exams. It is normal for breast changes to occur during menstrual cycles, pregnancy, and menopause and while taking birth control or hormone therapy. It’s best to check your chest once a month by pressing with your fingers, so you are familiar enough with how it feels normally to notice if something changes. If you ever find changes that seem unusual or cause you to worry, it’s a good idea to contact your health provider to schedule a breast exam or screening mammogram.  

What is a mammogram?

            Mammograms are x-ray images of the breast. They can find tumors that are too small to feel. The images can reveal normal findings, or tumors that may be benign or cancerous.

Many people find mammograms to be painful and even upsetting. But they are extremely important to maintaining health. Researchers who studied cancer in cisgender women found that those 40 to 74 years old who have screening mammograms have a lower chance of dying from breast cancer than those who do not have screening mammograms.

 It is important to remember that these screenings can reveal false positive or false negative findings, so not every abnormal result should make you worry. You may have to keep asking for an explanation of the results and what the health provider is doing next to get more answers for yourself. You may also need to advocate for yourself to get a mammogram or other screening, especially if you are transgender.

Who should get a mammogram?

            Every person with breasts can and should get regular breast cancer screening. Annual mammograms should begin at age 40 in those who have no symptoms and are at an average risk for breast cancer. Those who are 20 to 40 years old should receive a clinical breast exam at least every 3 years.

            Cisgender men do not need to get screened for breast cancer, but it’s important to notice if any lumps grow in the breast area and to tell the health provider.

            Trans women need, and have a right to, the same breast cancer screenings that cisgender women get. People who take estrogen or progestin are believed to be at higher risk than those who do not. Breast implants are not thought to affect cancer risk, but they may make it harder to find lumps during a self-exam.

            Trans men and gender non-binary people who have had chest reconstructive surgery are probably less likely to get breast cancer. But it’s possible to get breast cancer after top surgery. It’s best to get regular examinations of the chest wall and lymph nodes after age 50. If you are taking testosterone and the dose is too high, it’s possible for the testosterone to be converted to estrogen, which could increase breast cancer risk.

Sources:  National Cancer Institute and QMUNITY

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