Case 60 Answer 2
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.