Transmen and Cancer AFTER "Top Surgery"

From a recent paper  on breast cancer in trans females: According to medical literature, in the last 50 years only three papers have been published with four cases of breast cancer in transsexual female to male patients. The paper goes on to say incidence of breast carcinoma after prophylactic mastectomy is probably less than 2% in females who have had "top surgery" sans hormone treatment.
At present there are no randomized studies on the effects of long-term testosterone use on breast cancer risk. All hormonal pathways included in this complex hormonal and surgical procedure of transgender surgery have important implications for women undergoing prophylactic mastectomy because of a high risk of possible breast cancer. 

The case in question involves a  female to male transsexual, who underwent complex sex reassignment surgery after bilateral subcutaneous nipple sparing mastectomy (weight of removed breast tissue: left breast tissue, 275 g; right breast tissue, 295 g), presented 1 year after surgery with a painless left areoral mass. Samples of the left and right breast tissues sent for pathological analysis following subcutaneous mastectomy were benign.The patient was 42 years old at the time the breast cancer was discovered, and 41 years old at the time of transgender surgery. The patient started testosterone therapy 18 months prior to sex reassignment (250 mg intramuscularly every 2 weeks). After the sex reassignment surgery, he received 250mg testosterone every 17 days for the next 12 months. At the time of sex change surgery, the patient was premenopausal. The patient did not have any relatives with a history of any type of cancer. Family history of breast cancer and ovarian cancer in first-degree or second-degree relatives was thus negative, with no prior breast biopsies in clinical history, and therefore he was not a high-risk patient for breast cancer.

Prior to the backlash against feminism, female transition was at most rare. Fast forward to today's Trans Trending happening among females under the age of 25, thousands are transitioning yearly. The serious study of breast cancer in females who have had "top surgery" and been hormonally treated with testosterone in our mass female transition era is NIL. The lack of breast cancer studies in trans females also hurts trans females from the ability to properly utilize breast cancer advances such as mammograms. 

Clearly there is breast tissue left in EVERY single "top surgery" victim, and surely every one of those victims will need to have some sort of regular mammogram. But without those studies, we are left with questions such as, at what point after hormonal use will a trans female need to have a mammogram? Will her age make a difference? Will the amount/frequency of hormone use make a difference? Will family cancer make a difference? Should certain diets be maintained to combat testosterone poisoning to the female body? And a whole host of other questions, none of which it seems has any real answers any time soon. Like most minority health issues, we wont have any answers until the bodies start piling up.




  2. Although prophylactic breast removal cannot remove all of a woman's breast tissue, studies show that it reduces the chances of developing breast cancer by more than 90 percent.

    If there isn't a 100% reduction in breast cancer with prophylactic mastectomies, then how in the heck can people say that FTMs who get "top surgery" never can get breast cancer. A surgeon isn't going to do prophylactic mastectomy without a strong family history BRCA gene etc, and most breast cancers are in women without a family history. Some transgender females take testosterone for years before getting "top sugery". Do we know everything about testosterone and breast cancer?

    "Prospective epidemiologic studies have consistently shown that levels of circulating androgens in postmenopausal women are positively associated with breast cancer risk. However, data in premenopausal women are limited.....

    Premenopausal concentrations of testosterone and free testosterone are associated with breast cancer risk. Testosterone and free testosterone measurements are also highly reliable (that is, a single measurement is reflective of a woman's average level over time). Results from other prospective studies are consistent with our results. The impact of including testosterone or free testosterone in breast cancer risk prediction models for women between the ages of 40 and 50 years should be assessed. "

    All I can say is ****Consult a physician, and do your own research.****

    Since neither dirt nor I are physicians, I feel uncomfortable addressing this issue.

    Dirt, please don't throw up one study. If researchers aren't sure, then how can you or I be so sure? Having said this, in many ways, I feel as if women are being experimented on, and by women I mean transgender females who are still female despite the exogenous source of testosterone, "top surgery" etc. Perhaps the burden of proof needs to be placed on the transgender community to prove that it's safe. I don't care what anyone says, I can't see how years of an external source of hormones is completely safe in the long run.


  3. Having a prophylactic mastectomy doesn't guarantee that you'll never develop breast cancer because all of your breast tissue can't be removed during surgery. Sometimes breast tissue can be found in your armpit, above your collarbone or on the upper part of your abdominal wall, where it may not be detected at the time of your surgery. Breast tissue remaining in your body can still develop breast cancer, although the chances are slim.

    Medications to reduce risk. In this approach, you may reduce your risk of breast cancer by taking drugs that block the effects of estrogen, because estrogen can promote breast cancer development and growth. Medications used for this purpose include tamoxifen, raloxifene (Evista) and, in certain cases, exemestane (Aromasin). These drugs may reduce the risk of invasive breast cancer by approximately 50 percent. However, they carry a risk of side effects. Talk with your doctor about the risks and benefits of these medications.
    Surgery to remove the ovaries. Prophylactic oophorectomy can reduce the risk of both breast cancer and ovarian cancer. Women with BRCA mutations also have an increased risk of ovarian cancer. Prophylactic oophorectomy may reduce the risk of breast cancer up to 50 percent in women with a high risk of breast cancer.

    Hormone-sensitive breast cancer cells contain proteins known as hormone receptors that become activated when hormones bind to them. The activated receptors cause changes in the expression of specific genes, which can lead to the stimulation of cell growth.

    To determine whether breast cancer cells contain hormone receptors, doctors test samples of tumor tissue that have been removed by surgery. If the tumor cells contain estrogen receptors, the cancer is called estrogen receptor-positive (ER-positive), estrogen-sensitive, or estrogen-responsive. Similarly, if the tumor cells contain progesterone receptors, the cancer is called progesterone receptor-positive (PR- or PgR-positive). Approximately 70 percent of breast cancers are ER-positive. Most ER-positive breast cancers are also PR-positive (1).

    Breast cancers that lack estrogen receptors are called estrogen receptor-negative (ER-negative). These tumors are estrogen-insensitive, meaning that they do not use estrogen to grow. Breast tumors that lack progesterone receptors are called progesterone receptor-negative (PR- or PgR-negative).

  4. Hudson's recommends the following:

    Self "chest" exams (for breast-tissue cancer)

    Even if you have already had chest surgery, it is wise to continue to give yourself monthly chest exams, as some residual breast tissue may have been left behind after surgery. Keep in mind that breast cancer does occasionally occur in non-trans men.

    Below is a description of how to do a self-chest exam. It is a good idea to do them every month or two in order to get used to how the chest tissue feels so that you can better detect changes and irregularities.

    Begin by looking at your chest in the mirror with your shoulders straight and your hands on your hips. Look for any unusual change in size, shape, swelling, soreness, or color. Note of your nipples are bulging, have changed position, or an have become inverted (pushed inward instead of sticking out).

    Raise your arms above your head and look for the same changes.
    Next, gently squeeze each nipple between your finger and thumb and check for any type of discharge.
    Lay down down and examine your chest area, using your right hand to feel your left side and then your left hand to feel your right side. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together. Follow a pattern to be sure that you cover the area. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the chest. Be sure to feel all the tissue: just beneath your skin with a soft touch and down deeper with a firmer touch. Don't forget the area near your armpits! You are looking for changes in tissue density or unusual lumps.
    Finally, feel your chest while you are standing or sitting. You may wish to do this step in the shower. Again, you are looking for changes in tissue density or unusual lumps.

    This link suggests the following:
    Transgender men who have not had chest reconstructive surgery should get mammograms annually after age 50; those who have had top surgery still need annual breast tissue exams by a health care professional

  5. Sending a hug to this person....don't know what their problem is

    Sorry they feel so bad.

  6. Dirt, I think it's important for people to understand a few basic science facts.

    In mammals, testosterone is a naturally occurring steroid hormone produced in the testes of males, in much smaller amounts by the ovaries in females, and by the adrenal glands of both sexes. The human body tends to convert excess testosterone to estrogen. This is nothing new and scientists have known this for some time. It's a delicate balancing act that the body is constantly going through to achieve homeostasis.

    Below is an article from breast cancer research about testosterone.

    Susan G. Komen is also a respected source of information, although I don't think they have a lot of information on testosterone and breast cancer.

    Susan Love Research Foundation is also a good source.

    This is a website that tries to sell hormones, so consider the source. I thought the "tpellet" sounded suspicious.

    I wish the person in this paper all the best. We often forget that these are human beings not numbers or statistics.

  7. I know this old and you probably won't see this, but you are an ignorant insensitive dick. They are not "women." They are men. Fix your pronouns and do better research. "He had top surgery," "transgender male," transgender females are biologically born male and transition into and identify as female. If you don't even understand basic pronouns and what transgender is, how can anyone ever take you seriously?

    1. I was just about to write this. Thanks for speaking up! Too many cis people speak on transgender issues with no knowledge or care

  8. I was looking for a good quality informative article, but as a trans-man, a psychology student and a professional in healthcare, I believe this article is partial and biased and it should be reviewed, as it presents stigmatizing strong negative [personal] biased views on transgender people, and uses wrong pronouns. I would advise the author to review and correct this issues.

    1. You are a shit "healthcare professional" if you are treating bodies based on IDEA or BIOLOGY. Get help!



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