Favorable predictive value of thyroid autoimmunity in high aggressive breast cancer

Abstract

A high incidence of anti-thyroid antibodies (TAb) has been found in patients with breast cancer (BC). The aim of this study was to evaluate the prognostic value of TAb in a group of 47 women submitted to mastectomy for high malignancy degree BC. All patients were evaluated for thyroid disorders after breast surgery and before any anti-tumoral adjuvant therapy. Five yr after BC diagnosis 31/47 (65.9%) patients were alive (survivors group: SG) and 16/47 (34.1%) were dead (deaths group: DG). The overall prevalence of TAb was 15/47 (31.9%): 14/31 (45.1%) in SG and 1/16 (6.2%) in DG (p=0.008). Five-yr mortality was 15/32 (46.9%) in TAb- and 1/15 (6.7%) in TAb+ patients (p=0.01). Eight out of 47 (17.0%) patients had Hashimoto's thyroiditis and 7 of them (87.5%) were in SG. Estrogen receptor (ER) was measured in 43/47 (91.5%) BC specimens. ER was detected in 19/30 (63.0%) patients in SG and 3/13 (23.1%) in DG (p=0.01). Five-yr mortality was 10/21 (47.6%) in ER- and 3/22 (13.6%) in ER+ patients (p=0.008). Absence of ER expression [odds ratio (OR) 6.54; p=0.006] and absence of TAb (OR 9.37; p=0.03) were related to a higher mortality rate. TAb were detected in 8/21 (38.1%) ER- and in 7/22 (31.8%) ER+ patients; no relation was found between ER expression and TAb positivity (p=ns). Patients with ER+ and TAb+ have a better prognosis and the absence of a significant relationship between these two parameters suggests an independent prognostic role in high malignancy degree BC women.

Is there an association between thyroid function abnormalities and breast cancer?

“…In particular, TPO mRNA and protein have been found to be weakly but clearly expressed in BC tissues, peri-tumor tissues and in fat depots, and although they lack their functional activity, they maintain their antigenic role and can trigger B lymphocytes (37). Clinically, TPO-Abs have been associated with both an increased risk of BC (8,9,38) and a lower risk of BC; in some cases, TPO-Abs have even been associated with a lower frequency of distant metastases (39), a better outcome and better overall survival (27,38). Our data did not find an association between thyroid autoantibodies and risk of BC, which is consistent with a prospective study by Kuijpens and cols.…”

Triiodothyronine levels in relation to mortality from breast cancer and all causes: a population-based prospective cohort study

“…These findings on recurrence-free survival and overall survival in relation to TPO-Ab status were not confirmed by Jiskra et al (7), including 84 patients where 11 died. Fiore et al (6) and Jiskra et al (7) also investigated T 4 levels and TSH in relation to overall survival, but they found no clear associations. A problem in the interpretation of the above studies is that thyroid hormones, TSH and TPO-Ab, may indeed be affected by prevalent breast cancer, stress, or treatment.…”

“…survival following breast cancer, but they found no clear associations (6,7). A problem in studies measuring thyroid hormones in breast cancer patients is, however, that the disease per se, surgery, or adjuvant treatment may affect hormonal levels.…”

Incidental Diffuse Thyroid 18F-FDG Uptake Related to Autoimmune Thyroiditis May Be a Favorable Prognostic Factor in Advanced Breast Cancer

“…Interestingly, previous studies have demonstrated that the presence of autoimmune thyroid disorders is associated with a good prognosis in breast cancer patients (8,12,13). Thus, this study was conducted to determine whether incidental diffuse uptake of 18 F-FDG in the thyroid may have a good prognostic value in the outcomes of breast cancer patients.…”