Background
Breast cancer (BC) impact on lesbian (LCW) and bisexual cis-women (BCW), transgender women (TW) and transgender men (TM) remains understudied. We summarized current available literature on BC incidence, risk factors (RF) prevalence, screening recommendations, and health outcomes in above-mentioned populations.
Methods
Searched databases included PubMed, Scopus and CINAHL. Key search terms included 28 different variables of above-mentioned populations and BC, LGBTQ, and mammogram amongst others. 61 articles/manuscripts were analyzed.
Results
All of the above-mentioned populations have higher prevalence of RF such as nulliparity, alcohol (11.1% vs. 6.8%; p <.05) and tobacco use (15.1% vs. 8.3%; p < .001), while obesity affects LCW/BCW more commonly.1,2 GAHT increases BC risk in TW compared to cis-men (SIR = 46.7). LCW/BCW mammography rates are contradictory but higher age and levels of education, and BC awareness are associated with higher completion rate. TW on GAHT and TM s/p top-surgery lack guideline-approved BC screening recommendations. LCW/BCW do not have higher BC incidence. TW/TM have a 46-fold higher BC risk compared to cis-men (SIR = 46.7) but lower than cis-women (SIR = 0.3). All of the above have lower levels of satisfaction with healthcare and higher risk for BC recurrence, morbidity and mortality, although many report better psychosocial outcomes and community/partner support. TW adults may be hesitant to suspend GAHT following BC diagnosis.
Conclusions
RF for BC are more common in sexual and gender minorities, some of whom lack guideline approved BC screening recommendations. BC incidence is higher in certain members of the community who may be hesitant to discontinue GAHT. Information regarding best screening practices for TW on GAHT and TM who undergo top surgery with above-average genetic risk for BC are necessary. Prospective trials looking to improve their patient satisfaction and determine safe resumption/incorporation of GAHT following BC diagnosis are warranted.