ReachRxResearch
Home
Research
Sign Up
  1. Home
  2. Research Hub
  3. Healthcare professional perspectives on…

Healthcare professional perspectives on hereditary breast cancer risk assessment prior to gender-affirming mastectomy

Breast Cancer Research and Treatment·July 29Open Access
OncologySafety signalBreast CancerHereditary Breast CancerQualitative StudyGender-Affirming MastectomyGenetic CounselingMixed

Summary

View source

What was studied

Semi-structured qualitative interviews with 20 HCPs (6 primary care providers, 5 genetic counselors, 6 oncologists, 3 plastic surgeons) explored factors influencing breast cancer risk assessment and genetic counseling integration into gender-affirming mastectomy (GAM) pathways for transgender and gender diverse (TGD) patients.

Key findings

Five themes emerged: (1) no clear ownership for breast cancer risk assessment in GAM pathways; (2) conflicting guidelines force HCPs to rely on personal judgment, causing inconsistent practice; (3) care pathways depend on individual 'champions' rather than standardized protocols; (4) GAM often occurs at ages younger than standard cancer screening initiation, complicating risk discussions; and (5) structural failures—including inadequate assessment of residual breast tissue—compromise patient safety, including at least one reported patient death from delayed diagnosis.

Study limitations

Small sample (n=20) with limited representation per specialty; geographic concentration in academic medical centers; snowball sampling likely overrepresented providers already familiar with genetics and TGD care.

Clinical implications

Clinicians should proactively initiate hereditary breast cancer risk assessment and family history review before GAM, rather than deferring to other specialists, given the documented diffusion of responsibility. Embedding genetic counseling into multidisciplinary gender-affirming care teams—rather than relying on individual champions—is a critical step toward equitable, consistent care.

Caveats

  • Study design is qualitative; themes represent HCP perspectives, not quantitative outcome data, limiting generalizability.
  • The paper reports a single anecdotal patient death from delayed breast cancer diagnosis post-GAM; this should be interpreted as illustrative, not epidemiological evidence of incidence.
  • The sample size is small (n=20) and skewed toward academic medical centers and providers already engaged with TGD care — findings may not reflect community practice settings.

Related Questions

Explore related topics

What are current guidelines for breast cancer risk assessment before gender-affirming mastectomy?How does gender-affirming mastectomy differ from risk-reducing mastectomy in terms of residual breast tissue and cancer risk?What genetic testing criteria apply to transgender and gender diverse patients with a family history of BRCA-related cancers?

Publication Details

Year
2026
Journal
Breast Cancer Research and Treatment
Sample Size
n=20
Source
View article
Keep scrolling
More content below.
Up Next