Supplementary Material for: Complexities in Adjuvant Endocrine Therapy for Breast Cancer in Female-to-Male Transgender Patients

Introduction: Managing breast cancer in female-to-male (FtM) transgender patients is complicated and challenging. Androgens play a crucial role in the development of secondary sexual identity in FtM transgender patients, but their effectiveness in breast cancer remains unclear. Furthermore, the considerations for adjuvant endocrine therapy in this population are highly intricate and warrant thorough discussion. Case Presentation: We describe the case of a 44-year-old FtM transgender diagnosed with breast cancer 3 years after initiating androgen receptor agonist therapy as part of his gender identity transition. After mastectomy, adjuvant endocrine therapy was initiated, consisting of a combination of an aromatase inhibitor and a gonadotropin-releasing hormone agonist, along with a cross-sex hormone. Conclusion: Estradiol levels were significantly reduced, and male-typical levels of sex hormones were attained.

引言：针对女性至男性（FtM）跨性别患者的乳腺癌管理复杂且充满挑战。雄激素在FtM跨性别患者发展次性征身份方面发挥着至关重要的作用，但其对乳腺癌治疗的有效性尚不明确。此外，针对该群体辅助内分泌治疗的考量极其复杂，亟需深入探讨。病例报告：我们描述了一位44岁的FtM跨性别患者在性别认同转换过程中，于开始使用雄激素受体激动剂治疗3年后被诊断为乳腺癌的案例。在接受乳房切除术之后，开始了辅助内分泌治疗，包括芳香酶抑制剂、促性腺激素释放激素激动剂以及跨性别激素的联合使用。结论：雌二醇水平显著降低，达到男性典型的性激素水平。