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Review
. 2022 Dec 30;15(1):245.
doi: 10.3390/cancers15010245.

Effects of Hormones on Breast Development and Breast Cancer Risk in Transgender Women

Martine Berliere  1   2 , Maximilienne Coche  1   2 , Camille Lacroix  1   2 , Julia Riggi  1   2 , Maude Coyette  1   3 , Julien Coulie  1   3 , Christine Galant  1   4 , Latifa Fellah  1   5 , Isabelle Leconte  1   5 , Dominique Maiter  1   6 , Francois P Duhoux  1   7 , Aline François  1   4
Affiliations
Review

Effects of Hormones on Breast Development and Breast Cancer Risk in Transgender Women

Martine Berliere et al. Cancers (Basel). .

Abstract

Transgender women experience gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity. Transgender people undergo different surgical procedures and receive sex steroids hormones to reduce psychological distress and to induce and maintain desired physical changes. These persons on feminizing hormones represent a unique population to study the hormonal effects on breast development, to evaluate the risk of breast cancer and perhaps to better understand the precise role played by different hormonal components. In MTF (male to female) patients, hormonal treatment usually consists of antiandrogens and estrogens. Exogenous hormones induce breast development with the formation of ducts and lobules and an increase in the deposition of fat. A search of the existing literature dedicated to hormone regimens for MTF patients, their impact on breast tissue (incidence and type of breast lesions) and breast cancer risk provided the available information for this review. The evaluation of breast cancer risk is currently complicated by the heterogeneity of administered treatments and a lack of long-term follow-up in the great majority of studies. Large studies with longer follow-up are required to better evaluate the breast cancer risk and to understand the precise mechanisms on breast development of each exogenous hormone.

Keywords: breast cancer risk; breast development; exogenous hormones; heterogeneity of hormonal treatments; transgender women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Human breast development (figure created by Florence Boulvain).
Figure 2
Figure 2
Hematoxylin and eosin staining: the surrounding breast parenchyma shows fibro-cystic changes with apocrine metaplasia, cystic ducts and usual duct hyperplasia.
Figure 3
Figure 3
Hematoxylin and eosin staining: at low magnification, the breast parenchyma shows a fibrous stroma containing an irregularly shaped lesion with a fibro-myxoïd dense stroma and inflammatory changes containing cystic ducts and hyperplastic ducts.
Figure 4
Figure 4
Hematoxylin and eosin staining: at mid magnification, the ducts vary in size, and some look irregularly shaped and pseudo-invasive in the retracted fibrous stroma, whereas others are enlarged and contain an intra-ductal epithelial proliferation.
Figure 5
Figure 5
Hematoxylin and eosin staining: at higher magnification, some intraepithelial proliferations are formed by stubby micropapillae with a heterogeneous nuclear population showing no significant cellular atypia, and some are of cribriform architecture with slit-like fenestrations and nuclear streaming, showing no significant cellular atypia either.
Figure 6
Figure 6
Estrogen receptors immunostaining: the hyperplastic ducts (arrows) show a heterogeneous expression of estrogen receptors, as do the normal ducts and lobules in the vicinity.
Figure 7
Figure 7
Cytokeratin 5 immunostaining: the intraductal proliferation in the hyperplastic ducts (arrows) still show the presence of myoepithelial cells, as do the normal ducts and lobules in the vicinity.
See this image and copyright information in PMC

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Cited by

  • Breast Development and Cancer.
    Berliere M, Duhoux FP, François A, Galant C. Berliere M, et al. Cancers (Basel). 2023 Mar 13;15(6):1731. doi: 10.3390/cancers15061731. Cancers (Basel). 2023. PMID: 36980617 Free PMC article.

References

    1. Shumer D.E., Nokoff N.J., Spack N.P. Advances in the Care of Transgender Children and Adolescents. Adv. Pediatr. 2016;63:79–102. doi: 10.1016/j.yapd.2016.04.018. - DOI - PMC - PubMed
    1. Cohen-Kettenis P.T., Klink D. Adolescents with gender dysphoria. Best. Pract. Res. Clin. Endocrinol. Metab. 2015;29:485–495. doi: 10.1016/j.beem.2015.01.004. - DOI - PubMed
    1. Safer J.D., Tangpricha V. Care of the Transgender Patient. Ann. Intern. Med. 2019;171:ITC1–ITC16. doi: 10.7326/AITC201907020. - DOI - PubMed
    1. Puckett J.A., Cleary P., Rossman K., Newcomb M.E., Mustanski B. Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals. Sex. Res. Soc. Policy. 2018;15:48–59. doi: 10.1007/s13178-017-0295-8. - DOI - PMC - PubMed
    1. McNamara M.C., Ng H. Best practices in LGBT care: A guide for primary care physicians. Clevel. Clin. J. Med. 2016;83:531–541. doi: 10.3949/ccjm.83a.15148. - DOI - PubMed

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