Breast Cancer Development in Transsexual Subjects Receiving Cross-Sex Hormone Treatment
Breast Cancer Development in Transsexual Subjects Receiving Cross-Sex Hormone Treatment
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DOI：
10.1111/jsm.12319
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发表时间：
2013-12-01
影响因子：
3.5
通讯作者：
van Diest, Paul J.
中科院分区：
文献类型：
--
作者：
Gooren, Louis J.;van Trotsenburg, Michael A. A.;van Diest, Paul J.
变性人接受异性激素作为治疗的一部分，可能诱发激素敏感的恶性肿瘤。目的探讨荷兰一大批变性者中乳腺癌的发生情况，并评价其流行病学是否与出生性别或新生性别相符。主要结果测量1975年至2011年间患乳腺癌的人数。方法对18 ~ 80岁、接触异性激素5 ~ 50 ~ 30年的变性人群乳腺癌的发生情况进行研究。我们的研究包括2307名接受雄激素剥夺和雌激素治疗的男变女（MtF）变性人（52370人-年暴露）和795名接受睾酮治疗的女变男（FtM）受试者（15974年暴露）。结果在MtF患者中发现1例，还有1例可能但未证实的第二例。如果这两例被认为是女性乳腺癌，估计的发生率为4.1 / 100,000人年（95%置信区间[CI]: 0.8-13.0）低于预期，但如果被认为是男性乳腺癌，则在预期范围内。在FtM受试者中，与MtF组相比，他们更年轻，接触异性激素的时间更短，发生了一例乳腺癌病例。这转化为每10万人年5.9例（95% CI: 0.5-27.4），再次低于女性乳腺癌的预期，但在男性乳腺癌的预期标准范围内。结论：研究对象的数量和激素暴露的持续时间是有限的，但似乎在MtF或FtM变性个体中，使用异性激素不会增加乳腺癌发展的风险。两组的乳腺癌发病率与男性乳腺癌相当。对变性人进行异性激素治疗似乎与乳房恶性发展的风险增加无关。古伦LJ， van Trotsenburg MAA, Giltay EJ, van Diest PJ。接受异性激素治疗的变性人乳腺癌的发展。[J]性医学杂志2013；10:3129-3134。
IntroductionTranssexual people receive cross-sex hormones as part of their treatment, potentially inducing hormone-sensitive malignancies.AimTo examine the occurrence of breast cancer in a large cohort of Dutch male and female transsexual persons, also evaluating whether the epidemiology accords with the natal sex or the new sex.Main Outcome MeasureNumber of people with breast cancer between 1975 and 2011.MethodsWe researched the occurrence of breast cancer among transsexual persons 18-80 years with an exposure to cross-sex hormones between 5 to >30 years. Our study included 2,307 male-to-female (MtF) transsexual persons undergoing androgen deprivation and estrogen administration (52,370 person-years of exposure), and 795 female-to-male (FtM) subjects receiving testosterone (15,974 total years of exposure).ResultsAmong MtF individuals one case was encountered, as well as a probable but not proven second case. The estimated rate of 4.1 per 100,000 person-years (95% confidence interval [CI]: 0.8-13.0) was lower than expected if these two cases are regarded as female breast cancer, but within expectations if viewed as male breast cancer. In FtM subjects, who were younger and had shorter exposure to cross-sex hormones compared with the MtF group, one breast cancer case occurred. This translated into a rate of 5.9 per 100,000 person-years (95% CI: 0.5-27.4), again lower than expected for female breast cancer but within expected norms for male breast cancer.ConclusionsThe number of people studied and duration of hormone exposure are limited but it would appear that cross-sex hormone administration does not increase the risk of breast cancer development, in either MtF or FtM transsexual individuals. Breast carcinoma incidences in both groups are comparable to male breast cancers. Cross-sex hormone treatment of transsexual subjects does not seem to be associated with an increased risk of malignant breast development. Gooren LJ, van Trotsenburg MAA, Giltay EJ, and van Diest PJ. Breast cancer development in transsexual subjects receiving cross-sex hormone treatment. J Sex Med 2013;10:3129-3134.