Difficulties of gender affirming treatment in trans women with BRCA1+ mutation: A case report.

Miguel Ángel Mangas-Cruz, Ana Piñar-Gutiérrez, Irene de Lara-Rodríguez, Suset Dueñas Disotuar, Sandra Amuedo-Domínguez, Carmen González-Cejudo, José Tejero-Delgado

Journal: Endocrinologia, diabetes y nutricion 2024;71(3):144-148

PMID: 38555112

Full Text on Elsevier Science View on PubMed

Abstract

Gender affirming treatment in transgender women is based on a combination of antiandrogens and estrogens, with the latter maintained over the long term. When prescribing these treatments, we must consider the possibility of developing estrogen-dependent breast cancer. In transgender women, a breast cancer incidence of 4.1 per 100,000 has been estimated, which would increase the risk by 46% in relation to cisgender men but decrease it by 70% in relation to cisgender women. It is known that certain gene mutations such as BRCA1 imply an increased risk of breast cancer, but at present the risk in transgender women with BRCA1 treated with estrogens is not well established. We present the case of a transgender woman with a family history of breast cancer and BRCA1 mutation and the therapeutic decisions made in a multidisciplinary team. Following this case, we review and discuss the published literature.

Address: UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain. Electronic address: [email protected].; UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain.; UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain; UGC de Ginecología, Oncología Ginecológica y Patología mamaria, Hospital Universitario Virgen del Rocío, Sevilla, Spain.; UGC de Ginecología, Oncología Ginecológica y Patología mamaria, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

DOI: 10.1016/j.endien.2023.12.002

Link outs

Free resources

Medical:

https://medlineplus.gov/breastcancer.html

Miscellaneous:

https://assays.cancer.gov/CPTAC-916

Subscription / membership required

Full Text Sources:

MeSH Terms: Male, Humans, Female, Transgender Persons, Transsexualism, Breast Neoplasms, Estrogens, Mutation, BRCA1 Protein