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. 2025 Sep-Oct;75(5):376-386.
doi: 10.3322/caac.70021. Epub 2025 Jun 6.

Breast cancer in a transgender man

Alison May Berner  1   2 , Tristan Michael MacKenzie  3 , Shirish Kulkarni  4 , Chin Chong  5 , Loren Schechter  6 , Caroline Michie  4   7 , Ole-Petter Riksfjord Hamnvik  8
Affiliations

Breast cancer in a transgender man

Alison May Berner et al. CA Cancer J Clin. 2025 Sep-Oct.
No abstract available

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Conflict of interest statement

Alison M. Berner reports grants/contracts from Gilead Sciences Inc., and Eli Lilly & Company; personal/consulting fees from Pfizer Ltd.; and support for other professional activities from Astellas Pharma, AstraZeneca UK Ltd., Gilead Sciences Inc., Ipsen Biopharm Ltd., and NHS Health Scotland outside the submitted work. Loren Schechter is currently President‐Elect of World Professional Association for Transgender Health (WPATH) outside the submitted work. The remaining authors disclosed no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Expected physical changes from gender‐affirming hormone therapy with testosterone. Created in BioRender (Hamnvik O. [2025]; https://BioRender.com/z99l900).
FIGURE 2
FIGURE 2
Changes in scores for gender incongruence (GPSQ), depression (PHQ‐9) and suicidal ideation (SIDAS) scores after 3 months of gender‐affirming hormone treatment with testosterone (intervention group) versus no treatment (standard group). The numbers refer to the difference in the change of scores between the intervention group and the standard group and the 95% confidence interval. GPSQ indicates Gender Preoccupation and Stability Questionnaire; PHQ‐9, Patient Health Questionnaire‐9; SIDAS, Suicidal Ideation Attributes Scale. Based on data from Nolan BJ, Zwickl S, Locke P, Zajac JD, Cheung AS. Early access to testosterone therapy in transgender and gender‐diverse adults seeking masculinization: a randomized clinical trial. JAMA Netw Open. 2023;6(9):e2331919.
FIGURE 3
FIGURE 3
Mechanisms of androgen receptor‐mediated gene transcription in different subtypes of breast cancer. In ERα‐negative/HER 2‐positive breast cancer, the Wnt/β‐catenin pathway is implicated and facilitates the transcriptional activity of AR, promoting tumor growth. In TNBC, androgens seem to initiate second‐messenger signaling cascades, which often results in a feedback loop, leading to the progression of the tumor. In the ER‐positive breast cancer subtype, there is a dynamic relationship between ER and AR, in which the two receptors can transcriptionally regulate each other through heterodimerization and binding to the same DNA sequence. AR indicates androgen receptor; ARE, androgen receptor element; DHT, dihydrotestosterone; ER+, estrogen receptor‐positive; GPER, G protein–coupled estrogen receptor; HER2+, human epidermal growth factor 2‐positive; TF, transcription factor; TNBC, triple‐negative breast cancer. Figure reproduced under a Creative Commons Attribution (CC BY license; http://creativecommons.org/licenses/by/4.0/) from: Anestis A, Zoi I, Papavassiliou AG, Karamouzis MV. Androgen receptor in breast cancer‐clinical and preclinical research insights. Molecules. 2020;25(2):358.
FIGURE 4
FIGURE 4
Computed tomography scan of the chest showing a left‐sided rib lesion (arrow).
FIGURE 5
FIGURE 5
Computed tomography scan of the spine showing a sclerotic lesion in the T4 vertebra (arrow).
FIGURE 6
FIGURE 6
Computed tomography scan of the chest showing small lesions in (A) the horizontal fissure (arrow) and (B) the lung periphery (arrow).
See this image and copyright information in PMC

References

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    1. Nolan BJ, Zwickl S, Locke P, Zajac JD, Cheung AS. Early access to testosterone therapy in transgender and gender‐diverse adults seeking masculinization: a randomized clinical trial. JAMA Netw Open. 2023;6(9):e2331919. doi: 10.1001/jamanetworkopen.2023.31919 - DOI - PMC - PubMed