目前，良性甲状腺病对乳腺癌发病风险的影响尚不明确。
5月18日，施普林格自然旗下《乳腺癌研究与治疗》在线发表德国马尔堡大学、法兰克福艾昆纬、罗斯托克大学的研究报告，探讨了甲状腺炎、甲状腺功能亢进或甲状腺功能减退对乳腺癌发病风险的影响。
该病例对照回顾研究通过艾昆纬（由艾美仕和昆泰合并而成）疾病分析数据库，对1月～12月英国200家全科医院首次诊断乳腺癌的7408例年龄18～80岁女性进行回顾分析，其中此前已被确诊癌症并且观察期少于12个月的患者已被剔除。对照组包括7408例健康女性，按年龄、体重指数、激素补充治疗、医师与病例组患者1∶1进行配对，两组女性平均年龄均为58.4岁。主要结局指标为乳腺癌发病前的促甲状腺激素值、甲状腺功能减退、甲状腺功能亢进、甲状腺肿、甲状腺炎。通过单因素逻辑回归模型，对良性甲状腺病、促甲状腺激素值与乳腺癌之间的关系进行分析。
结果，乳腺癌女性与对照组相比：
甲状腺病比例相似：11.0%比10.5%（比值比：1.05，P=0.218）
甲状腺肿比例相似：1.4%比1.4%（比值比：1.00，P=0.487）
甲状腺炎比例较高：0.3%比0.2%（比值比：1.91，P=0.01）
甲状腺功能亢进比例相似：1.7%比1.5%（比值比：1.14，P=0.583）
甲状腺功能减退比例相似：8.3%比8.1%（比值比：1.00，P=0.431）
促甲状腺激素平均值相似：2.2比2.3（比值比：0.99，P=0.263）
因此，该流行病学研究结果表明，甲状腺炎与乳腺癌发病风险增加存在相关性，故有必要对甲状腺炎女性加强乳腺癌筛查监测。
相关链接
乳腺癌患者甲状腺自身抗体阳性率较高
甲状腺功能与乳腺甲状腺癌的因果关系
中国女性健康体检乳腺甲状腺病变风险
正常范围甲状腺功能与乳腺癌风险
复旦发现乳腺癌与甲状腺癌相关性
甲状腺继发乳腺转移癌一例并文献复习
关注乳腺癌患者甲状腺疾病的筛查与诊治
甲状腺功能亢进症可能增加乳腺癌风险
Breast Cancer Res Treat. May 18. [Epub ahead of print]
Association between thyroid gland diseases and breast cancer: a case-control study.
Laura Bach, Karel Kostev, Leif Schiffmann, Matthias Kalder.
Philipps University of Marburg, Marburg, Germany; IQVIA, Frankfurt, Germany; University of Rostock, Rostock, Germany.
BACKGROUND: At the present time, there is no consensus on the association between benign thyroid diseases and breast cancer (BC). Therefore, the aim of this study is to help shed some light on the association between hyperthyroidism, hypothyroidism, and thyroiditis and breast cancer risk.
METHODS: Use of the Disease Analyzer database (IQVIA) enabled us to perform a retrospective case-control study of 7408 women aged between 18 and 80, who were treated for an initial breast cancer diagnosis in a general practice in the United Kingdom between and (index date). Patients with a previous cancer diagnosis and an observation time of less than 12 months prior to the index date were excluded. The control group consisted of 7408 healthy women, who were matched to cases 1:1 by age, body mass index, hormone replacement therapy, and physician. The main outcome parameters of this study were the presence of thyroid disease (hypothyroidism, hyperthyroidism, struma, and thyroiditis) and the TSH values in the two groups. A univariate logistic regression model was used to investigate the association between benign thyroid diseases, TSH values, and BC.
RESULTS: The mean age was 58.4 years in both groups. We found a significant association between thyroiditis and BC (OR: 1.91, p=0.01) and were able to refute the association between hyperthyroidism/hypothyroidism and BC. We also found that thyroid-stimulating hormone (TSH) had no significant effect on breast cancer risk.
CONCLUSION: Many experimental studies suggest a link between hyperthyroidism/hypothyroidism and BC. We were able to demonstrate an epidemiological association between thyroiditis and an increased BC risk. This shows the need for close monitoring for BC in women with thyroiditis.
KEYWORDS: Breast cancer, Benign thyroid disease, Thyroiditis, Hyperthyroidism, Hypothyroidism
DOI: 10.1007/s10549-020-05675-6
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