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Open Access Highly Accessed Case report

Importance of revealing a rare case of breast cancer in a female to male transsexual after bilateral mastectomy

Dejan V Nikolic125*, Miroslav L Djordjevic1, Miroslav Granic12, Aleksandra T Nikolic13, Violeta V Stanimirovic4, Darko Zdravkovic12 and Svetlana Jelic12

Author Affiliations

1 Faculty of Medicine, University of Belgrade, Dr.Subotica 8, 11000, Belgrade, Serbia

2 University Medical Center “Bezanijska kosa”, Bezanijska kosa bb, 10080, Belgrade, Serbia

3 Dedinje Cardiovascular Institute, Heroja Milana Tepica 1a, 11000, Belgrade, Serbia

4 Medicines and Medical Devices Agency of Serbia, Vojvode Stepe 458, 11221, Belgrade, Serbia

5 Department of Oncosurgery, Clinic for Oncology, University Medical Center “Bezanijska kosa”, 11080, Belgrade, Serbia

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World Journal of Surgical Oncology 2012, 10:280  doi:10.1186/1477-7819-10-280

Published: 28 December 2012

Abstract

The incidence of breast carcinoma following prophylactic mastectomy is probably less than 2%. We present a 43-year-old female to male transsexual who developed breast cancer 1 year after bilateral nipple- sparing subcutaneous mastectomy as part of female to male gender reassignment surgery. In addition to gender reassignment surgery, total abdominal hysterectomy with bilateral salpingo-oophorectomy (to avoid the patient from entering menopause and to eliminate any subsequent risk of iatrogenic endometrial carcinoma), colpocleisys, metoidioplasty, phalloplasty, urethroplasty together with scrotoplasty/placement of testicular prosthesis and perineoplasty were also performed. Before the sex change surgery, the following diagnostic procedures were performed: breast ultrasound and mammography (which were normal), lung radiography (also normal) together with abdominal ultrasound examination, biochemical analysis of the blood and hormonal status.

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. 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.

Keywords:
Female to male surgery; Mastectomy; Breast cancer