Carcinoma of Breast in Trans-Sexual Individuals after Surgical and Hormonal Interference with the Primary and Secondary Sex Characteristics

Abstract

Two cases of metastasizing primary mammary adenocarcinoma are reported. In each the tumour presented about five years after completion of surgical procedures intended to effect a change of sex from male to female. The procedures included castration, amputation of the penis, construction of a pro-vagina, and mammoplasty. Oestrogens were administered by inunction into the skin of the breasts, by subcutaneous implantation, and orally. None of these procedures, with the exception of mammoplasty in the case of one of the patients, was carried out in the British Isles. The mammoplasty (transplantation of adipose tissue in one case and implantation of moulded prostheses in the other) is not thought to have been related to the subsequent development of carcinoma. The latter is likely to have been determined by the hormonal disturbance resulting from castration and the prolonged administration of oestrogens. © 1968, British Medical Journal Publishing Group. All rights reserved.