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    Home > Active Ingredient News > Endocrine System > Front Endocrinol: the relationship between benign thyroid disease and breast cancer risk

    Front Endocrinol: the relationship between benign thyroid disease and breast cancer risk

    • Last Update: 2023-01-04
    • Source: Internet
    • Author: User
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    Background: In 2020, the latest data from the World Health Organization's International Agency for Research on Cancer (IARC) showed that the number of breast cancer (BC) patients had increased to 2.
    26 million, making it the most common cancer
    in the world.
    Therefore, it is important
    to identify possible risk factors, prevent them in time, and reduce the incidence of BC.
    Many risk factors, such as age, sex, estrogen, family history, genetic mutations, and unhealthy lifestyle habits, have been shown to increase the probability
    of BC.
    Since both the thyroid and breast glands are regulated by the hypothalamic-pituitary-glandular axis, there may be some intrinsic connection and interaction
    between BC and benign thyroid disease (BTD).
    The first to propose a link between BTD and BC was Schottenfeld et al
    .
    While it failed to prove the relationship between the two, it provided new insights
    for later researchers.
    However, the results of the available studies are inconsistent
    .
    Some studies have shown that BTD increases the risk of BC, while some studies suggest that BTD reduces the risk of
    BC.
    In addition, some studies have found no link
    between BTD and BC risk.
    Therefore, whether BTD increases the risk of BC requires further research
    .

    A meta-analysis published in 2012 by Hardefeldt et al.
    confirmed a positive association
    between autoimmune thyroiditis (AITD), goiter, and antithyroid antibodies and the risk of BC.
    However, the effects of Graves disease (GD), hypothyroidism, and hyperthyroidism on the risk of BC have not been elucidated, and the relationship between BTD and BC aggressiveness is unclear
    .
    In addition, recently published high-quality clinical studies were not included in previous meta-analyses, adding justification
    to the performance of current studies.

    Purpose: Therefore, our meta-analysis aimed to systematically review and assess the impact of different types of BTD on the risk of BC, including the latest research findings, and subgroup analyses
    based on different regions.
    Compared with existing studies, we further identify the potential relationship between BTD and BC aggressiveness based on different markers of BC aggressiveness, which is of great significance
    in clinical practice.

    Methods: A systematic literature search (PubMed, Web of Science, MEDLINE, and Embase databases) identified studies
    assessing the association between BTD and BC risk.
    Data were analyzed using version 16.
    0 of the STATA software, including odds ratios (OR) and their corresponding 95% confidence intervals (ci).

    Included studies were assessed
    for publication bias and quality.

    Results: A total of 18 studies involving 422,384 patients with
    BTD were included.
    The results showed autoimmune thyroiditis (OR: 2.
    56, 95%CI: 1.
    95 ~ 3).

    I2 = 0.
    0%, p = 0.
    460), goiter (OR: 2.
    13, 95% ci: 1.
    19 3
    .
    I2 = 80.
    6%, p=0.
    000), Graves disease (OR: 5.
    01, 95% CI: 1.
    49-16).

    I2 = 0.
    0%, p=0.
    358) was associated with
    a higher risk of BC.
    Hypothyroidism (OR: 0.
    82, 95% CI: 0.
    64 to 1.
    04, I2 = 85.
    0%, p=0.
    000) and hyperthyroidism (OR: 1.
    07, 95% CI: 0.
    93-1).

    I2 = 24.
    9%, p=0.
    206) was not significantly associated
    with BC risk.
    In addition, pooled analysis showed no significant correlation
    between BTD and BC aggressiveness.
    However, subgroup analysis showed that BTD in the European subgroup was positively correlated with BC aggressiveness (HR: 2.
    05, 95% CI: 1.
    32-3
    .
    I2 = 86.
    4%, p=0.
    000)

    Figure 1 (A) Forest plot
    used to assess the relationship between BTD and breast cancer.
    (B) Forest plot
    used to assess the relationship between GD and breast cancer.
    (C) Subgroup analysis
    of BTD and BC risk in different regions.

    Figure 2 Sensitivity analysis
    of BTD and BC risks.

    Fig.
    3 (A) BTD and aggressiveness
    of breast cancer.
    (B) Subpopulation analysis
    of BC and aggressiveness by different types of BTD.
    (C) Analysis
    of invasive subpopulations of BC in different regions.
    a = grade II, b = grade III, c = tumor> 20 mm, d = lymph node metastases, e = estrogen receptor negative, f = progesterone receptor negative
    .

    Figure 4 Assessment of publication bias
    .
    No publication bias
    was found in the subgroups of (A) autoimmune thyroiditis; (B) goiter; (C) hypothyroidism; (D) hyperthyroidism (autoimmune thyroiditis (p=0.
    857), hypothyroidism (p=0.
    287), and hyperthyroidism (p=0.
    754).
    The goiter subgroup had publication bias, with a p-value of 0.
    019).

    Conclusions: Autoimmune thyroiditis, goiter and Graves disease are associated with
    an increased risk of BC.
    In addition, subgroup analysis showed that BTD geographically increased the aggressiveness
    of BC in the European population.
    However, further research is needed to prove these findings
    .

    Han M, Wang Y, Jin Y, et al.
    Benign thyroid disease and the risk of breast cancer: An updated systematic review and meta-analysis Front Endocrinol (Lausanne) 2022; 13

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