Question 5 - Georgina

53-year old Georgina comes to see you. She has risk factors for cardiovascular disease (hypertension, overweight, ex-smoker) and you recall from the notes that you recently sent to A&E for investigation of acute coronary syndrome. This was excluded. 

For the past 8 years she has used Estradot (estradiol hemihydrate) patches as HRT, and Finasteride 5mg daily as an anti-androgen and to protect against scalp hair loss. She discontinued her GnRH agonist treatment, claiming it made her feel “like a wet weekend in Weymouth”.

She comes to see you as she has noticed a lump in her left breast.

Checking through her medical record, she took part in the national breast screening programme at the age of 50, and all was well. Her mother died of ovarian carcinoma. 


Regarding breast health in trans people using estrogen-only HRT:


palpation of a suspicious lump should be referred on to a breast clinic


breast screening is not feasible for women who have undergone breast augmentation surgery


breast cancer risk is higher than in the cis-male population but not as high as for the cis-female population and therefore breast screening is not required


the primary care medical records will denote gender as ‘F’ thus ensuring routine call up for breast screening


A, and B




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