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Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

BACKGROUND: Mastectomy is a commonly requested procedure in the transmasculine population and has been shown to improve quality of life, although there is limited research on safety. The aim of this study was to provide a nationwide assessment of epidemiology and postoperative outcomes following mas...

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Autores principales: Cuccolo, Nicholas G., Kang, Christine O., Boskey, Elizabeth R., Ibrahim, Ahmed M.S., Blankensteijn, Louise L., Taghinia, Amir, Lee, Bernard T., Lin, Samuel J., Ganor, Oren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635198/
https://www.ncbi.nlm.nih.gov/pubmed/31624695
http://dx.doi.org/10.1097/GOX.0000000000002316
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author Cuccolo, Nicholas G.
Kang, Christine O.
Boskey, Elizabeth R.
Ibrahim, Ahmed M.S.
Blankensteijn, Louise L.
Taghinia, Amir
Lee, Bernard T.
Lin, Samuel J.
Ganor, Oren
author_facet Cuccolo, Nicholas G.
Kang, Christine O.
Boskey, Elizabeth R.
Ibrahim, Ahmed M.S.
Blankensteijn, Louise L.
Taghinia, Amir
Lee, Bernard T.
Lin, Samuel J.
Ganor, Oren
author_sort Cuccolo, Nicholas G.
collection PubMed
description BACKGROUND: Mastectomy is a commonly requested procedure in the transmasculine population and has been shown to improve quality of life, although there is limited research on safety. The aim of this study was to provide a nationwide assessment of epidemiology and postoperative outcomes following masculinizing mastectomy and compare them with outcomes following mastectomy for cancer prophylaxis and gynecomastia correction in cisgender patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2017 was queried using International Classification of Diseases and Current Procedural Terminology codes to create cohorts of mastectomies for 3 indications: transmasculine chest reconstruction, cancer risk-reduction (CRRM), and gynecomastia treatment (GM). Demographic characteristics, comorbidities, and postoperative complications were compared between the 3 cohorts. Multivariable regression analysis was used to control for confounders. RESULTS: A total of 4,170 mastectomies were identified, of which 14.8% (n = 591) were transmasculine, 17.6% (n = 701) were CRRM, and 67.6% (n = 2,692) were GM. Plastic surgeons performed the majority of transmasculine cases (85.3%), compared with the general surgeons in the CRRM (97.9%) and GM (73.7%) cohorts. All-cause complication rates in the transmasculine, CRRM, and GM cohorts were 4.7%, 10.4%, and 3.7%, respectively. After controlling for confounding variables, transgender males were not at an increased risk for all-cause or wound complications. Multivariable regression identified BMI as a predictor of all-cause and wound complications. CONCLUSION: Mastectomy is a safe and efficacious procedure for treating gender dysphoria in the transgender male, with an acceptable and reassuring complication profile similar to that seen in cisgender patients who approximate either the natal sex characteristics or the new hormonal environment.
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spelling pubmed-66351982019-10-17 Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes Cuccolo, Nicholas G. Kang, Christine O. Boskey, Elizabeth R. Ibrahim, Ahmed M.S. Blankensteijn, Louise L. Taghinia, Amir Lee, Bernard T. Lin, Samuel J. Ganor, Oren Plast Reconstr Surg Glob Open Original Article BACKGROUND: Mastectomy is a commonly requested procedure in the transmasculine population and has been shown to improve quality of life, although there is limited research on safety. The aim of this study was to provide a nationwide assessment of epidemiology and postoperative outcomes following masculinizing mastectomy and compare them with outcomes following mastectomy for cancer prophylaxis and gynecomastia correction in cisgender patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2017 was queried using International Classification of Diseases and Current Procedural Terminology codes to create cohorts of mastectomies for 3 indications: transmasculine chest reconstruction, cancer risk-reduction (CRRM), and gynecomastia treatment (GM). Demographic characteristics, comorbidities, and postoperative complications were compared between the 3 cohorts. Multivariable regression analysis was used to control for confounders. RESULTS: A total of 4,170 mastectomies were identified, of which 14.8% (n = 591) were transmasculine, 17.6% (n = 701) were CRRM, and 67.6% (n = 2,692) were GM. Plastic surgeons performed the majority of transmasculine cases (85.3%), compared with the general surgeons in the CRRM (97.9%) and GM (73.7%) cohorts. All-cause complication rates in the transmasculine, CRRM, and GM cohorts were 4.7%, 10.4%, and 3.7%, respectively. After controlling for confounding variables, transgender males were not at an increased risk for all-cause or wound complications. Multivariable regression identified BMI as a predictor of all-cause and wound complications. CONCLUSION: Mastectomy is a safe and efficacious procedure for treating gender dysphoria in the transgender male, with an acceptable and reassuring complication profile similar to that seen in cisgender patients who approximate either the natal sex characteristics or the new hormonal environment. Wolters Kluwer Health 2019-06-12 /pmc/articles/PMC6635198/ /pubmed/31624695 http://dx.doi.org/10.1097/GOX.0000000000002316 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Cuccolo, Nicholas G.
Kang, Christine O.
Boskey, Elizabeth R.
Ibrahim, Ahmed M.S.
Blankensteijn, Louise L.
Taghinia, Amir
Lee, Bernard T.
Lin, Samuel J.
Ganor, Oren
Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title_full Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title_fullStr Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title_full_unstemmed Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title_short Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes
title_sort mastectomy in transgender and cisgender patients: a comparative analysis of epidemiology and postoperative outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635198/
https://www.ncbi.nlm.nih.gov/pubmed/31624695
http://dx.doi.org/10.1097/GOX.0000000000002316
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