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Routine histopathological examination after female-to-male gender-confirming mastectomy
S M J Van Renterghem1, J Van Dorpe1,2, S J Monstrey3
1Department of Pathology, Ghent University Hospital, Ghent, Belgium.
The British Journal of Surgery
|April 7, 2018
Summary
Routine histopathological examination of mastectomy specimens from transmen is crucial. This study found that nearly half of specimens had lesions, including unexpected breast cancer, highlighting the need for thorough examination.
Area of Science:
- Pathology
- Oncology
- Endocrinology
Background:
- Increasing numbers of transmen undergo mastectomy for gender confirmation.
- Pathologists face more transmale mastectomy specimens, questioning the utility of routine histopathological examination.
- This study investigates the value of detailed histopathological analysis of these specimens.
Purpose of the Study:
- To explore the benefits of routine histopathological examination of mastectomy specimens from transmen.
- To describe lesions encountered in these specimens.
- To inform best practices for specimen analysis.
Main Methods:
- Retrospective review of breast tissue from 344 transmen undergoing female-to-male gender-confirming surgery.
- Quantification of terminal duct-lobule units (TDLUs) per low-power field (LPF).
- Recording of benign and malignant breast lesions, with retrieval of hormone therapy and morphometry data for selected patients.
Main Results:
- Nearly half (48.3%) of specimens contained breast lesions (benign or malignant).
- Invasive breast cancer was identified in 0.6% of cases, with one being an unexpected finding.
- Older individuals had more breast lesions, and lesion detection increased with more tissue blocks examined.
Conclusions:
- Thorough histopathological examination of mastectomy specimens from transmen is essential.
- The discovery of unexpected breast cancer underscores the importance of this routine analysis.
- The number of tissue blocks examined should consider patient age and breast weight.
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