Frequency and Outcomes of Benign Breast Biopsies in Trans
Women: a Nationwide Cohort study
by Christel JM. de Blok, Benthe Dijkman, Chantal M. Wiepjes,
Inge RHM. Konings, Koen Dreijerink, Ellis Barbé, Martin den Heijer
The Breast: VOLUME 57, P118-122, JUNE
01, 2021 (Published: March 25, 2021)
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.
