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Breast atypia, breast cancer in patients undergoing chest masculinization surgery extremely low – study

The incidence of breast atypia and breast cancer in transgender patients undergoing chest masculinization surgery is  extremely low.

Photo by leo abdelnaby from Unsplash.com

In focus: transgender men’s health.

The incidence of breast atypia and breast cancer (BC) in patients undergoing chest masculinization surgery is  extremely low.

This is according to a study – “Incidental Atypia in Patients Undergoing Chest Masculinization Surgery: An Observational Series” by Madison Kolbow, Jade Cohen, Saranya Prathibha, Schelomo Marmor, Marie-Claire Buckley, and Jane Yuet Ching Hui – that appeared in Transgender Health.

For this study, a retrospective electronic medical record (EMR) review of transgender men who underwent chest masculinization surgery within one academic health system was conducted to evaluate the incidence of breast atypia and BC.

Breast atypia was defined as “atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), or lobular carcinoma in situ (LCIS).” Meanwhile, BC was defined as “invasive lobular carcinoma, invasive ductal carcinoma, and ductal carcinoma in situ (DCIS).”

The findings included:

  • Of the 880 patients included, 7 (0.8%) were diagnosed with atypia and none with BC.
  • The median age at surgery for patients without and with atypia was 25.0 and 36.0 years, respectively.
  • Preoperative testosterone therapy utilization was similar among patients with atypia (71%) and patients without (79%).
  • No patients with atypia were diagnosed with subsequent BC during a median follow-up of 37 months.

The researchers stressed that “the incidence of breast atypia at the time of chest masculinization surgery was extremely low.” As such, “screening transgender men for BC after chest masculinization surgery is likely unnecessary in the absence of risk factors. Furthermore, incidental diagnoses of atypia at the time of chest masculinization surgery may not be a significant risk factor for this population as it is for cisgender women who have not undergone mastectomy.”

All the same, the researchers noted the need for future studies to “elucidate the appropriate BC screening and risk management of transgender men undergoing chest masculinization surgery to provide necessary preventative care at the same level of evidence that exists for cisgender patients.”

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