When was the last time you checked your breasts/chest for lumps or changes? When was the last time you got a mammogram? Sometimes dealing with our physical health can feel intimidating and scary—especially considering health insurance, or lack thereof, which is a reality for many LGBTQ people. Breast/chest cancer awareness needs to expand beyond simply the month of October. While it is vital to bring more awareness to this disease and ensure that people at risk have all the information they need about screening, we can’t just stop having these conversations at the end of October.
GO spoke with Juliet Widoff, MD at Callen-Lorde Community Health Center, to better understand what preventive care we can all be doing around breast/chest cancer.
1. Frequency of mammograms depends on health risk
“Recommendations differ depending on who you go to for your guidance and the best recommendations take individual risk into consideration and thus involve a discussion with a provider who knows your personal and family medical history,” Widoff says. Some people are at higher risk for breast/chest cancer: for example, if it is a disease that runs in your maternal familial line, meaning your mother or grandmother had breast cancer, you are likely at higher risk. For folks at normal risk, Widoff recommends getting a mammogram every two years from the ages of 50 to 75. “More frequent mammography and an earlier starting age may be appropriate for folks with higher risk.”
2. Every gender is at risk
Everyone is at risk for breast/chest cancer. This disease does not discriminate based on gender. “0.5-1.0 percent of all breast cancers occur in folks who are identified as male,” Widoff tells GO. More specifically, trans men, women, and GNC folks are also at risk. “As with all issues regarding trans health, we do not have great, long-term studies which give us lots of robust data on outcomes and what studies there are have some issues in terms of general applicability,” Widoff says.
“One of the difficulties with making general statements about risks for trans folks is that there is no one way to be trans in this world, folks start hormones at different times in their lives (or not at all), have gender-affirming surgeries at different times in their lives, and all of this may affect risk. WPATH does not provide specific guidance for screening recommendations. I think the most important message we can provide folks with is that everyone has some risk and it’s important to have discussions about this with a medical provider.”
3. At-home self-exams do not improve outcomes
“At-home self-exams have not been shown to improve outcomes,” Widoff reports. This was the most shocking bit of information Widoff shared with GO as I feel like I’m always seeing people advocate for self-exams to check for early signs of breast/chest cancer. “That being said, there is minimal harm to doing a self-exam and some possible benefit.” You can find online guides to doing your own self-exam here.
4. Self-exams can help you get to know your body
While doing self-exams isn’t the best preventive care—as by the time you find a lump, the cancer is usually pretty advanced—there are some ways in which it can help. Self-exams help you get to know your body’s status quo. Pay attention to the size, shape, and texture of your nipples and breasts.”I think it is never too early to get to know your body and understand what is normal for you,” Windoff tells GO. Every body has its own unique ebb and flow, get to know yours better and pay attention to any changes.
5. Early signs of symptoms are not clearly recognizable
“The reason we recommend screening tests (a test done before someone has any signs or symptoms of a disease) for breast cancer is that there are not usually early signs and symptoms which are clearly recognizable,” Widoff says. In reality, by the time people have symptoms, the cancer is usually fairly advanced.
Talk to your friends and your community about the last time they went in for a screening. Maybe have a buddy system. Being queer and going to the doctor has its own set of barriers when it comes to fear of discrimination or not being listened to. But queer and trans health matters.