BACKGROUND: The health needs of the transgender population have not been well understood and have been an interest when it comes to research. There were several reported cases of breast cancer, specifically in male-to-female (MtF) transgenders or those who were born genotypic male but addressed themselves psychosocially as females. The characteristics, risk factors, and recommendations METHODS: In this study, three independent reviewers conducted literature searches using various online databases for all types of studies in relation to breast cancer occurrences in MtF transgenders in adult patients during the publication timeline of 2016–2022. Studies were excluded if RESULTS: A total of 14 articles were included and categorized in which quality assessment for risk of bias was done accordingly. Most of the studies were case reports, case series, and literature reviews making the overall quality poor. Most of the MtF transgenders were diagnosed with breast cancer at a median age of 58.9 years. The use of cross-sex hormones for at least 5 years by a transgender women may contribute the most to the risk of developing breast cancer. Other possible risk factors include a family history of breast cancer and obesity with body mass index (BMI) >35. The level of risk of developing breast cancer is still uncertain, but chronic hormonal use may increase one’s risk. CONCLUSION Due to the poor quality of the studies included, it is not possible at this time to quantify the risk of breast cancer among MtF transgenders. However, long-term use of cross-sex hormones (estrogen and/or progesterone) may be a contributing factor, but more large-scale studies are needed to establish the relationship. Most studies recommend mammography as the screening diagnostic modality at the age of 50 and older, with significant risk factors as identified annually or biennially. These recommendations still vary and are not yet well established by strong evidence due to various limitations, one of which is the uncertainty of the size of the MtF transgender population. Hence, further investigations are warranted and this study aims to uplift the recognition of breast cancer risk among the MtF transgenders.
Human ; Breast Neoplasms ; Transgender Persons

Background: Olfactory neuroblastoma, also known as esthesioneuroblastoma, is a rare malignant tumor that presents as a locally aggressive disease. It accounts for an incidence of 0.4 per million population affecting men and women equally in all ages. As olfactory neuroblastoma is rare, having an intracranial extension is even more unusual. Only a few cases have been reported in literature, hence, there is no widely accepted standard of care. Case Presentation: This is a case of a 33-year-old female who presented with a 4-month history of nasal congestion which progressed to a rapidly growing nasal mass and bilateral proptosis. She soon became bedridden and exhibited signs of increased intracranial pressure. Imaging revealed a heterogeneously enhancing nasal cavity mass with intracranial extension. Biopsy and immunohistochemistry confirmed the olfactory neuroblastoma. She subsequently underwent chemotherapy and radiotherapy since the tumor was unresectable. In a span of three months, after only three cycles of chemotherapy with cisplatin and etoposide and thirty fractions of radiation therapy, the patient significantly improved from being completely bedridden to an ambulatory individual capable of self-care. We completed eight cycles of chemotherapy and referred to surgical specialists for possible resectability. However, the patient did not consent for surgery and opted to have palliative care. Conclusion Most cases of olfactory neuroblastoma are treated through combination therapy. The patient significantly improved from the administration of chemotherapy with cisplatin and etoposide plus radiotherapy. This case report shows the significance of chemotherapy with radiotherapy as the treatment of choice for late-stage olfactory neuroblastoma in which surgery is not amenable.
Esthesioneuroblastoma, Olfactory ; Drug Therapy ; Radiotherapy