| Background and purpose:Breast cancer and thyroid disease are common illnesses,especially in women.Both breast and thyroid gland are hormone responsive organs,It has been reported that breast cancer and thyroid diseases have some relevance.In this study,we will study the status of thyroid nodules and thyroid functions breast cancer patients at initially diagnosed stage,during chemotherapy and after systemic therapy.Method:1.All the data of female patients with breast diseases treated and accepted thyroid ultrasonography from May 2015 to January 2017 in the Department of Endocrine and Breast Surgery,the First Affiliated Hospital of Chongqing Medical University,were analyzed,including 275 cases of benign breast disease(average age:45.77±11.21),632 cases of initially diagnosed breast cancer(average age:50.16±10.76),461 breast cancer patients during chemotherapy(average age:49.34±8.85)and 233 breastcancer patients after systemic therapy(average age:51.53±9.73).At the same time,the data of 14161 healthy people who accepted thyroid ultrasonography(average age:41.48±12.58)in the Medical Examination Center of the First Affiliated Hospital of Chongqing Medical University were comparatively analyzed.2.All the 1215 female patients with breast diseases presented from May 2015 to January 2017 in the Department of Endocrine and Breast Surgery,the First Affiliated Hospital of Chongqing Medical University,and screened with thyroid function and antibody were analyzed,including726 cases of initially diagnosed breast cancer(average age:51.03±10.98),153 breast cancer patients during chemotherapy(average age:49.03±8.50)and 336 cases of benign breast disease(average age:44.5±12.23).Then the data of the thyroid function in patients with benign breast disease,initially diagnosed breast cancer and breast cancer patients during chemotherapy were comparatively analyzed.Result:1.The levels of tetraiodothyronine(T4)in patients with initially diagnosed breast cancer were higher than those in patients with benign breast diseases(p<0.001),the levels of thyroid stimulating hormone(TSH)were lower than those in patients with benign breast diseases,but without significant difference(p=0.302).During chemotherapy,the levels of T4(7.08±1.69ug/dl),free triiodothyronine(FT3)(2.87±0.48pg/ml)and freetetraiodothyronine(FT4)(0.83±0.15ng/dl)were significantly lower than those in patients with initially diagnosed breast caner(7.68±1.51ug/dl,3.07±0.50pg/ml,0.88±0.20ng/dl)(p<0.05),respectively.And the levels of TSH was also lower in the initially diagnosed breast cancer patients,but without significant difference(p=0.242).The total incidences of hypothyroidism in benign breast disease and initially diagnosed breast cancer patients were 32.74%,28.65%,respectively,but there was no significant difference(p=0.195)between them.The total incidence of hypothyroidism during chemotherapy(30.72%)was not significantly different compared with that in initially diagnosed breast cancer patients(p=0.625).2.The incidence of thyroid nodules in healthy population(34.49%,4884/14161)was obviously lower than that in benign breast disease patients(43.64%,120/275)and initially diagnosed breast cancer patients(56.17%,355/632),respectively,there was statistical difference between them(p<0.001).The incidences of thyroid nodules in breast cancer patients during chemotherapy and after systemic therapy were52.93%(244/461),55.79%(130/233),respectively,but there was no significant difference between them.3.The incidence of thyroid nodules of TI-RADS?4 in healthy population(2.87%,406/14161)was obviously lower than that in benign breast disease patients(9.45%,26/275)(p<0.001)and initially diagnosedbreast cancer patients(7.27%,46/632)(p<0.001),respectively,there were no significant statistical difference between benign breast disease patients and initially diagnosed breast cancer patients.The incidences of thyroid nodules of TI-RADS?4 in breast cancer patients during chemotherapy(11.71%,54/461)was higher than that in initially diagnosed breast cancer patients(p=0.014);the incidence in breast cancer patients after systemic therapy(6.87%,16/233)was lower than that in patients during chemotherapy(p=0.046),but there was no significant difference between benign breast disease patients and initially diagnosed breast cancer patients(p=0.883).4.The constituent ratio of TI-RADS?4 thyroid nodules in healthy population(8.3%,406/4884)was obviously lower than that in benign breast disease patients(21.67%,26/120)and initially diagnosed breast cancer patients(12.96%,46/355),respectively,there was significant statistical difference between the three groups(p<0.05).The constituent ratio of TI-RADS?4 thyroid nodules in breast cancer patients during chemotherapy(22.13%,54/244)was higher than that in initially diagnosed breast cancer patients(p=0.004);the constituent ratio of TI-RADS?4 thyroid nodules in patients after systemic therapy(12.30%,16/130)was lower than that in patients during chemotherapy(p=0.025),but was no significant difference between patients after systemic therapy and at initially diagnosed breast cancer(p=1).Conclusion:1.The thyroid function status in initially diagnosed breast cancer patients was slightly higher than that in patients with benign breast disease.At the same time,the incidence of hypothyroidism was also higher in the initially diagnosed breast cancer patients.2.The thyroid function of breast cancer patients during chemotherapy declined significantly,suggesting that chemotherapeutic drugs may inhibit the secretion of thyroid or inhibit the hypothalamus-pituitary-thyroid axis.3.The incidences of thyroid nodules in initially diagnosed breast cancer patients and benign breast disease patients were significantly higher than that in the healthy population,and the incidence of thyroid nodules in initially diagnosed breast cancer patients was also significantly higher than that in benign breast disease patients.It is suggested that the breast diseases,especially breast cancer,may be related to the occurrence of thyroid nodules;and the metabolic activity of breast cancer cells may further stimulate the occurrence of thyroid nodules.4.The incidences of TI-RADS?4 thyroid nodules in initially diagnosed breast cancer patients and benign breast disease patients were significantly higher than that in the healthy population,but there were no significant difference between benign breast disease patients and initially diagnosed breast cancer patients.The incidences of TI-RADS?4 thyroid nodules in breast cancer patients during chemotherapy is significantly higher thanthat in initially diagnosed breast cancer patients,but after systemic therapy the thyroid nodules downgrade,suggesting chemotherapy drugs may cause thyroid nodule distortion during chemotherapy.5.More attention should be paid to screening thyroid function and thyroid nodules in patients with breast cancer patients(initially diagnosis,during chemotherapy and after systemic treatment).At the same time,it is also necessary to pay attention to screen thyroid function and thyroid nodules in patients with benign breast disease. |
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