Frequency and outcomes of benign breast biopsies in trans women: A nationwide cohort study
Christel JM. de Blok,
Benthe AM. Dijkman,
Chantal M. Wiepjes,
Inge RHM. Konings,
Koen MA. Dreijerink,
Ellis Barbé,
Martin den Heijer
Affiliations
Christel JM. de Blok
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
Benthe AM. Dijkman
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
Chantal M. Wiepjes
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
Inge RHM. Konings
Department of Oncology, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
Koen MA. Dreijerink
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
Ellis Barbé
Department of Pathology, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
Martin den Heijer
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; Corresponding author. Department of Internal Medicine, Section Endocrinology, Amsterdam UMC, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
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.
