Effects of Long-term Androgen Administration on Breast Tissue of Female-to-Male Transsexuals

Margrita H. Slagter ¹, Louis J.G. Gooren ¹, Andreas Scorilas ¹, Constantina D. Petraki ¹ and Eleftherios P. Diamandis ^1*

¹ Department of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands (MHS,LJGG); Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Athens, Athens, Greece (AS); Department of Pathology, Evangelismos Hospital, Athens, Greece (CDP); Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada (EPD); and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (EPD)

^* To whom correspondence should be addressed. E-mail: ediamandis{at}mtsinai.on.ca.

Submitted on January 18, 2006
Accepted on 29 March 2006

	Abstract

Our aim was to examine the effects of androgen administration on breast tissue histology of female-to-male transsexuals, as well as study the immunohistochemical expression of three human tissue kallikreins, hK3 (PSA), hK6 and hK10. We studied 23 female-to-male transsexuals who were treated with injectable testosterone for 18-24 months. We also used 10 control female breast tissues. All tissues were fixed in buffered formalin, embedded in paraffin and examined by hematoxylin-eosin staining and immunohistochemical staining for PSA, hK6 and hK10. Females treated with androgens exhibited similar involutionary changes as those seen in breast of menopausal women such as marked reduction of glandular tissue, involution of the lobuloalveolar structures and prominence of fibrous connective tissue, but presence of only small amounts of fat tissue. Fibrocystic lesions were generally not observed. In immunohistochemistry, in control breast tissues, we found moderate to strong cytoplasmic immunoexpression of hK6 and hK10 in the epithelial ductal and lobuloalveolar structures, but myoepithelial cells were negative. Luminal secretions were also positive. In menopausal breast, the immunoexpression of hK6 and hK10 was weaker and focal. No control case showed immunoexpression for PSA. In female-to-male transsexuals, one case showed focal PSA cytoplasmic immunoexpression in the epithelium of moderately involuting lobules. Long-term administration of androgens in female-to-male transsexuals causes marked reduction of glandular tissue and prominence of fibrous connective tissue. These changes are similar to those observed at the end-stage of menopausal mammary involution.

Key Words: transsexuals, hormones, breast tissue, immunohistochemistry

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