HORMONE THERAPY IN TRANSSEXUALS AND THE RISK OF BREAST CANCER

Gabriela F. Araújo; Fábio F. Marques; Guilherme N. Corrêa; Mateus F. O. Vilela;

Bráulio B. Rodrigues; Diogo T. de Lima; Mirian P. Silva.

UniEVANGÉLICA

Objective: To carry out a systematic review of the literature on the relation of breast

cancer in transsexual women using hormone therapy. Methods: Systematic review of

the literature, using the PubMed databases, between 2003 and 2016, using the key

words “breast cancer”, “femaile-to-male transsexuals”, “male-to-female-transsexuals “,”

Hormone therapy “. From the total of 22 articles found, a total of 15 articles were

selected in the last 13 years. Six studies were excluded because they were not the

morphological alterations of the use of hormonal therapy in transsexuals, as well as the

possibility and occurrences of breast cancer in these. Results: The nine articles

selected show the relationship between hormone therapy and breast cancer in

transsexuals, taking into account that in all the cases reported, the patients had firstdegree

relatives with a history of breast, ovary or prostate cancer. However there are

differences between studies. Lancet Oncol. 2013 September sees strong association of

breast cancer laughter with serum concentration of testosterone. It discusses the action

of testosterone to be aromatized in estrogen and stimulate the direct activation of

estrogen receptors, exposed in two cases reported by Shao T, et al. in which in both

the expression of estrogen receptors in transsexuals using testosterone presented in

90%. While in a study by SLAGTER, Margarita H. et al. it is stated that testosterone

promotes apoptotic effects in cancerous cells of breast cancer. Therefore, the

simultaneous presence of high circulating testosterone and estrogens in these subjects

could have prevented the biological action of E2, causing a histological image of

involution. Conclusion: Although not yet studied, when referring to transsexuals from

woman to man in use hormone therapy with high testosterone levels, strongly

associated with positive family history, risks can not be excluded. As well as the

presence of the BRCA2 mutation in transsexuals from man to woman using antiandrogen

and estrogen may lead to breast cancer. A full family history is important in

evaluating transgender people seeking hormone treatment.