Best for my Chest
Cisgender women
Trans women and non-binary people assigned male at birth who have taken feminising hormones for five years or more
Trans men and non-binary people assigned female at birth who have not had top surgery or a bilateral mastectomy
WHAT IS THE TEST FOR?
Breast cancer screening uses a test called mammography which involves taking X-rays of the breast tissue on your chest. The scan looks to find breast cancers at an early stage, when they may be too small to see or feel. Identifying cancer at this stage increases the chance of treatment being successful. These tests are conducted at Breast Clinics, not at your local General Practice.
WILL I BE INVITED TO BREAST SCREENING?
If you’re registered as female with your GP
You will be automatically invited to breast screening when you reach 50.
If you’ve not been sent a letter
Contact your local breast screening service if you’ve not been invited for breast screening by the time you’re 53 and you think you should have been. You should also contact them if it’s been more than 3 years since your last appointment and you think you’re overdue.
If you’re registered as male with your GP
Currently you will not be automatically invited for breast screening. If you’ve not had top surgery / bilateral mastectomy and would like to take part in screening, then you can organise your mammogram by visiting your GP or by booking an appointment with a breast cancer screening service.
If you have no symptoms and it has been more than three years since your last screening, you can contact your GP or local NHS breast screening service to book an appointment.
You may be called for screening earlier if you’re known to have a higher risk of breast cancer or undergo a procedure that requires ongoing observation.
If you’ve had top surgery (bilateral mastectomy with masculine chest reconstruction), it’s not possible to examine your chest with mammography, but you should continue to monitor your chest yourself for any signs and symptoms of cancer where breast tissue remains. If you’ve had a bilateral (both sides) total mastectomy, you do not need to attend for mammography.
If you’ve had a breast reduction, you should still attend for breast cancer screening.
WHAT HAPPENS AT THE APPOINTMENT?
During the appointment you’ll have four X-rays (mammograms) taken by a female specialist: two for each breast / side of the chest.
The mammograms only take a few minutes. The whole appointment should take about 30 minutes.
Step 1
Before starting, the mammographer will check your details and ask if you’ve had any problems with your breasts / chest. They’ll also explain what will happen during the screening and answer any questions.
Step 2
Before you can begin your mammogram, you’ll need to undress so that you’re naked from the waist up. You’ll be given a private changing area and you may also be given a hospital gown to wear. If you wear a binder, you’ll need to remove it.
Step 3
When you’re ready, you’ll be called into the X-ray room and the mammographer will explain what will happen. Remember, you can ask as many questions as you feel you need to.
Step 4
The mammographer will place your breast / the breast tissue on your chest onto the X-ray machine. It will then be squeezed between two pieces of plastic to keep it still while the image is taken. This takes a few seconds and you need to stay still.
Step 5
Once completed, the mammographer will tilt the machine to one side and prepare you to be screened from the other side.
Step 6
Your other breast / side of your chest will be X-rayed in the same way.
Step 7
You’ll then return to the changing area to get dressed.
Step 8
Your results will be sent to you in the post.
Breast screening can be uncomfortable and some people find the procedure painful. Talk to the mammographer if you’re concerned about pain, or are in pain during the procedure. They’re trained to help you feel more comfortable and give you support. You can also ask to stop at any time.
Breast cancer and breast tissue are clinical terms and are commonly used during the screening process. If you prefer to refer to this area as your chest, your attending clinician should respect this. There may be times when they need to speak clinically, and times when they can speak personally – they should be able to explain the difference between these two.
How might coronavirus affect my breast clinic appointment?
Measures to reduce the spread of coronavirus may mean that you’re not able to take someone with you to your appointment. You should be told in advance if this is the case, but you may want to call the clinic to check.
TIPS THAT MAY HELP DURING YOUR SCREENING
Call the clinic
Call the clinic ahead of your appointment to discuss any concerns
Discuss affirming language
Tell the person carrying out the mammogram the language you’d like them to use when referring to your body
Ask to avoid certain language
Ask staff not to use any phrases or words that make you uncomfortable or nervous
Remove jewellery
Remove necklaces and nipple piercings before you arrive
Share your pronouns
Let them know which name and pronouns you’d like them to use
Ask to bring a friend
Ask to bring a friend with you to your appointment
Use roll-on deodorant
Do not use talcum powder or spray deodorant on the day as this may affect the mammogram – roll-on deodorant is OK
Let them know your past experiences
Tell them if you’ve found screening uncomfortable or painful in the past
Choose your timing
Ask to be seen at the beginning or end of a clinic to avoid long stays in the clinic or waiting room
Let people know if you are worried about dysphoria
Let them know if people touching your breasts / chest is a dysphoria trigger for you
Wear something comfortable
Wear something comfortable that lets you easily undress to the waist
You can always request to be screened if you identify a risk symptom, even if you’ve had top surgery/a mastectomy.
Symptoms to watch out for include: If you have any of the listed symptoms, contact your GP who can refer you to the symptomatic breast clinic.
- Discharge or liquid that comes from the nipple without squeezing
- New, unusual lumps or an area that feels thicker than the rest
- Puckering or dimpling of the skin (it may look like orange peel)
- A sudden, persistent or unexplained change in size or shape
- Unexplained pain that doesn’t go away with your period (if you have them)
- The nipple inverts or points in a different direction
- A lump, swelling or thickening in your upper chest or armpit area
- Redness, a rash or crusting of the nipple or the surrounding skin
CHAR’S STORY
Routine breast cancer screening is for anyone between the ages of 50 and 70 who has breasts. But for Char, things were different: she was young, had found a lump and decided to take action.
“My partner felt the lump in my breast, so I knew it was time to get checked. It turned out to be a really positive experience – it was simple, easy and everyone was really friendly. Plus I took my mum along which made me feel safe and ‘held’.”
Char did the right thing. If YOU have any concerns at all, get checked.
Self care is not selfish
Listen to Char and Leeanne as they discuss their experiences of checking their chests, how it felt when they found a lump, and how it has changed their outlooks on life, community, and their own bodies.
DOES TRANSITION AFFECT BREAST CANCER RISK?
Chest binding
There’s no evidence that chest binding increases your risk of breast cancer.
Hormone therapy
Research shows that the risk of breast cancer in trans women is about three times lower than it is for cisgender women. The risk is still much higher than for cisgender men.
Oestrogen therapy leads to breast tissue growth which can increase breast cancer risk. We also know that oestrogen can help breast cancer cells to grow. Some trans women also take the hormone progesterone. There is now evidence that progesterone can increase the risk of breast cancer in cisgender women.
Trans men have a five times lower risk than cisgender women, but this is still higher than for cisgender men.
Surgery
There are risks with all surgery, and there are risks with all implants (prostheses). However, breast implants do not increase your risk of breast cancer. The risk of breast cancer is reduced after top surgery. This is because most of your breast tissue is taken away during the procedure.
Testimonials
“Taking part in this campaign was so rewarding. If sharing my experience makes it easier for other LGBTIQ+ people, I’m glad to have helped. It’s been a big confidence boost for me personally – but more importantly, it’s helped others.” – Sophie
“It felt right to be part of this project. I hope my screening story encourages all queer women to engage with the process. My first breast screening was enormously positive so it felt right to be able to help other queer women.” – Yvonne
VISIT THE NHS BREAST CANCER SCREENING
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OUTpatients provides a safe space for anyone who identifies as part of the queer spectrum and has had an experience with any kind of cancer – at any stage.