Testosterone therapy considerations in oestrogen, progesterone and androgen receptor–positive breast cancer in a transgender man

Light, M.; McFarlane, Thomas; Ives, Andrew; Shah, Bhaumik; Lim, Elgene; Grossmann, Mathis; Zajac, Jeffrey D; Cheung, Ada S

doi:10.1111/cen.14263

Cited by 10 publications

(22 citation statements)

References 4 publications

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“…(2016) [ 28 ] Case report 41 Yes (12 years after mastectomy) Negative 15 Invasive ductal carcinoma Unknown ER+, PR+, HER2– Light et al. (2020) [ 29 ] Case report 44 No∗ Unknown, due to adoption 4 months Invasive ductal carcinoma grade 2 Unknown ER+, PR+, AR+, HER2- Nikolic et al. (2012) [30] Case report 42 Yes (1 year after mastectomy) Negative 2.5 Invasive ductal carcinoma Not Tested ER-, PR-, AR+, HER2+ Shao et al.…”

Section: Resultsmentioning

confidence: 99%

Breast malignancy in female-to-male transsexuals: systematic review, case report, and recommendations for screening

et al. 2020

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Background Female-to-male (FtM) transsexuals may use testosterone therapy for masculinization, which potentially influences the risk of breast cancer development. Guided by our case report, we aimed to investigate the evidence regarding the risk of testosterone therapy on breast malignancy in female-to-male transsexuals and evaluate breast cancer screening in this subgroup. Methods We conducted a systematic literature search according to the PRISMA checklist in June 2020 in PubMed/MEDLINE and Ovid/EMBASE. Reference lists of included articles were screened to find additional articles that met the inclusion criteria. All cohort studies and case reports evaluating breast cancer in FtM transsexuals after testosterone therapy were included. Results We found 23 cases of FtM transsexuals who developed breast cancer after testosterone therapy, including our own case. Moreover, we evaluated ten retrospective cohort studies investigating breast malignancy in the transsexual population. The cohort studies showed no elevated risk in FtM transsexuals compared to natal women. Including our own case, nine cases were described in which breast malignancy was incidentally found during routine histological examination after mastectomy. High-level evidence for a correlation between testosterone therapy and breast malignancy is missing. Conclusion Few cases are described of FtM transsexuals with breast malignancy. However, cases such as these make physicians aware of the possibility of breast cancer in FtM transsexuals. Radiological screening of FtM transsexuals for breast cancer prior to mastectomy and histological screening of the mammalian tissue after mastectomy should be considered; physicians should decide together with every individual FtM transsexual if screening is necessary.

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Section: Resultsmentioning

confidence: 99%

Breast malignancy in female-to-male transsexuals: systematic review, case report, and recommendations for screening

et al. 2020

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“…Second, as all eligible quantitative studies were crosssectional, it is not possible to draw causal relations on mental health. Future studies should include various study designs (eg, longitudinal studies, intervention programmes including pharma cological interventions and psychological interventions, regular comprehensive medical evaluations during or after gender-affirming hormone therapy, 63 potential side-effects of genderaffirming hormone therapy medications) to investigate the mental health of TGNC individuals compared with cisgender popu lations and provide more compelling data to support evidence-based medicine and better health-care service. Third, most studies only focused on adolescents or emerging adults (18-29-year olds).…”

Section: Discussionmentioning

confidence: 99%

The mental health of transgender and gender non-conforming people in China: a systematic review

Lin

Xie

Huang

et al. 2021

The Lancet Public Health

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Transgender and gender non-conforming (TGNC) individuals are at a high risk of adverse mental health outcomes due to minority stress-the stress faced by individuals categorised as stigmatised social minority groups. This systematic review sought to summarise the key mental health findings of the research on TGNC individuals in mainland China. We also aimed to consolidate research on the topic, identify specific mental health disparities, and offer new perspectives for future research to inform both policy and clinical practice. An extensive search of the literature, published in English and Chinese, was done between Jan 1, 1990, and Aug 1, 2021, using PubMed, PsycINFO, Scopus, Wanfang (in Chinese), and CNKI (in Chinese). Overall, two qualitative and 28 quantitative articles were identified. The quantitative findings showed a high prevalence of mental health problems, such as depression, anxiety, substance use disorders, and stress-related issues, and greater disparities in psychological wellbeing. High prevalence is also reported in suicidality and self-harm behaviours in this group. Across the two qualitative studies, attributable factors included gender-related discrimination, barriers to accessing health services, low social support, decreased knowledge and awareness of HIV prevention, and demographic characteristics-such as marital status, educational level, and gender identity. This Review also found little evidence of gender-affirming care and mental health interventions in mainland China. Following from these results, the next step is to integrate multi-level, socialpsychological interventions with education to reduce cultural stereotypes and transphobia in mainland China. Political and social implications are also discussed to inform a standard set of guidelines for transgender-inclusive health-care services, including advocating for funding to create these special care programmes and services.

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“…For those who desire, GAHT has been shown to significantly improve psychological well-being in transgender individuals [37].Specifically, in a cross-sectional studyof 446 transgender men, those who received testosterone therapy reported significantly higher quality-of-life scores, specifically in social functioning, mental health, vitality, and emotional domains [38]. Therefore, the decision to discontinue GAHT in light of theoretical oncologic risk must be balanced with overall quality of life on an individual basis, which is consistent with shared decision-making model of care [39]. It is paramount to evaluate this on an individual basis and understand the patient's individual concerns around this analysis along with their baseline mental health and supports.…”

Section: Psychosocial Impact Of Gender-affirming Hormonal Therapy (Gaht)mentioning

confidence: 87%

Implications for management of ovarian cancer in a transgender man: Impact of androgens and androgen receptor status

Aubrey

Saad

Köbel

et al. 2021

Gynecologic Oncology

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Testosterone therapy considerations in oestrogen, progesterone and androgen receptor–positive breast cancer in a transgender man

Cited by 10 publications

References 4 publications

Breast malignancy in female-to-male transsexuals: systematic review, case report, and recommendations for screening

Breast malignancy in female-to-male transsexuals: systematic review, case report, and recommendations for screening

The mental health of transgender and gender non-conforming people in China: a systematic review

Implications for management of ovarian cancer in a transgender man: Impact of androgens and androgen receptor status

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