Top Surgery Patients Miss Cancer Risk Info

Transgender individuals undergoing gender-affirming mastectomy, or 'top surgery,' are not being sufficiently counseled regarding their ongoing risk of breast cancer. While this surgery removes most breast tissue, it does not eliminate risks stemming from genetic or hereditary factors, which account for 10% to 20% of breast cancers. Healthcare professionals frequently assume another team member will address cancer risk assessments, leading to a critical gap in patient education.

Conflicting medical guidelines and a lack of standardized communication leave many transgender patients unaware of the continued need for breast cancer screening or genetic testing for mutations like BRCA. This oversight is particularly concerning as gender-affirming mastectomies often occur at younger ages, prior to typical screening eligibility. The research team is developing CHESTcare, an online toolkit designed to integrate cancer and hereditary risk education with support for informed decision-making, aiming to improve safety and care for transgender and nonbinary individuals.