Breast Cancer Risk Assessment and Screening in Transgender Patients

Pivo, Sarah; Montes, Jennifer; Schwartz, Shira; Chun, Jennifer; Kiely, Deirdre; Hazen, Alexes; Schnabel, Freya

doi:10.1016/j.clbc.2016.08.003

Cited by 24 publications

(12 citation statements)

References 22 publications

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“…15 Torous and Schnitt 16 identified 5 cases of atypical hyperplasia in their cohort of 148 transgender men (3%; atypical ductal hyperplasia in 2; 34 showed significantly lower rates of neoplastic findings (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, or ductal carcinoma in situ) in transmasculine individuals (n ¼ 211 of which 142 were taking hormone therapy) as compared with hormone naïve cisgender women (n ¼ 273), with rates of 2.8% and 7%, respectively (P ¼ .04). Pivo et al 36 describe a case of a transgender man with a significant family history of breast cancer who underwent prophylactic mastectomies, a more extensive surgery than would be typical for gender affirming surgery. In this case, the patient had no atypical or malignant findings.…”

Section: Study Selectionmentioning

confidence: 99%

Histologic Findings in Surgical Pathology Specimens From Individuals Taking Masculinizing Hormone Therapy for the Purpose of Gender Transition

Andrews

Kakadekar

Greene

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Transgender men and transmasculine persons experience a discordance between the female sex they were assigned at birth and their gender. They may choose to take hormone therapy and/or undergo surgery to masculinize the body. Understanding the common (and less common) histologic changes present in patients taking masculinizing hormones will empower pathologists to better serve this unique patient population. Objective.— To summarize histologic findings in surgical pathology specimens from persons taking masculinizing hormones as a part of gender transition. Data Sources.— A systematic review of the OVID Medline and PubMed databases was performed to identify all studies describing histologic findings in surgical pathology specimens from transgender men from January 1946 to January 2021. Conclusions.— Publication in this area has markedly increased in the last 2 decades. However, most of the studies identified were descriptive and case reports describing changes seen in specimens removed as a part of masculinizing surgical procedures. Benign histologic findings include stromal hyalinization and epithelial atrophy in the breast, polycystic ovarian syndrome–like changes in the ovary, and transitional cell metaplasia in the cervix. The most commonly reported neoplastic finding was adenocarcinoma of the breast, with rare cases of ovarian, endometrial, cervical, vaginal, pituitary, pancreatic, and cardiovascular neoplasia also reported. Ongoing research in this area is needed to better characterize the histologic findings in persons taking masculinizing hormones to provide a deeper understanding of the effect of these treatments on different tissues and facilitate better patient management.

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Section: Study Selectionmentioning

confidence: 99%

Histologic Findings in Surgical Pathology Specimens From Individuals Taking Masculinizing Hormone Therapy for the Purpose of Gender Transition

Andrews

Kakadekar

Greene

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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show abstract

“…While incompletely understood, the suggested increased risk of breast cancer in transgender women may follow this same association, especially taking into consideration that approximately 90% of male breast cancers are ER+ [10] . Thus, breast cancer screening is generally recommended for transgender women at the age of 50 after 5 years of CSH therapy [11] . The woman discussed in this case may have benefited from screening but would not have met these criteria, as she was 70 years old but had only taken CSH therapy for 2 years.…”

Section: Discussionmentioning

confidence: 99%

A rare case of breast cancer in a transgender woman

Sieberg

Soriano

Zuurbier

2021

Radiology Case Reports

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“…Mammography is the first-line screening recommended for any person with breast implants; however, it is less sensitive in detecting breast cancer in a person with breast implants compared to someone without. 41,42 Ultrasound, on the other hand, is not recommended for routine screening but rather to investigate implant complications in people with pain, lumps, or asymmetries. 43 Additional prospective research is needed to better characterize predictors of breast cancer in transgender women and cost-effectiveness among screening modalities.…”

Section: Screening For Breast Cancer In Transgender Womenmentioning

confidence: 99%

Routine Screening for Transgender and Gender Diverse Adults Taking Gender-Affirming Hormone Therapy: a Narrative Review

Iwamoto,

Grimstad,

Irwig

et al. 2021

J GEN INTERN MED

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Despite the growing number of adult transgender and gender diverse (TGD) patients seeking health services, there are many unknowns regarding how routine screening recommendations should be applied to TGD persons receiving gender-affirming hormone therapy (GAHT). Patients taking GAHT may have disease risks that differ from what is expected based on their sex assigned at birth or affirmed gender identity. We discuss two patient cases, one transgender man and one transgender woman who present for routine medical care, to review several conditions that may be impacted by the hormones utilized in masculinizing and feminizing GAHT and for which screening recommendations are available for TGD adults: cardiovascular risk factors, osteoporosis, breast cancer, cervical cancer, and prostate cancer. We reviewed the TGD-specific screening recommendations from several major medical organizations and programs and found them to be largely based upon expert opinion due to a lack of evidence. The goal of this narrative review is to assist healthcare professionals in counseling and screening their TGD patients when and where appropriate. Not all TGD adults have the ability or need to receive routine medical care from a specialized TGD health clinic; therefore, it is essential for all healthcare professionals involved in routine and genderaffirming care to have knowledge about these conditions and screenings.

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Breast Cancer Risk Assessment and Screening in Transgender Patients

Cited by 24 publications

References 22 publications

Histologic Findings in Surgical Pathology Specimens From Individuals Taking Masculinizing Hormone Therapy for the Purpose of Gender Transition

Histologic Findings in Surgical Pathology Specimens From Individuals Taking Masculinizing Hormone Therapy for the Purpose of Gender Transition

A rare case of breast cancer in a transgender woman

Routine Screening for Transgender and Gender Diverse Adults Taking Gender-Affirming Hormone Therapy: a Narrative Review

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