Sunday, September 14, 2025 9/14/2025

Understanding Breast Cancer Risk and Screening in Transgender Persons through a Pilot Breast Cancer Screening Program

Award Number: K08CA276706
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/20/2023
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Understanding Breast Cancer Risk and Screening in Transgender Persons through a Pilot Breast Cancer Screening Program - PROJECT SUMMARY/ABSTRACT In the U.S., an estimated 1.4 million people identify as transgender (TG), defined as a person whose gender is different than their sex assigned at birth, and are a designated minority population by the NIH (NOT-MD-19-001). Many TG persons take gender-affirming hormone therapy, usually estrogen or testosterone based, to alter their physical appearance and improve their psychological health. Lifetime exposure to estrogen is a well-established risk factor for breast cancer (BC). Despite a growing TG population, the risk of developing BC in TG persons is unclear and there is no consensus on how to ideally screen this undeserved population for BC. These knowledge gaps prevent informed decision-making among healthcare providers and TG persons, likely contributing to the cancer disparities observed in the TG community. The overarching goal of my research agenda is to develop evidence-based TG BC screening guidelines. The proposed K08 will begin to fill critical knowledge gaps. In collaboration with our LGBTQ+ Inclusion Health Clinic, we will establish a pilot BC screening program and utilize a mixed methods approach to explore BC risk and screening in this population. These data will provide the necessary foundation to develop a multi-institutional longitudinal TG BC screening cohort study which will inform the development of BC screening guidelines and best practices for BC screening within the TG community. The foundational K08 work will be accomplished through three specific aims: 1) determine the callback and biopsy rates of TG persons after screening mammography and automated breast ultrasonography, 2) assess perceptions towards BC risk, screening, and the screening experience of TG individuals through surveys and interviews, and 3) identify individual and systems-level barriers to BC screening for TG persons and methods to optimize the screening process through interviews and focus groups. These findings will provide the first-ever prospective scientific data on screening mammography and automated breast ultrasonography lesion detection in TG persons. The qualitative data from Aims 2 and 3 will identify individual and systems-level barriers to screening and opportunities to improve the screening process and experience. The research proposal is complemented by a comprehensive and distinctive training plan focused on mixed methods and survey research, gender studies, database development, and cohort recruitment and retention. In combination with my diverse and collaborative mentorship team, this study and training plan is designed to optimize my seamless transition to becoming an independently funded surgeon–scientist and my efforts to mitigate BC disparities in TG persons through a 3-step process. The novel pilot BC screening study (Step 1) will provide the necessary preliminary data and experience to submit an R01 application to develop a multi-institutional longitudinal TG BC screening program (Step 2) which will definitively establish the lifetime risk and incidence of BC to inform the development of evidence-based BC screening guidelines for TG persons and best practice guidelines (Step 3).


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	002	2	8/27/2025	NON-COMPETING CONTINUATION	$0
2025	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	003	2	9/5/2025	NON-COMPETING CONTINUATION	$108,866
2025	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	000	2	3/24/2025	NON-COMPETING CONTINUATION	$0
2025	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	001	2	7/17/2025	NON-COMPETING CONTINUATION	-$108,866
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $210,062 )
2024	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	000	2	6/13/2024	NON-COMPETING CONTINUATION	$210,062
														Subtotal = $210,062

Issue Date FY: 2023 ( Subtotal = $210,324 )
2023	2023	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Cancer Research Manpower	000	1	7/20/2023	NEW	$210,324
														Subtotal = $210,324

Grand Total All Awards = $420,386

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Understanding Breast Cancer Risk and Screening in Transgender Persons through a Pilot Breast Cancer Screening Program

Award Number: K08CA276706

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/20/2023

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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