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This study aimed to identify factors that influence healthcare professionals\u2019 (HCPs) integration of cancer risk evaluation, including genetic assessment, within the context of GAM and pre-surgical planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted semi-structured qualitative interviews with 20 healthcare professionals - including six primary care providers, five cancer genetic counselors, six oncologists, and three plastic surgeons - experienced in caring for TGD patients considering or undergoing GAM. Using a social constructivist framework, we applied reflexive thematic analysis to explore HCP perspectives and generate key themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We conceptualized five key themes: (1) HCPs perceive no clear ownership for care integration of breast cancer risk assessment; (2) conflicting guidelines force HCPs to rely on their own judgment, resulting in inconsistent practice; (3) care pathways are driven by individual HCP champions rather than standardized protocols; (4) GAM frequently occurs at young ages prior to age of population cancer risk screening initiation, complicating risk discussions; and (5) structural failures in care delivery compromise patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improving cancer risk assessment for TGD patients undergoing GAM demands clear institutional accountability, harmonized evidence-based guidelines, standardized care pathways, and genetic counseling embedded into multidisciplinary gender-affirming care teams. These coordinated structural efforts are critical to integrate equitable, personalized, and patient-centered cancer prevention with gender-affirming surgical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-08038-9","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:32:59Z","timestamp":1785339179000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare professional perspectives on hereditary breast cancer risk assessment prior to gender-affirming mastectomy"],"prefix":"10.1007","volume":"218","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1712-6403","authenticated-orcid":false,"given":"Kimberly","family":"Zayhowski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8905-0318","authenticated-orcid":false,"given":"Kai","family":"Blumen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-9171","authenticated-orcid":false,"given":"Kathleen F.","family":"Mittendorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-8276","authenticated-orcid":false,"given":"Rebekah","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-6336","authenticated-orcid":false,"given":"Tala","family":"Berro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3075-253X","authenticated-orcid":false,"suffix":"Jr.","given":"Carl","family":"Streed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0896-1952","authenticated-orcid":false,"given":"Ian M.","family":"MacFarlane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"1","key":"8038_CR1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.soncn.2017.11.002","volume":"34","author":"U Boehmer","year":"2018","unstructured":"Boehmer U (2018) LGBT Populations\u2019 Barriers to Cancer Care. 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