Study IDs Gaps in Hereditary Breast Cancer Risk Assessment Before Gender-Affirming Mastectomy

FRIDAY, Aug. 7, 2026 (HealthDay News) — Structural and systemic gaps exist that hinder effective integration of hereditary breast cancer risk assessment in transgender and gender-diverse (TGD) individuals undergoing gender-affirming mastectomy (GAM), according to a study published online July 29 in Breast Cancer Research and Treatment.

Kimberly Zayhowski, from Boston University Chobanian and Avedisian School of Medicine, and colleagues conducted semistructured interviews with 20 health care professionals (HCPs) experienced in caring for TGD patients considering or undergoing GAM to identify factors that influence integration of cancer risk evaluation within the context of GAM. A reflexive thematic analysis was applied to explore HCP perspectives and generate key themes.

The researchers conceptualized five key themes: HCPs perceive no clear ownership for care integration of assessment of breast cancer risk; conflicting guidelines result in HCPs relying on their own judgement, yielding inconsistent practice; care pathways are driven by individual HCPs rather than standardized protocols; risk discussions are complicated by GAM frequently occurring at young ages, prior to age of population cancer risk screening initiation; and patient safety is compromised by structural failures in care delivery.

“Every person — transgender or cisgender — deserves clear information about their cancer risk and access to prevention. As it stands, trans people are diagnosed with cancer at later, more dangerous, stages than cisgender people,” Zayhowski said in a statement. “We”re calling on health care institutions and organizations to move beyond reliance on individual provider commitment and invest in the institutional infrastructure necessary to guarantee that trans patients receive comprehensive cancer risk information to make truly informed decisions about their care.”

Abstract/Full Text