Archived Case 54

This is an oval solid palpable mass. Margins are obscured on mammogram, but are well defined at ultrasound examination. The mass lacks a thin white echogenic pseudocapsule.

A core needle biopsy yielded fibroadenoma.

While you are performing the ultrasound, the patient relays the fact that she has had a sex change operation. She would like to know your recommendations for screening

The ACR does not currently have a recommendation for screening in the transsexual population; however, it would be reasonable to reason that her risk is higher than that of men. It is unclear that her risk is as high as genetically female women. She has certainly developed benign breast disease (fibroadenoma) which is very uncommon in men, but very common among women.

It is reasonable to screen starting at age 40, though there are no studies to guide this decision.