Apocrine ductal carcinoma in situ associated with testosterone therapy in a transgender individual

Breast J. 2021 May;27(5):475-477. doi: 10.1111/tbj.14187. Epub 2021 Feb 5.

Abstract

We report the first case of apocrine ductal carcinoma in situ (DCIS) in a female-to-male transgender individual on testosterone therapy (TT). The gender confirmation total mastectomy revealed 2 cm DCIS with apocrine cytology, high nuclear grade with associated calcification, and necrosis. Immunohistochemistry revealed the DCIS was negative for ER, positive for AR with HER2/neu overexpression (3+). This patient with negative screening mammography developed apocrine DCIS on TT, suggesting that gender-affirming hormone therapy may have advanced malignant transformation of atypical apocrine cells. This may have implications for increased surveillance within the transgender population.

Keywords: androgen receptor; apocrine; ductal carcinoma in situ; testosterone therapy; transgender.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Carcinoma in Situ*
  • Carcinoma, Ductal, Breast*
  • Carcinoma, Intraductal, Noninfiltrating* / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating* / drug therapy
  • Carcinoma, Intraductal, Noninfiltrating* / surgery
  • Early Detection of Cancer
  • Female
  • Humans
  • Male
  • Mammography
  • Mastectomy
  • Receptor, ErbB-2
  • Testosterone / adverse effects*
  • Transgender Persons*

Substances

  • Testosterone
  • Receptor, ErbB-2