Deciphering the Risk of Developing Second Primary Thyroid Cancer Following a Primary Malignancy—Who Is at the Greatest Risk?

Trinh, Lily N.; Crawford, Andrew; Hussein, Mohammad; Zerfaoui, Mourad; Toraih, Eman A.; Randolph, Gregory W.; Kandil, Emad

doi:10.3390/cancers13061402

Cited by 14 publications

(20 citation statements)

References 55 publications

(45 reference statements)

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“…Primarily, such connections have generated much interest around the possibility of identifying common genetic and environmental factors responsible for the etiology and progression of these diseases. In particular, a number of different reports have described the association between thyroid cancers and other primary EM, including breast cancer (BC) [1][2][3][4]. This has led to the hypothesis that the long-term carcinogenic effects of anticancer treatments could be responsible for a second primary cancer.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Diseases and Breast Cancer

Baldini

Lauro

Tripodi

et al. 2022

JPM

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Epidemiological studies aimed at defining the association of thyroid diseases with extra-thyroidal malignancies (EM) have aroused considerable interest in the possibility of revealing common genetic and environmental factors underlying disease etiology and progression. Over the years, multiple lines of evidence indicated a significant relationship between thyroid carcinomas and other primary EM, especially breast cancer. For the latter, a prominent association was also found with benign thyroid diseases. In particular, a meta-analysis revealed an increased risk of breast cancer in patients with autoimmune thyroiditis, and our recent work demonstrated that the odds ratio (OR) for breast cancer was raised in both thyroid autoantibody-positive and -negative patients. However, the OR was significantly lower for thyroid autoantibody-positive patients compared to the negative ones. This is in agreement with findings showing that the development of thyroid autoimmunity in cancer patients receiving immunotherapy is associated with better outcome and supports clinical evidence that breast cancer patients with thyroid autoimmunity have longer disease-free interval and overall survival. These results seem to suggest that factors other than oncologic treatments may play a role in the initiation and progression of a second primary malignancy. The molecular links between thyroid autoimmunity and breast cancer remain, however, unidentified, and different hypotheses have been proposed. Here, we will review the epidemiological, clinical, and experimental data relating thyroid diseases and breast cancer, as well as the possible hormonal and molecular mechanisms underlying such associations.

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Section: Introductionmentioning

confidence: 99%

Thyroid Diseases and Breast Cancer

Baldini

Lauro

Tripodi

et al. 2022

JPM

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“…32 In the recent detailed review of 40 studies encompassing 1,613,945 patients, females were more likely to develop a second primary thyroid cancer (RR = 1.58, 95% CI, 1.2-2.01). 21 In our study, the female:male ratio was derived from among patients with thyroid cancer as a second malignancy. This cohort of patients included individuals with history of exposure to therapeutic radiation.…”

Section: Discussionmentioning

confidence: 99%

“…32 In the recent detailed review of 40 studies encompassing 1,613,945 patients, females were more likely to develop a second primary thyroid cancer (RR = 1.58, 95% CI, 1.2–2.01). 21…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, a greater risk of developing a second malignancy as thyroid cancer was found following primary breast (56.6%, 95% CI, 44.3–68.9, p < 0.001), renal cell (12.2%, 95% CI, 7.68–16.8, p < 0.001), basal cell (7.79%, 95% CI, 1.79–13.7, p = 0.011), and ovarian cancer (11.4%, 95% CI, 3.4–19.5, p = 0.005). 21…”

Section: Discussionmentioning

confidence: 99%

“…The mean latency period for development of second thyroid cancer was 9 year (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In PedCa and AdCa patients, the latency periods were 10.8 (range, 3-16) years, and 9.5 (range, 3-22) years, respectively, p = 0.64.…”

Section: Clinico-pathological Characteristics Of Patients With Thyroid Cancermentioning

confidence: 99%

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Clinical and molecular characterization of thyroid cancer when seen as a second malignant neoplasm

Romanelli

Wells

Patel

et al. 2021

Therapeutic Advances in Endocrinology

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Background: Second malignant neoplasms (SMN) are among the most serious long-term adverse health conditions in cancer survivors. The aim of this study was to characterize clinical findings of patients who developed thyroid cancers as SMN, and to examine genomic alterations in thyroid cancer tissue. Methods: Retrospective analysis of medical records from patients seen for management of thyroid cancer over 10-year period was performed. Clinical and pathologic data were retrieved from their medical charts. Tumor DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissue and subjected to next-generation sequencing (NGS) using Ion Torrent Oncomine Focus Assay. Microfluidic digital polymerase chain reactions (PCRs) were performed using QIAcuity Digital PCR System to identify BRAFV600E mutations and RET/PTC fusions. Results: Sixteen of 620 patients operated for thyroid cancer had history of previously diagnosed malignancy. Eight patients were male and eight patients were female, with a median age at diagnosis of 58.5 years (range, 4–78). Four patients had history of pediatric malignancy (PedCa), and 12 patients had a history of prior malignancy as an adult (AdCa). The latency periods for development of SMN in PedCa and AdCa patients were 10.8 (±5.2) years and 9.5 (±5.2) years, respectively. Histopathology revealed papillary thyroid cancers in 15 cases, and follicular thyroid cancer in 1 case. All tumors were classified as T1 or T2, and there were no patients presenting with metastases at the time of surgery. Genomic alterations were detected in 13/16 (81.2%) tumors including eight gene mutations ( BRAFV600E (N = 4), RAS (N = 2), PI3CA (N = 2) and five gene fusions ( RET/PTC1 (N = 4) and STRN/ALK (N = 1). In patients with PedCa and AdCa, mutations were detected in 1/4 (25%) and 7/12 (58.3%), respectively, p = 0.56; and fusions were detected in 3/4 (75%) and 2/12 (16.6%), respectively, p = 0.06. In patients with and without history of therapeutic irradiation, mutations were detected with the same frequencies (5/10 (50%), and 3/6 (50%), respectively, p = 1.0). Gene fusions were detected in patients with and without history of irradiation in 5/10 (55.5%) and 0/6 (0%), respectively, p = 0.09. Conclusions: Monitoring of cancer survivors for thyroid disorders allowed diagnosis of second thyroid cancers at early stages. Second thyroid cancers harbor genomic alterations that are typical for sporadic as well as for radio-induced thyroid cancers.

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Use of multikinase inhibitors/lenvatinib in patients with synchronous/metachronous cancers coinciding with radioactive‐resistant differentiated thyroid cancer

Sambo

2022

Cancer Medicine

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The entity of multiple neoplasms is not rare or new, having been first described by Billroth in 1889 1 and further reported on by Owen 2 in 1921.Multiple primary malignant neoplasm (MPMN) is defined as more than one primary histologically distinct malignant tumor that occurs in a single individual and may include solid cancers and hematologic malignancies. MPMN can be divided into two categories (based on International Association of Cancer Registries and International Agency for Research on Cancer definitions):(i) synchronous -malignancies occurring within 6 months of a previous malignant neoplasm; and (ii) metachronous -defined as malignancies occurring more than 6 months apart. 3 The prevalence of MPMN is reported to be 2%-17%. 3-5 It is expected that the prevalence of MPMN (mainly metachronous) will increase in the future due to increasingly aging populations combined with improved cancer survival, improved diagnostic tests, increasingly sophisticated treatment, better screening, and enhanced surveillance of patients with previous cancer.

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Deciphering the Risk of Developing Second Primary Thyroid Cancer Following a Primary Malignancy—Who Is at the Greatest Risk?

Cited by 14 publications

References 55 publications

Thyroid Diseases and Breast Cancer

Thyroid Diseases and Breast Cancer

Clinical and molecular characterization of thyroid cancer when seen as a second malignant neoplasm

Use of multikinase inhibitors/lenvatinib in patients with synchronous/metachronous cancers coinciding with radioactive‐resistant differentiated thyroid cancer

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