PATHOLOGIC FINDINGS IN GENDER-AFFIRMING MASTECTOMY: A SYSTEMATIC REVIEW

Area of Science:

• Oncology
• Pathology
• Gender-affirming care

Background:

• Gender-affirmation mastectomy (GAM) is increasingly sought by transgender individuals.
• Pathologic evaluation of post-GAM breast tissue is standard, but its utility is debated.
• Limited research exists on the incidence and types of breast lesions found in GAM specimens.

Approach:

• A systematic literature review following PRISMA guidelines was conducted.
• Medical publications on pathology reports following GAM were analyzed.
• The incidence of benign and malignant breast lesions was assessed.

Key Points:

• Eight studies comprising 1278 patients met inclusion criteria.
• The overall incidence of pre-malignant lesions was 2.42%.
• Specific pre-malignant findings included flat epithelial atypia, atypical hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ.

Conclusions:

• While premalignant or malignant findings are uncommon in GAM specimens, pathologic evaluation is prevalent.
• Inconsistent reporting of patient characteristics (age, hormonal therapy, family history) limits statistical analysis.
• Further research with standardized pathology methods is required to establish practice guidelines.