Testosterone and Breast Cancer in Transmen: Case Reports, Review of the Literature, and Clinical Observation

Limited information exists regarding breast health in the transgender population. The incidence of breast cancer in transmen is very rare and only a few cases have been described in the literature. Nonetheless, a correlation between high dosage of testosterone and risk of breast cancer has been postulated. This is a very important issue within the health care of transgender people. Our experience is with 80 transmen who underwent top surgery to create an aesthetically pleasing male chest. Only in 2 of them we identified breast cancer. The first diagnosis was before top surgery, the second one was an occasional histological finding. It is important to bear in mind all of the complex relationships between testosterone therapy and breast cancer. It is necessary to inform transgender persons, especially those who have not yet undergone top surgery, of risk factors for breast cancer and the potential risk of developing a breast cancer, about the importance of selecting the most appropriate surgical technique according to the patient's risk and preferences, and to perform accurate postoperative surveillance. A multidisciplinary approach to these patients is strongly recommended, and large database creation and networking is warranted. (C) 2018 Elsevier Inc. All rights reserved.