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The Impact of Exogenous Testosterone on Breast Cancer Risk in Transmasculine Individuals
Rakesh R Gurrala1, Taruni Kumar1, Aran Yoo2
1From the Tulane University School of Medicine.
Annals of Plastic Surgery
|December 19, 2022
Summary
Exogenous testosterone use in transmasculine individuals shows a lower breast cancer (BCa) risk compared to cisgender women. However, BCa in this population may present differently, warranting further research into underlying mechanisms.
Area of Science:
- Endocrinology
- Oncology
- Gender-affirming care
Background:
- Exogenous testosterone is crucial for gender-affirming therapy in transmasculine individuals.
- Testosterone's potential to activate androgen and estrogen receptors raises questions about breast cancer (BCa) risk.
- This review investigates the impact of exogenous testosterone on BCa risk in transmasculine individuals.
Approach:
- Systematic review of clinical and preclinical studies.
- Searched PubMed/MEDLINE and Ovid/Embase for relevant articles.
- Assessed evidence levels and risk of bias using established tools.
Key Points:
- BCa incidence in transmasculine individuals is higher than cisgender men but lower than cisgender women.
- BCa in transmasculine individuals occurs at a younger age and is predominantly hormone receptor positive.
- Mechanisms may involve androgen receptor stimulation or estradiol conversion; testosterone's effect varies with dose and estradiol levels.
Conclusions:
- Transmasculine individuals on testosterone therapy have a decreased BCa risk compared to cisgender women.
- BCa in this population may exhibit distinct clinical features and mechanisms.
- Further research is needed due to study limitations and conflicting preclinical findings.
