Center of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Endocrinology, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Department of Oncology, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Breast. 2021 Jun;57:118-122. doi: 10.1016/j.breast.2021.03.007. Epub 2021 Mar 25.
No literature is available on the benign versus malignant breast lesion ratio in trans women (male sex assigned at birth, female gender identity). As hormone treatment in trans women results in breast tissue histologically comparable with cis (non-trans) women, breast pathology may be expected. Previously, an increased breast cancer risk compared with cis men have been observed. We aimed to investigate the frequency and outcomes of breast biopsies in trans women. Therefore, we retrospectively examined the medical files of 2616 trans women. To gain data on breast lesions, we linked our cohort to a national pathology database. In this study we found that 126 people (5%) had one or more breast biopsies (n = 139). Of these, 21 trans women had a breast biopsy before the start of hormone treatment, and 53 after the start of hormone treatment. Breast biopsies were performed predominantly because of abnormalities during physical examination (37%, n = 51/139 biopsies), or because of capsular formation or contraction (28%, n = 16/57 biopsies) in trans women with breast implants. The most common breast lesions after the start of hormone treatment were fibroadenomas (n = 20), breast cancer (n = 6), fibrosis (n = 5), cysts (n = 4), and infections (n = 4). The benign versus malignant breast biopsy ratio was 88:12, which is comparable to the ratio in cis women (90:10). This study shows breast lesions in a limited number of trans women. Since the indications and outcomes of biopsies in trans women were similar to those in cis women, it seems reasonable to follow breast care guidelines as developed for cis women.
尚无关于跨性别女性（出生时被指定为男性，性别认同为女性）良性与恶性乳房病变比例的文献。由于跨性别女性的激素治疗会导致组织学上与 cis（非跨性别）女性相似的乳房组织，因此可能会出现乳房病变。此前，与 cis 男性相比，跨性别女性的乳腺癌风险增加。我们旨在调查跨性别女性的乳房活检的频率和结果。因此，我们回顾性地检查了 2616 名跨性别女性的医疗记录。为了获得有关乳房病变的数据，我们将我们的队列与一个国家病理学数据库相关联。在这项研究中，我们发现 126 人（5％）进行了一次或多次乳房活检（n=139）。其中，21 名跨性别女性在开始激素治疗之前进行了乳房活检，53 名在开始激素治疗后进行了乳房活检。乳房活检主要是因为体格检查异常（37％，n=51/139 活检），或者因为乳房植入物的跨性别女性出现包膜形成或收缩（28％，n=16/57 活检）。开始激素治疗后最常见的乳房病变是纤维腺瘤（n=20），乳腺癌（n=6），纤维化（n=5），囊肿（n=4）和感染（n=4）。激素治疗后良性与恶性乳房活检的比例为 88:12，与 cis 女性（90:10）的比例相当。这项研究显示了少数跨性别女性的乳房病变。由于跨性别女性活检的指征和结果与 cis 女性相似，因此似乎可以遵循为 cis 女性制定的乳房保健指南。
