A rare case of breast cancer in a transgender woman

Cancer screening and management in the transgender population: Review of literature and special considerations for gender affirmation surgery

“…Of these six, two were positive for BRCA2 mutations. Both patients elected to discontinue hormone therapy[ 23 , 24 ]. The first patient declined tamoxifen and was just surgically treated with a simple unilateral mastectomy of the right side with sentinel lymph node biopsy.…”

“…The other patient was treated with bilateral mastectomy and sentinel lymph node dissection, neoadjuvant tamoxifen and adjuvant radiation (patient declined chemotherapy). No recurrence was reported[ 24 ]. This brings up the discussion on what treatment options should be for patients who are positive for BRCA2 mutations.…”

“…This brings up the discussion on what treatment options should be for patients who are positive for BRCA2 mutations. Additionally, it is difficult to know whether ER positivity in these two patients is due to hormone therapy or the mutation itself[ 24 ]. This may require more research to determine the effect of BRCA2 mutations on ER+ cancer in the presence of gender affirming hormone (GAH) therapy.…”

“…Of the 30 case studies, four patients were identified who were positive for BRCA2[ 23 , 24 , 33 ]. These four patients were transgender women.…”

“…This seems to be the current standard of practice for management of these patients yet many patients choose not to discontinue hormone therapy. In fact, our review came across a few arguments against cessation, namely the history of treating advanced breast cancer with low dose estrogens and the deleterious effects of cessation on the mental well-being of TGGD patients[ 24 , 26 , 33 ]. More research is required to determine if there is a true therapeutic benefit to cessation of GAHs.…”