{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:33:07Z","timestamp":1788395587082,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T00:00:00Z","timestamp":1506038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Michigan Medicine Department of Pathology Anatomic Pathology"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Gender dysphoria is a diagnosis whereby an individual identifies as the opposite gender. The management of patients seeking female\u2010to\u2010male (<jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content>) transition includes hormonal therapy and surgical intervention, including mastectomy. The aim of this study was to characterize the immunohistological findings in resection specimens from <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We reviewed 68 cases (67 patients, one with re\u2010excision) of <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content> breast tissue resection by collecting clinical data, reviewing breast imaging and pathology reports (gross fibrous density, specimen weight, and number of cassettes submitted), and reviewing pathology slides [number of tissue pieces submitted, number of terminal duct lobule units (<jats:styled-content style=\"fixed-case\">TDLU<\/jats:styled-content>s), and the presence of histological findings]. Significant histological findings were present in 51 of 68 (75.0%) cases, including one case (1.5%) of flat epithelial atypia. Fibrocystic changes were the most common finding (27\/68, 39.7%), followed by gynaecomastoid change, fibrotic stage, (22\/68, 32.4%), and fibroadenomatoid change (11\/68, 16.2%). Fibrocystic change was associated with increased numbers of <jats:styled-content style=\"fixed-case\">TDLU<\/jats:styled-content>s, and gynaecomastoid change was associated with lower body mass index and decreased numbers of <jats:styled-content style=\"fixed-case\">TDLU<\/jats:styled-content>s. Gynaecomastoid change showed a moderate proportion of luminal epithelial cells with strong\u2010intensity immunohistochemical staining for oestrogen receptor, progesterone receptor, and androgen receptor, and a three\u2010layered epithelium demonstrated by the use of cytokeratin 5\/6 immunohistochemistry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We identified gynaecomastoid change at a significantly higher rate than previously reported in female patients. We support the continued gross and histological evaluation of <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content> specimens in light of the identification of atypia in one case.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13299","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T09:09:04Z","timestamp":1498640944000},"page":"859-865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Clinicopathological findings in female\u2010to\u2010male gender\u2010affirming breast surgery"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2799-6576","authenticated-orcid":false,"given":"Ellen G","family":"East","sequence":"first","affiliation":[{"name":"Department of Pathology Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine M","family":"Gast","sequence":"additional","affiliation":[{"name":"Department of Surgery Section of Plastic Surgery Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"William M","family":"Kuzon","sequence":"additional","affiliation":[{"name":"Department of Surgery Section of Plastic Surgery Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-6670","authenticated-orcid":false,"given":"Julie M","family":"Jorns","sequence":"additional","affiliation":[{"name":"Department of Pathology Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"xliv","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders: Dsm\u20105","author":"American Psychiatric Association, American Psychiatric Association, DSM\u20105 Task Force","year":"2013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-014-0300-8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-007-9307-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.124.2.181"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb10638.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024051201160"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1981.tb00652.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01541980"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.119.549.195"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02437583"},{"key":"e_1_2_8_12_1","volume-title":"How many adults identify as transgender in the United States?","author":"Flores AR","year":"2016"},{"key":"e_1_2_8_13_1","volume-title":"Age of individuals who identify as transgender in the United States","author":"Herman JL","year":"2017"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2001.12098617"},{"key":"e_1_2_8_15_1","unstructured":"World Professional Association for Transgender Health.Standards of care for the health of transsexual transgender and gender nonconforming people. 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