{
  "abstract": "Cancer risk assessment in transgender patients presents a unique intersection of genetic, surgical, and psychological complexity. We present three cases: an 18-year-old trans male with familial PALB2 alteration risk, an 18-year-old trans male with BRCA2 risk, and a 20-year-old trans female with neurofibromatosis type 1.In trans male patients, distinction between gender-affirming top surgery and risk-reducing mastectomy is clinically and psychosocially significant, impacting breast surveillance and surgical decision-making. It is important to differentiate between gender-affirming top surgery, in which some breast tissue remains and breast screening may still be needed, and risk-reducing mastectomy, where all breast tissue is removed, which may lead to a less desired aesthetic outcome.For trans female patients, oestrogen-based hormone replacement therapy(HRT) increases breast cancer risk; current data suggest screening consideration after five years of HRT, although evidence remains limited. These cases highlight the limitations of current binary-focused surveillance guidelines and underscore the urgent need for inclusive, evidence-based strategies. We also address the challenges of consent, dysphoria, and timing of risk-reducing options in adolescents. A multidisciplinary approach is essential to integrate gender-affirming care with cancer prevention, balancing identity, autonomy, and medical safety. Genetic services must integrate UKCGG guidance with psychological support to navigate this evolving field.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "Titiksha Masand"
    },
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "B Kaemba"
    },
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "J Barwell"
    }
  ],
  "title": "P13 Transitioning risk: cancer susceptibility and clinical complexity in transgender patients with inherited cancer predisposition",
  "uid": "41acf3b8-fc84-5001-9695-5ccb5416e08f"
}