Clinicopathological study of breast tissue in female-to-male transsexuals

Gender identity disorder is defined as persistent feelings of gender discomfort and the inappropriateness of one's anatomical sex. To study the effects of androgens on female breast tissue, we examined mammary glands from female-to-male transsexual (FTMT) women using androgen therapy and from those not using androgen therapy. Female-to-male transsexual breast tissue is a rare specimen in surgical pathology and there are no well-defined guidelines for its examination. We evaluated the clinicopathologic findings of 186 FTMT mammary glands. The patients' ages at presentation ranged from 18 to 49 years (mean 27.4 years). We detected breast carcinoma in only 1 of 130 FTMT women who had not used androgen therapy and in none of 56 FTMT women who had used androgen therapy. We described the histopathological morphology of FTMT breast tissue. The frequency of carcinoma and hyperplasia did not differ significantly between FTMT women who had used androgen therapy and those who had not. These findings suggest that androgen does not alter the risk of carcinoma developing in the mammary glands of FTMT women.