The Silent Question of Breast Cancer in Transgender People – The New Indian Express

Express press service

HYDERABAD: In the whirlwind of various articles and concerns, transgender communities are focusing less on their health, especially breast cancer, given that there isn’t a lot of awareness around it. Dr Ridhima Bindlish, consultant breast oncoplastic surgeon, who works at the Indo-American Basavatarakam Hospital and Cancer Research, Banjara Hills, spoke about breast cancer risks among transgender people at Shilparamam, where the Indian Council cultural relations had organized a cultural program this weekend. She told us more about the matter in an exclusive interview:

Why is breast cancer among the transgender population not talked about a lot?
Transgender people face many stigmas that prevent them from obtaining appropriate health care. The main obstacle is the social stigma that pushes them to hide their identity to avoid discrimination. Second, there is still a lack of knowledge and training among health care providers. Third, they still face legal and monetary complications. But with the changing legal and social scenarios, we can hope that the situation will become more and more friendly for our transgender population, where they can exercise their right to appropriate health care in the future.

Is there an increased risk of breast cancer among the transgender population?
Currently, the risk of breast cancer in the transgender population is lacking due to the heterogeneity of the population. A study conducted and published in the Netherlands in 2019 reported an increased risk of breast cancer in transgender women (male assigned at birth, female gender identity) compared to cisgender men. The main reason was an alteration in their body with hormones, silicone injections, surgery, or a combination of the two. Feminizing hormone therapy primarily includes drugs that reduce estrogen and androgens such as spironolactone. But a similar risk has been reported in transgender men (assigned female sex at birth, male gender identity) as natal women who did not have gender reassignment surgery, whether or not they took supplements. hormonal. But future studies are needed to further investigate the cause of breast cancer in transgender people receiving hormone therapy.

How can others be more inclusive in terms of support?
The key to providing better care is to accept that people are free to express their identity differently from the norms set by society and that basic health care is the right of everyone despite their gender preference. The importance of this issue has been recognized and most hospitals and clinicians are doing their best to make the healthcare system more LGBTQIA + friendly where they can feel comfortable voicing their concerns and not feel discriminated against. Clinicians treating them should be aware of strict patient-physician confidentiality so that people can openly discuss their concerns and obtain appropriate advice and treatment.

Does an affected transgender person feel different from an affected cisgender person?
Most of the time, since many withhold relevant medical information, it becomes difficult for clinicians to diagnose it correctly. A transgender person might not inform properly
the clinician about any hormonal supplements they are taking or the surgery being done for body imaging. This can lead to difficulties in advising the correct imaging and treatment modality. There should be full transparency between
the treating clinician and the transgender person so that the best treatment can be provided.

What treatments are available?
Treatment modalities include clinical examination, appropriate imaging, and tissue biopsies to confirm the diagnosis. Surgery, chemotherapy, radiation therapy and hormone therapy are the four main treatment modalities. But of course, it is adapted to each patient specifically according to their diagnosis and the stage of the disease.