Risk of Breast Cancer in Patients with Thyroid Cancer Receiving or Not Receiving ¹³¹I Treatment: A Nationwide Population-Based Cohort Study

Abstract

An increased risk of second primary malignancy after 131 I therapy has been reported. The objective of this study was to determine the risk of breast cancer in patients with thyroid cancer receiving or not receiving radioiodine treatment in Taiwan. Methods: This nationwide population-based cohort study was conducted using data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 10,361 female patients with thyroid cancer (3,292 did not receive 131 I treatment and 7,069 received 131 I treatment) were enrolled, and 41,444 female controls were frequency-matched to the thyroid cancer patients in a 1:4 ratio by age (5-y age group). A Cox proportional hazards model was applied to estimate the risk of breast cancer in thyroid cancer patients receiving or not receiving 131 I treatment in terms of hazard ratios and 95% and 98% confidence intervals. Results: The incidence rates of breast cancer in patients with thyroid cancer receiving 131 I therapy, those not receiving 131 I therapy, and controls were 18.9, 17.7, and 13.1 per 10,000 person-years, respectively. Compared with patients with thyroid cancer treated with a cumulative 131 I dose of 4.44 GBq or less, the risk of breast cancer was not significantly increased in those treated with a cumulative 131 I dose of more than 4.44 GBq (adjusted hazard ratio, 0.78; 95% confidence interval, 0.50-1.21, P 5 0.26; 98% confidence interval, 0.45-1.33, P . 0.02). Conclusion: The greatest increased risk of breast cancer in patients with thyroid cancer is associated with the fact that the patient has thyroid cancer regardless of 131 I administration. However, 131 I further increased that risk but not as much as just having thyroid cancer.

Association between radioiodine treatment for thyroid cancer and risk of stroke

“…First, the study was based on clinical data, but personal characteristics, such as social support, body mass index, family history, and behavioral risk of stroke (eg, smoking and alcohol consumption), were unavailable. 37 Second, because they contain many sources of inherent bias, the evidence derived from retrospective cohort studies is typically lower in statistical quality than that derived from other types of study and, thus, must be adjusted for confounding factors. Third, the registries in the NHI claims have not been verified for scientific use and are primarily used for administrative billing.…”

Breast cancer and family history for breast cancer in patients with differentiated thyroid carcinoma

“…An increased risk of second primary malignancy after RAI treatment has been reported (25). Lin et al (26) showed that patients with thyroid cancer treated with RAI had a significantly increased risk of breast cancer compared with controls. In our study, 73.8 % patients were treated with RAI and we were unable to detect a correlation between second primary breast cancer and RAI treatment.…”

The combined therapeutic effects of 131iodine-labeled multifunctional copper sulfide-loaded microspheres in treating breast cancer

“…Secondly, HCuSNPs-MS-PTX can be labeled with iodine-125 ( 125 I) as the method of labeling with 131 I. The radiolabeling process is straightforward and the radioisotope 131 I and 125 I are widely used in clinic and are easier to produce than 177 Lu 47 , 48 . Therefore, our multifunctional agent is a promising candidate to eliminate unresectable solid tumor tissues due to the synergistic effect.…”