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Peckham M, Spencer HJ, Syed S, Armstrong WB, Farwell DG, Gal TJ, Goldenberg D, Russell MD, Solis RN, King D, Stack BC. Breast and thyroid cancer: A multicenter study with Accrual to Clinical Trials Network. J Surg Oncol 2022; 125:1211-1217. [PMID: 35195923 DOI: 10.1002/jso.26825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/06/2022] [Accepted: 02/03/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate a possible link between breast and thyroid cancer. METHODS A multicenter retrospective review of patients in the electronic medical records of six Accrual to Clinical Trial (ACT) institutions with both breast cancer and thyroid carcinoma. Each center queried its data using a predefined data dictionary. Information on thyroid and breast cancer included dates of diagnosis, histology, and patient demographics. RESULTS A random-effects model was used. There were 4.24 million women's records screened, 44 605 with breast cancer and 11 846 with thyroid cancer. The relative risks observed at each institution ranged from 0.49 to 13.47. The combined risk ratio (RR) estimate was 1.77 (95% confidence interval: 0.50-5.18). CONCLUSION There was no association between the risk of developing thyroid cancer and being a breast cancer survivor compared to no history of breast cancer, but the range of relative risks among the participating institutions was wide. Our findings warrant further study of more institutions with larger sample size. Additionally, further analysis of the significance of regional RR differences may be enlightening.
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Affiliation(s)
- Merry Peckham
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Horace J Spencer
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Shorabuddin Syed
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - William B Armstrong
- Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, USA
| | - Donald Gregory Farwell
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas J Gal
- Department of Otolaryngology - Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - David Goldenberg
- Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Marika D Russell
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Roberto N Solis
- Department of Otolaryngology - Head and Neck Surgery, University of California, Davis, Davis, California, USA
| | - Deanne King
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Brendan C Stack
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Otolaryngology - Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
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Comparison of Incidental Thyroid Nodules Between Early Breast Cancer Patients and Healthy Controls: Higher Incidence and Thyroid Imaging Reporting and Data System (TI-RADS) Score of Patients with Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.113500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Breast and thyroid cancers remain among the most common malignancies in women. In previous studies, the co-occurrence of thyroid and breast cancers has been reported. Objectives: The aim of this study was to evaluate and compare the risk and incidence of incidental thyroid nodules (ITNs) between patients with breast cancer and healthy controls, based on the Thyroid Imaging Reporting and Data System (TI-RADS). Methods: This case-control study was conducted on 140 patients with breast cancer and 140 cancer-free women in a similar age range. Thyroid ultrasonography (US) was performed before the onset of treatment. The risk stratification of thyroid nodules was based on the TI-RADS. Results: The mean age of the participants was not significantly different between the case (43.35 ± 7.85 years) and control (42.11 ± 3.69 years) groups (P = 0.094). Invasive ductal carcinoma was the most frequent type of breast cancer in the patients. Normal thyroid US findings were significantly less frequent in patients with breast cancer (35.7%) compared to the healthy controls (76.4%) (P = 0.001). On the other hand, thyroid nodules were more frequent in the patients and associated with a higher risk of malignancy (i.e., high TI-RADS scores) compared to healthy women (P = 0.001 and P = 0.001, respectively). Besides, patients with breast cancer showed more thyroid abnormalities in the US examinations. Conclusions: A higher frequency of ITN, with an elevated TI-RADS score, which raised the suspicion of malignancy, was seen in patients with breast cancer. Overall, patients with breast cancer may benefit from a regular thyroid US examination.
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Zhou L, Chen L, Xu D, Shao Q, Guo Z, Ge M. Breast cancer metastasis to thyroid: a retrospective analysis. Afr Health Sci 2017; 17:1035-1043. [PMID: 29937874 PMCID: PMC5870294 DOI: 10.4314/ahs.v17i4.11] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Breast cancers metastasizing to thyroid gland are relatively uncommon in clinical practice. Objective Retrospective analysis of data from breast cancer patients with thyroid metastasis (TM). Methods The US suspected, fine-needle aspiration cytology (FNAC) confirmed TM in breast cancer patients, treated between 2005 and 2015 at our hospital, was retrospectively analyzed. The data were re-evaluated by the pathologist and radiologist who were blinded to the patients' data. Results FNAC and immunohistochemistry confirmed the ultrasonography (US) suspected TM in eight breast cancer patients. Clinically both unilateral and bilateral TM was seen, which were symptomless and metachronously (6–121 months) metastasized. Six of eight cases exhibited recurrence/distant metastasis and were treated with chemotherapy/thyroidectomy of which two cases passed away. The remaining two patients had no recurrences/distant metastases and were treated with partial/total thyroidectomy. Post-chemotherapy US showed more homogenous thyroid parenchyma with gathering of calcification that reduced in size, revealing the sensitiveness of TM to chemotherapy. Conclusion US was useful in screening TM in breast cancer patients. Both partial and total thyroidectomy was effective in disease free survival of isolated TM cases, with controlled primary condition. TM responded well to chemotherapy in most of the recurrent breast cancer cases with or without distant metastasis.
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Affiliation(s)
- Lingyan Zhou
- Department of Ultrasound, Zhe Jiang Cancer Hospital affiliated to Zhejiang Chinese Medical University, Guangji road 38, GongShuQu, Hangzhou 310022, Zhejiang, China
| | - Liyu Chen
- Department of Ultrasound, Zhe Jiang Cancer Hospital affiliated to Zhejiang Chinese Medical University, Guangji road 38, GongShuQu, Hangzhou 310022, Zhejiang, China
| | - Dong Xu
- Department of Ultrasound, Zhe Jiang Cancer Hospital affiliated to Zhejiang Chinese Medical University, Guangji road 38, GongShuQu, Hangzhou 310022, Zhejiang, China
| | - Qi Shao
- Department of Pathology, Zhe Jiang Cancer Hospital, Hangzhou, Zhe jiang province, China
| | - Zhenying Guo
- Department of Pathology, Zhe Jiang Cancer Hospital, Hangzhou, Zhe jiang province, China
| | - Minghua Ge
- Department of Head and Neck surgery, Zhe Jiang Cancer Hospital, Hangzhou, Zhe jiang province, China
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Higher urinary bisphenol A concentration and excessive iodine intake are associated with nodular goiter and papillary thyroid carcinoma. Biosci Rep 2017; 37:BSR20170678. [PMID: 28684549 PMCID: PMC5529210 DOI: 10.1042/bsr20170678] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 12/31/2022] Open
Abstract
In the present study, we investigated whether bisphenol A (BPA) levels and excessive iodine intake were associated with papillary thyroid carcinoma (PTC) and nodular goiter (NG). We determined total BPA concentrations (TBC) in paired serum and urine samples, and urinary iodine concentrations (UIC) in urine samples collected from PTC patients, NG patients, and healthy individuals, then compared BPA concentrations and UIC within and between each patient group. The results showed that there were no gender-specific differences in serum TBC and UIC in each group, and no differences across all patient groups. Urinary BPA concentrations (UBC) were higher in the NG and PTC groups compared with the control group. UBC showed gender-specific differences in the NG and PTC group. Furthermore, UIC were higher in the NG and PTC groups compared with the control group. Higher UBC and excessive iodine intake were risk factors for NG and PTC according to multivariate logistic regression analysis. There was a significant correlation between UBC and UIC in each group. These data suggested that higher UBC and excessive iodine intake are associated with NG and PTC. The metabolic and functional pathways between BPA and iodine are potentially linked to the pathogenesis and progression of NG and PTC.
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Evaluation of thyroid cancer in Chinese females with breast cancer by vascular endothelial growth factor (VEGF), microvessel density, and contrast-enhanced ultrasound (CEUS). Tumour Biol 2014; 35:6521-9. [DOI: 10.1007/s13277-014-1868-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 03/18/2014] [Indexed: 01/08/2023] Open
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Park CM, Lee YD, Oh EM, Kim KI, Park HK, Ko KP, Chung YS. The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer. Ann Surg Treat Res 2014; 86:169-76. [PMID: 24783175 PMCID: PMC3996722 DOI: 10.4174/astr.2014.86.4.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/13/2013] [Accepted: 10/24/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Due to the increased prevalence of thyroid cancer, it has been frequently detected in breast cancer patients recently. The aim of this study was to evaluate the clinicopathologic characteristics of thyroid cancer in breast cancer patients with respect to prognosis and treatment. METHODS From August 1998 to September 2012, 101 breast cancer patients were diagnosed with thyroid cancer (BT group). One hundred ninety-three female patients with a thyroid malignancy that underwent thyroidectomy in 2008 were recruited as controls (oT group). The clinicopathologic results of these two groups were compared. RESULTS Patients were older (51.40 vs. 47.16, P < 0.001), mean tumor size was smaller (0.96 cm vs. 1.43 cm, P < 0.001), and extrathyroidal extension was less common in the BT group. In both groups, papillary thyroid carcinoma was the most common type of thyroid malignancy. T and N classifications of thyroid cancer were less severe in the BT group, but group TNM stages were similar. Endoscopic thyroid surgery was performed in 12.9% of patients in the BT group and in 6.7% of patients in the oT group. Postoperative radioactive iodine ablation was performed less often in the BT group (P < 0.001). Group recurrence rates were not significantly different. CONCLUSION Thyroid cancer in breast cancer patients was diagnosed at earlier status than ordinary thyroid cancer. However, the prognosis of thyroid cancer in breast cancer patients was not superior to that in patients with thyroid cancer alone. Radioactive iodine ablation was performed less often and endoscopic surgery could be performed in breast cancer patients.
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Affiliation(s)
- Chang Min Park
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea
| | - Young Don Lee
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Eun Mee Oh
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kwan-Il Kim
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Heung Kyu Park
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gachon University School of Medicine, Gachon University, Incheon, Korea
| | - Yoo Seung Chung
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Brito JP, Davies L, Zeballos-Palacios C, Morris JC, Montori VM. Papillary lesions of indolent course: reducing the overdiagnosis of indolent papillary thyroid cancer and unnecessary treatment. Future Oncol 2014; 10:1-4. [DOI: 10.2217/fon.13.240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Juan P Brito
- Knowledge & Evaluation Research Unit, Division of Diabetes, Metabolism & Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Louise Davies
- VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT, USA
| | - Claudia Zeballos-Palacios
- Knowledge & Evaluation Research Unit, Division of Diabetes, Metabolism & Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - John C Morris
- Division of Endocrinology, Diabetes, Metabolism & Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Victor M Montori
- Knowledge & Evaluation Research Unit, Division of Diabetes, Metabolism & Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Kweon SS, Shin MH, Chung IJ, Kim YJ, Choi JS. Thyroid cancer is the most common cancer in women, based on the data from population-based cancer registries, South Korea. Jpn J Clin Oncol 2013; 43:1039-46. [PMID: 23894204 DOI: 10.1093/jjco/hyt102] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Similar to worldwide trends, the incidence of thyroid cancer in South Korea has increased steadily in recent decades. We examined the trends in thyroid cancer incidence in Gwangju and Jeonnam provinces between 1996 and 2010, and identified 19 881 cases (men 3282/16.5%; women 16 599/83.5%) from the Gwangju Cancer Registry and Jeonnam Cancer Registry databases, which are population-based cancer registries. Age-standardized incidence rates per 100 000 persons, using hypothetical world standard population (Segi), increased from 1.9 in 1996 to 27.0 in 2010 in men, and from 10.6 to 111.3 in women, respectively. The estimated annual percentage changes (95% confidence interval) of age-standardized incidence rates were 27.1% (24.6-29.6) and 19.7% (16.4-23.2) for men and women, respectively, during the same period. The proportion of papillary-type thyroid cancer increased from 74.2 and 75.4% in 1996 to 97.9 and 98.3% in 2010 for men and women, respectively. We found the most prominent increasing trends and the highest incidence rate of thyroid cancer among those that have ever been reported. Thyroid cancer has been the leading cancer in women since 2003 and is now the fifth most common cancer in men in Gwangju and Jeonnam, South Korea.
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Affiliation(s)
- Sun-Seog Kweon
- *Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseok-ro, Dong-gu, Gwangju, South Korea.
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Chandrasekhar SS, Randolph GW, Seidman MD, Rosenfeld RM, Angelos P, Barkmeier-Kraemer J, Benninger MS, Blumin JH, Dennis G, Hanks J, Haymart MR, Kloos RT, Seals B, Schreibstein JM, Thomas MA, Waddington C, Warren B, Robertson PJ. Clinical Practice Guideline. Otolaryngol Head Neck Surg 2013; 148:S1-37. [DOI: 10.1177/0194599813487301] [Citation(s) in RCA: 289] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective Thyroidectomy may be performed for clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. About 1 in 10 patients experience temporary laryngeal nerve injury after surgery, with longer lasting voice problems in up to 1 in 25. Reduced quality of life after thyroid surgery is multifactorial and may include the need for lifelong medication, thyroid suppression, radioactive scanning/treatment, temporary and permanent hypoparathyroidism, temporary or permanent dysphonia postoperatively, and dysphagia. This clinical practice guideline provides evidence-based recommendations for management of the patient’s voice when undergoing thyroid surgery during the preoperative, intraoperative, and postoperative period. Purpose The purpose of this guideline is to optimize voice outcomes for adult patients aged 18 years or older after thyroid surgery. The target audience is any clinician involved in managing such patients, which includes but may not be limited to otolaryngologists, general surgeons, endocrinologists, internists, speech-language pathologists, family physicians and other primary care providers, anesthesiologists, nurses, and others who manage patients with thyroid/voice issues. The guideline applies to any setting in which clinicians may interact with patients before, during, or after thyroid surgery. Children under age 18 years are specifically excluded from the target population; however, the panel understands that many of the findings may be applicable to this population. Also excluded are patients undergoing concurrent laryngectomy. Although this guideline is limited to thyroidectomy, some of the recommendations may extrapolate to parathyroidectomy as well. Results The guideline development group made a strong recommendation that the surgeon should identify the recurrent laryngeal nerve(s) during thyroid surgery. The group made recommendations that the clinician or surgeon should (1) document assessment of the patient’s voice once a decision has been made to proceed with thyroid surgery; (2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, if the patient’s voice is impaired and a decision has been made to proceed with thyroid surgery; (3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery if the patient’s voice is normal and the patient has (a) thyroid cancer with suspected extrathyroidal extension, or (b) prior neck surgery that increases the risk of laryngeal nerve injury (carotid endarterectomy, anterior approach to the cervical spine, cervical esophagectomy, and prior thyroid or parathyroid surgery), or (c) both; (4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery; (5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery; (6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery; (7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery; (8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery; (9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery; (10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation. The group made an option that the surgeon or his or her designee may monitor laryngeal electromyography during thyroid surgery. The group made no recommendation regarding the impact of a single intraoperative dose of intravenous corticosteroid on voice outcomes in patients undergoing thyroid surgery.
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Affiliation(s)
| | - Gregory W. Randolph
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Michael D. Seidman
- Department of Otolaryngology, Henry Ford Medical Center, West Bloomfield, Michigan, USA
| | - Richard M. Rosenfeld
- Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Peter Angelos
- University of Chicago Medical Center, Chicago, Illinois, USA
| | | | | | - Joel H. Blumin
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - John Hanks
- University of Virginia, School of Medicine, Charlottesville, Virginia, USA
| | - Megan R. Haymart
- Department of Internal Medicine, Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Brenda Seals
- Native American Cancer Research, Denver, Colorado, USA
| | - Jerry M. Schreibstein
- Ear, Nose and Throat Surgeons of Western New England LLC, Springfield, Massachusetts, USA
| | | | | | - Barbara Warren
- LGBT Health Services, Beth Israel Medical Center, New York, New York, USA
| | - Peter J. Robertson
- American Academy of Otolaryngology—Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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