Iodine, Thyroid and Breast Cancer: What does the research say?

 

Even if all the research printed here does not agree, clearly there is a connection.  Some studies say T3 seems to stilmulate the breast, others say auto immune thyroid is connected to breast cancer.  There is still new evidence coming all the time.  Suffice it to say, there is a connection.  See below for more resources.

78th Annual Meeting of the American Thyroid Association: Abstract 157. Presented October 5, 2007.

October 19, 2007 -- Breast cancer patients may have subtle hypothyroidism, even in the absence of overt or subclinical hypothyroidism, a new study suggests. The results were reported at the American Thyroid Association 78th Annual Meeting, in New York, by Peter Smyth, PhD, and colleagues, from University College, Dublin, Ireland.

The study compared 710 consecutive patients with postmenopausal breast cancer who were asymptomatic for thyroid disease with 179 postmenopausal controls. The results show that the breast cancer patients had significantly higher levels of antithyroid autoantibodies (TPOAb) and higher levels of serum thyroid stimulating hormone (TSH).

The autoantibodies levels were undetectable in 51.8% of breast cancer patients compared with 82.1% of controls ( P < .001), and this relationship continued for detectable values (24.5% in patients vs 3.9% in controls; P < .001) and for elevated values (22.9% in patients vs 14.0% in controls; P < .01).

Investigation of serum TSH levels in these groups showed not only that there was an association between elevated levels of antithyroid autoantibodies and serum TSH but also that that this association applied to those patients with breast cancer who had detectable levels, Dr. Smyth told the meeting. In the case of elevated levels of antithyroid autoantibodies, serum TSH greater than 4.0 mU/L was found in 61.5% of breast cancer patients compared with 20% of controls ( P < .001), while the corresponding figures for detectable levels were 24.3% for patients and 0 for controls ( P < .001).

Asked by Medscape Oncology to comment on this finding, Jayne Franklyn, MD, PhD, from Queen Elizabeth Hospital, in Birmingham, United Kingdom, who was not involved with the study, said: "There has been a suspicion for many years that there is an association between hypothyroidism and breast cancer, but the evidence has been conflicting. What this study shows is that antithyroid antibodies are more likely to be present and more likely to be elevated in breast cancer patients than controls, and these autoantibodies are associated with the very early stages of hypothyroidism." It suggests that there may a link between an autoimmune disease such as antibody-positive hypothyroidism and the risk of developing breast cancer, so this work advances the understanding of science, Dr. Franklyn said. However, there are no immediate practical or clinical implications from this work, such as, for example, investigating thyroid function in breast cancer patients, she added.

78th Annual Meeting of the American Thyroid Association: Abstract 157. Presented October 5, 2007.

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J Clin Endocrinol Metab. 2000 Mar;85(3):1245-50.

Tissue iodine content and serum-mediated 125I uptake-blocking activity in breast cancer.

Kilbane MT, Ajjan RA, Weetman AP, Dwyer R, McDermott EW, O'Higgins NJ, Smyth PP.

University College Dublin, St. Vincent's University Hospital, Ireland.

Abstract

In the thyroid, active transport of iodide is under control of the TSH-dependent Na+/I- symporter (NIS), whereas in the breast such control is less well understood. In this study, NIS expression was demonstrated by RT-PCR in 2 of 2 fibroadenomata and 6 of 7 breast carcinoma messenger ribonucleic acid isolates. In addition, mean total tissue iodine levels of 80.9 +/- 9.5 ng I/mg protein in 23 benign tumors (fibroadenomata) were significantly higher than those in 19 breast cancers taken from either the tumor (18.2 +/- 4.6 ng I/mg) or morphologically normal tissue taken from within the tumor-bearing breast (31.8 +/- 4.9 ng I/mg; P < 0.05 in each case). Inhibition of 125I uptake into NIS-transfected CHO cells was observed in serum from 20 of 105 (19.0%) breast carcinoma, 8 of 49 (16.3%) benign breast disease, and 27 of 86 (31.4%) Graves' patients, but in only 1 of 33 (3.0%) age-matched female controls. IgG purified from serum of patients showing positive 125I uptake inhibition also inhibited iodide uptake, suggesting that such inhibition was antibody mediated. 125I uptake inhibition was significantly associated with thyroid peroxidase antibody positivity (P < 0.05) in sera from breast cancer patients, but not in those with benign breast disease, once again suggesting an association between thyroid autoimmunity and breast carcinoma.

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Relationship between breast cancer and thyroid disease: relevance of autoimmune thyroid disorders in breast malignancy

C Giani, P Fierabracci, R Bonacci, A Gigliotti, D Campani, F De Negri, D Cecchetti, E Martino and A Pinchera

Institute of Endocrinology, University of Pisa, Italy.

The relationship between thyroid dysfunction and breast cancer (BC) is debated. To clarify this controversial issue, a prospective study on thyroid function in BC was performed. The prevalence of thyroid disease was examined in 102 consecutive BC patients with ductal infiltrating carcinoma after surgery and before starting any chemohormonal or x-ray therapy and in 100 age-matched control healthy women living in the same borderline iodine-sufficient geographic area.

All subjects were submitted to clinical ultrasound thyroid evaluation and serum free T4, free T3, TSH, thyroperoxidase antibody, and thyroglobulin antibody determination. Fine needle aspiration was performed in all thyroid nodules. Estrogen and progesterone receptors (ER and PR, respectively) were assayed in 92 and 55 BC specimens, respectively. The overall prevalence of thyroid disease was 47 in 102 (46%) in BC patients and 14 in 100 (14%) in controls (P < 0.0001). The prevalence of nontoxic goiter was 27.4% in BC patients and 11% in controls (P = 0.003). Hashimoto's thyroiditis was found in 13.7% of BC patients and in only 2% of the controls (P < 0.005). Other thyroid disorders found in the BC group included 2 cases of Graves' disease, 2 of thyroid carcinoma, and 1 of subacute thyroiditis, whereas in the control group only 1 case of Graves' disease and none of the other disorders were found. Mean free T3, free T4, and TSH concentrations showed no difference between BC patients and controls.

The prevalence of thyroperoxidase antibody was higher in BC patients than in controls (23.5% vs. 8%; P < 0.005), whereas the prevalence of thyroglobulin antibody was not different. In BC patients the presence of thyroid antibodies was more frequently associated with clinically detectable autoimmune thyroiditis (14 of 26, 51.8%; P = 0.03) and was more common in the younger group. The positivity of ER was found in 51 of 92 (55.43%) and that of PR was found in 26 of 55 (47.27%) BC specimens. No relationship was found among ER, PR status, and the presence of serum thyroid antibodies. In conclusion, 1) the present study provides evidence that the overall prevalence of thyroid disorders is increased in patients with breast cancer, and 2) thyroid autoimmune disorders, especially Hashimoto's thyroiditis, account to a large extent for the increased prevalence of thyroid disease in patients with breast cancer. This feature is independent from the ER and PR status of the primary tumor.

The present findings call attention to the usefulness of screening for thyroid disease in any patient with breast cancer.

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Thyroid Function in Breast Cancer Patients

Anticancer Research May 1, 2010 vol. 30 no. 5 1713-1717

Abstract

Background: Recent studies indicate a possible relationship between hypothyroidism and breast cancer in vivo. In addition, oestrogen-like effects of thyroid hormones on breast cancer cell growth are seen in vitro. Therefore, this study evaluated thyroid function in breast cancer patients, women with benign breast tumour and healthy controls. Patients and Methods: Breast cancer patients (n=65), women with carcinoma in situ (n=13) or benign breast tumour (n=27), and healthy controls (n=38) were included in the study. Thyroid history was reported. Thyroid hormones (fT4, fT3, TSH) and thyroid antibodies (TPO, TRAK and TG) were determined. Statistical analysis was performed by Mann-Whitney U and Fisher's exact test (p<0.005 significant). Results: fT3 and fT4 levels were highest in breast cancer patients, and differed significantly from controls (fT3 and fT4: p<0.001) as well as from patients with benign breast tumour (fT3: p=0.021; fT4: p=0.017). TSH was highest in the control group without reaching significance. With regard to TRAK antibodies, breast cancer patients showed the highest levels differing significantly from women with benign breast tumours (p=0.048). Conclusion: Significant differences in fT3/fT4 as well as TRAK levels were observed among breast cancer patients, women with benign breast tumours and healthy controls. Further studies using larger patient groups are part of ongoing research.

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J Steroid Biochem Mol Biol. 2008 Mar;109(1-2):57-66. Epub 2007 Dec 7.

Effects of thyroid hormones on human breast cancer cell proliferation.

Hall LC, Salazar EP, Kane SR, Liu N.

Safety and Environmental Protection Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA.

Abstract

The involvement of estrogens in breast cancer development and growth has been well established. However, the effects of thyroid hormones and their combined effects with estrogens are not well studied. We investigated the response of human breast cancer cells to thyroid hormone, particularly the role of T3 in mediating cell proliferation and gene expression. We demonstrated that 17beta-estradiol (E2) or triiodothyronine (T3) promoted cell proliferation in a dose-dependent manner in both MCF-7 and T47-D cell lines. The E2- or T3-dependent cell proliferation was suppressed by co-administration of the ER antagonist ICI. We also demonstrated that T3 could enhance the effect of E2 on cell proliferation in T47-D cells. Using an estrogen response element (ERE)-mediated luciferase assay, we determined that T3 was able to induce the activation of ERE-mediated gene expression in MCF-7 cells, although the effects were much weaker than that induced by E2. These results suggest that T3 can promote breast cancer cell proliferation and increase the effect of E2 on cell proliferation in some breast cancer cell lines and thus that T3 may play a role in breast cancer development and progression.

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Z Lymphol. 1988 Jul;12(1):24-9.

[The thyroid gland and the breast]

[Article in German]

Pavi? Z, Pavi? S.

Abt. Klinische Biochemie, Universität Göttingen.

Abstract

The results of experimental clinical and epidemiological studies published so far from 1896 until today on the connection between thyroid and breast diseases doubtless require critical examination, since these results are highly contradictory. Without being able to go into details of the sources of methodological errors and the highly heterogenous investigation material, two pathophysiological mechanisms can be discussed in the investigation of the interrelationship between the thyroid and the breast: 1. A low level of thyroid hormone might make the breast hypersensitive to prolactin, which might induce dysplasia or neoplasia of the mammary epithelium. In addition, there is the almost identical neurohumoral regulation of the hormones of the thyrotropic and lactotropic cells in the anterior pituitary. 2. Thyroid hormones have an effect on peripheral androgenic and estrogenic metabolism. The hyperthyroid state may cause an increase in the concentration of sex hormone-binding globulins, which might give rise to an alteration of the beneficial effect of sex hormones on the cellular levels. Compared to this, the iodine deficit might lead to neoplastic transformation of the mammary epithelium via the enhanced gonadotropin stimulation and the subsequent chronic hyperestrogenism. For better understanding of the always topical problem of the not yet completely elucidated correlation between thyroid function and breast diseases, a two-track procedure is appropriate: 1. Thyroid receptor assay on animal and human breast tumor tissue and 2. prospective clinical studies on a large scale.(ABSTRACT TRUNCATED AT 250 WORDS)

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Anticancer Res. 2010 May;30(5):1713-7.

Thyroid function in breast cancer patients.

Ditsch N, Liebhardt S, Von Koch F, Lenhard M, Vogeser M, Spitzweg C, Gallwas J, Toth B.

Department of Obstetrics and Gynecology - Grosshadern, Ludwig Maximilians University, Munich, Germany. nina.ditsch@med.uni-muenchen.de

Abstract

BACKGROUND: Recent studies indicate a possible relationship between hypothyroidism and breast cancer in vivo. In addition, oestrogen-like effects of thyroid hormones on breast cancer cell growth are seen in vitro. Therefore, this study evaluated thyroid function in breast cancer patients, women with benign breast tumour and healthy controls.

PATIENTS AND METHODS: Breast cancer patients (n=65), women with carcinoma in situ (n=13) or benign breast tumour (n=27), and healthy controls (n=38) were included in the study. Thyroid history was reported. Thyroid hormones (fT4, fT3, TSH) and thyroid antibodies (TPO, TRAK and TG) were determined. Statistical analysis was performed by Mann-Whitney U and Fisher's exact test (p<0.005 significant).

RESULTS: fT3 and fT4 levels were highest in breast cancer patients, and differed significantly from controls (fT3 and fT4: p<0.001) as well as from patients with benign breast tumour (fT3: p=0.021; fT4: p=0.017). TSH was highest in the control group without reaching significance. With regard to TRAK antibodies, breast cancer patients showed the highest levels differing significantly from women with benign breast tumours (p=0.048).

CONCLUSION: Significant differences in fT3/fT4 as well as TRAK levels were observed among breast cancer patients, women with benign breast tumours and healthy controls. Further studies using larger patient groups are part of ongoing research.

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J BUON. 2009 Jul-Sep;14(3):425-8.

Breast cancer in association with thyroid disorders.

Michalaki V, Kondi-Pafiti A, Gennatas S, Antoniou A, Primetis H, Gennatas C.

Oncology Clinic, Areteion Hospital, University of Athens, Athens, Greece.

Abstract

PURPOSE: The relationship between breast cancer and thyroid diseases is controversial. Conflicting results have been reported in the literature. The incidence of autoimmune and non-autoimmune thyroid diseases were investigated in patients with breast cancer who had received prior therapy as compared with age-matched control individuals without breast or thyroid disease.

PATIENTS AND METHODS: Clinical and ultrasound evaluation of the thyroid gland, and determination of serum thyroid hormones and autoantibody levels were performed in 143 breast cancer patients and 128 healthy control individuals. Patients were classified into subgroups according to estrogen receptor (ER) and progesterone receptor (PR) status and type of oncological treatment.

RESULTS: The mean values for serum antibodies against thyroid peroxidase (anti-TPO) were 9 IU/ml and 25 IU/ml for antithyroglobulin antibodies (anti-TGB) in breast cancer patients, and 9.5 IU/ml and 23.5 IU/ml, respectively, in the control group (p>0.05. The difference between breast cancer patients and the control group in the incidence of autoimmune and non-autoimmune thyroid diseases was not statistically significant. No significant differences between the groups according to both menopausal status and ER status were seen (p= 0.67). Also, no significant influence of hormonal therapy with tamoxifen and chemotherapy on serum levels of thyroid stimulating hormone (TSH), free thyroxin (fT4), TPO and TGB autoantibodies was proved.

CONCLUSION: This study demonstrated a similar incidence of thyroid enlargement and the same frequency of thyroid disturbances in patients with breast cancer and controls. No relationship was found among ER and PR status, and the presence of serum thyroid autoantibodies. Although we have been unable to demonstrate any impact of breast cancer therapy on thyroid function tests, more prolonged studies with larger number of patients may be required to demonstrate significant trends.

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Crit Rev Oncol Hematol. 2008 Nov;68(2):107-14. Epub 2008 Aug 3.

Role of lipid peroxidation and oxidative stress in the association between thyroid diseases and breast cancer.

Gago-Dominguez M, Castelao JE.

USC/Norris Comprehensive Cancer Center, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033-0800, United States. mgago@usc.edu

Abstract

Evidence is accumulating for a role of the thyroid in the natural history of breast cancer, although no plausible mechanism has been advanced to explain this association. We believe that the thyroid disease-breast cancer relationship provides a unique opportunity to find out the causes of breast cancer. Both diseases are female predominant, with specifically identified biological pathways and genetic and environmental determinants, and seeing them in concert provides an opportunity to identify the most relevant mechanistic pathways. In this communication, we advance a plausible mechanism to explain the thyroid disease-breast cancer relationship. We specifically propose that the reduction in risk associated with hyperthyroidism or increased levels of thyroid hormones, or iodine, may derive from the pro-oxidant properties of these compounds, i.e., from its ability to generate oxidative stress-induced apoptosis. Conversely, the increased risk from hypothyroidism may derive from its ability to inhibit this stress-mediated apoptotic process.

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Eur J Endocrinol. 2006 May;154(5):645-9.

Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery.

Giustarini E, Pinchera A, Fierabracci P, Roncella M, Fustaino L, Mammoli C, Giani C.

Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy. eligiustarini@hotmail.com

Comment in:

Abstract

BACKGROUND: Previous studies have demonstrated a high prevalence of thyroperoxidase antibodies (TPOAb) and autoimmune hypothyroidism in breast cancer (BC). These studies have been performed in BC patients generally 20-30 days after mastectomy. It is known that stress may have an influence on the immune system and a relation between stressful events and the onset or worsening of autoimmune thyroid disorders has been reported by several authors. The aim of the study was to evaluate the prevalence of autoimmune thyroid disease in patients with nodular breast disease selected for surgery before any treatment. Our hypothesis was that the high prevalence of thyroid autoimmune disorders in BC is independent of stressful events represented by surgery and/or anaesthetic procedures.

METHODS: Our series included 61 consecutive women aged 52.8 +/- 10.2 yrs (mean age +/- s.d.) with nodular breast disease selected for breast surgery: 36 out of 61 of them (59%) had BC and 25 out of 61 had benign breast disease (BBD). Controls included 100 healthy age-matched women. All patients and control subjects were submitted to clinical, ultrasound thyroid evaluation and serum-free thyroxine (FT4), serum-free tri-iodothyronine (FT3), TSH, TPOAb and thyroglobulin antibodies (TgAb) determination.

RESULTS: Mean FT3, FT4 and TSH concentration showed no differences between BC patients, BBD patients and controls. The prevalence of TPOAb in BC patients (12/36: 33.33%) was significantly higher than in BBD patients (5/25: 20%) (P < 0.01) and in controls (8/100: 8%) (P < 0.01). Similarly, the prevalence of TgAb in BC patients was 12 out of 36 (33.33%) significantly higher than that detected in BBD patients (4/25: 16%) (P < 0.01) and in controls (12/100: 12%) (P < 0.01). Of the 36 BC patients, 20 showed a diffuse hypoechogenicity of the thyroid gland to ultrasound evaluation, significantly higher than in BBD (7/25: 28%) (P = 0.03). Of the 20 BC patients who showed a hypoechogenic pattern of thyroid gland, 10 (50%) were associated with antithyroid antibodies positivity (TAb). This finding was present in two of seven BBD (28.57%) (P < 0.0001). Only two controls showed focal hypoechogenicity of the thyroid gland. Generally, 24 out of 36 (66.7%) of BC and 9 out of 25 (36%) of BBD (P = 0.02) had signs of thyroid autoimmunity consistent with the hypoechogenic pattern of thyroid gland associated or not with TAb; 2 out of 36 (5.55%) of BC and 1 out of 25 (4%) of BBD patients had autoimmune hypothyroidism and no hypothyroidism was found in controls.

CONCLUSIONS: The results of this study confirm the strong relation between thyroid autoimmunity and BC. This finding is independent of stressful events represented by surgery or anaesthetic procedures. The present data call attention to the usefulness of screening for autoimmune thyroid disorders in patients with nodular breast disease selected for surgery.

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Thyroid. 2007 Sep;17(9):851-9.

Uptake and gene expression with antitumoral doses of iodine in thyroid and mammary gland: evidence that chronic administration has no harmful effects.

Anguiano B, García-Solís P, Delgado G, Aceves Velasco C.

Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus UNAM-Juriquilla, Querétaro, México.

Abstract

Several studies have demonstrated that moderately high concentrations of molecular iodine (I(2)) diminish the symptoms of mammary fibrosis in women, reduce the occurrence of mammary cancer induced chemically in rats (50-70%), and have a clear antiproliferative and apoptotic effect in the human tumoral mammary cell line MCF-7. Nevertheless, the importance of these effects has been underestimated, in part because of the notion that exposure to excess iodine represents a potential risk to thyroid physiology. In the present work we demonstrate that uptake and metabolism of iodine differ in an organ-specific manner and also depend on the chemical form of the iodine ingested (potassium iodide vs. I(2)). Further, we show that a moderately high I(2) supplement (0.05%) causes some of the characteristics of the "acute Wolff-Chaikoff effect"; namely, it lowers expression of the sodium/iodide symporter, pendrin, thyroperoxidase (TPO), and deiodinase type 1 in thyroid gland without diminishing circulating levels of thyroid hormone. Finally, we confirm that I(2) metabolism is independent of TPO, and we demonstrate that, at the doses used here, which are potentially useful to treat mammary tumors, chronic I(2) supplement is not accompanied by any harmful secondary effects on the thyroid or general physiology. Thus, we suggest that I(2) could be considered for use in clinical trials of breast cancer therapies.

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J Mammary Gland Biol Neoplasia. 2005 Apr;10(2):189-96.

Is iodine a gatekeeper of the integrity of the mammary gland?

Aceves C, Anguiano B, Delgado G.

Instituto de Neurobiología, Universidad Nacional Autónoma de México, Juriquilla. caracev@servidor.unam.mx

Abstract

This paper reviews evidence showing iodine as an antioxidant and antiproliferative agent contributing to the integrity of normal mammary gland. Seaweed is an important dietary component in Asian communities and a rich source of iodine in several chemical forms. The high consumption of this element (25 times more than in Occident) has been associated with the low incidence of benign and cancer breast disease in Japanese women. In animal and human studies, molecular iodine (I(2)) supplementation exerts a suppressive effect on the development and size of both benign and cancer neoplasias. This effect is accompanied by a significant reduction in cellular lipoperoxidation. Iodine, in addition to its incorporation into thyroid hormones, is bound into antiproliferative iodolipids in the thyroid called iodolactones, which may also play a role in the proliferative control of mammary gland. We propose that an I(2) supplement should be considered as an adjuvant in breast cancer therapy.

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Cancer Causes Control. 2000 Feb;11(2):121-7.

Hypothesis: iodine, selenium and the development of breast cancer.

Cann SA, van Netten JP, van Netten C.

Special Development Laboratory, Royal Jubilee Hospital, Victoria, BC, Canada.

Abstract

BACKGROUND: In this paper we examine some of the evidence linking iodine and selenium to breast cancer development. Seaweed is a popular dietary component in Japan and a rich source of both of these essential elements. We hypothesize that this dietary preference may be associated with the low incidence of benign and malignant breast disease in Japanese women. In animal and human studies, iodine administration has been shown to cause regression of both iodine-deficient goiter and benign pathological breast tissue. Iodine, in addition to its incorporation into thyroid hormones, is organified into anti-proliferative iodolipids in the thyroid; such compounds may also play a role in the proliferative control of extrathyroidal tissues. Selenium acts synergistically with iodine. All three mono-deiodinase enzymes are selenium-dependent and are involved in thyroid hormone regulation. In this way selenium status may affect both thyroid hormone homeostasis and iodine availability. CONCLUSION: Although there is suggestive evidence for a preventive role for iodine and selenium in breast cancer, rigorous retrospective and prospective studies are needed to confirm this hypothesis.

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Cancer. 2005 Mar 15;103(6):1122-8.

Thyroid hormone and breast carcinoma. Primary hypothyroidism is associated with a reduced incidence of primary breast carcinoma.

Cristofanilli M, Yamamura Y, Kau SW, Bevers T, Strom S, Patangan M, Hsu L, Krishnamurthy S, Theriault RL, Hortobagyi GN.

Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mcristof@mdanderson.org

Abstract

BACKGROUND: To investigate the role of primary hypothyroidism (HYPT) on breast carcinogenesis, the authors evaluated 1) the association between HYPT and a diagnosis of invasive breast carcinoma and 2) the clinicopathologic characteristics of breast carcinoma in patients with HYPT.

METHODS: For this retrospective chart review study, 1136 women with primary breast carcinoma (PBC) were identified from the authors' departmental data base. These women (cases) were frequency-matched for age (+/- 5 years) and ethnicity with 1088 healthy participants (controls) who attended a breast carcinona screening clinic. Women with HYPT who were receiving thyroid-replacement therapy before they were diagnosed with breast carcinoma or before the screening visit were identified.

RESULTS: The mean ages of cases and controls (51.6 years vs. 51.0 years, respectively; P = 0.30) and their menopausal status (65.4% premenopausal vs. 62% postmenopausal; P = 0.10) were comparable. Two hundred forty-two women in the case group (10.9%) with HYPT were identified. The prevalence of this condition was significantly greater the control group compared with the case group (14.9% vs. 7.0%, respectively; P < 0.001). PBC patients were 57% less likely to have HYPT compared with their healthy counterparts (odds ratio, 0.43l 95% confidence interval, 0.33-0.57). Seventy-eight white patients with PBC had HYPT and, compared with women who were euthyroid, they were older at the time of diagnosis (58.8 years vs. 51.1 years; P < 0.001), were more likely to have localized disease (95.0% vs. 85.9% clinical T1 or T2 disease, respectively; P = 0.025), and were more likely to have no pathologic lymph node involvement (62.8% vs. 54.4%; P = 0.15).

CONCLUSIONS: Primary HYPT was associated with a reduced risk for PBC and a more indolent invasive disease. These data suggest a possible biologic role for thyroid hormone in the etiology of breast carcinoma and indicate areas of research for the prevention and treatment of breast carcinoma.

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J Clin Endocrinol Metab. 1998 Aug;83(8):2711-6.

Serum thyroid peroxidase autoantibodies, thyroid volume, and outcome in breast carcinoma.

Smyth PP, Shering SG, Kilbane MT, Murray MJ, McDermott EW, Smith DF, O'Higgins NJ

. Department of Medicine and Therapeutics, St. Vincent's Hospital and University College Dublin, Ireland. ppa.smyth@ucd.ie

Abstract

The prevalence of thyroid peroxidase autoantibodies (TPO.Ab) was assessed in patients with either breast carcinoma or benign breast disease, and its association with disease outcome in breast carcinoma was studied. TPO.Ab were detected by direct RIA in serum from 121/356 (34.0%) of patients with breast carcinoma, compared with 36/194 (18.5%) of controls (P < 0.001); and in 31/108 (28.7%) with benign breast disease, compared with 12/88 (13.6%) of controls (P < 0.05). Survival analysis in a group of 142 women with breast carcinoma demonstrated that TPO.Ab titres > or = 0.3 U/mL were associated with a significantly better disease-free [relative risk (RR) = 1.84, P < 0.05] and overall survival (RR = 3.46, P < 0.02), compared with those who were TPO.Ab-negative. Better outcome associated with higher TPO.Ab titres was confined to those who had thyroid volumes within the intermediate range (10.1-18.8 mL) and did not further enhance the good outcome recorded when volumes were < or = 10.0 mL or > 18.8 mL. Multivariate survival analysis showed that both TPO.Ab and thyroid volume were independently associated with prognosis in breast carcinoma and that RRs for disease-free survival were of a similar order of magnitude to well-established prognostic indices such as axillary nodal status or tumor size. These findings supply evidence that manifestations of thyroid autoimmunity are associated with a beneficial effect on disease outcome in breast carcinoma and provide the strongest evidence to date of a biological link between breast carcinoma and thyroid disease.

Our favorite site about this topic remains www.breastcancerchoices.org


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