Changes Of Thyroid Function In Patients With Breast Cancer After Adjuvant Chemotherapy

Objective: breast cancer is the most common malignant tumor in women,and thyroid disease also occurs in women.Thyroid hormones have been linked to the development of breast cancer.It has been suggested that the active hypothalamic-pituitary axis increases susceptibility to thyroid dysfunction during systemic chemotherapy.The purpose of this study was to investigate the changes of thyroid function and thyroid nodules in breast cancer patients after adjuvant chemotherapy.Methods:1.108 patients with newly diagnosed breast cancer,140 patients with benign breast disease and 102 patients with breast cancer after adjuvant chemotherapy were included in the department of breast and thyroid surgery,affiliated hospital of qinghai university from October 2017 to November 2019 who received thyroid function examination.To analyze and compare the thyroid function of newly diagnosed breast cancer patients,benign breast disease patients and breast cancer patients after adjuvant chemotherapy.2.A total of 86 patients with newly diagnosed breast cancer,149 patients with benign breast disease and 103 patients with breast cancer after adjuvant chemotherapy were enrolled in the department of breast and thyroid surgery,affiliated hospital of qinghai university from October 2017 to November 2019 who received thyroid ultrasound examination.The thyroid nodule incidence,ti-rads ?4 thyroid nodule incidence and the proportion of ti-rads ?4 thyroid nodule in the three groups of patients with newly diagnosed breast cancer,benign breast disease and breast cancer after adjuvant chemotherapy were compared.Results: 1.The level of free triiodine-thyrogenic acid(FT3)in patients with newly diagnosed breast cancer(2.75±0.41 pg/ ml)was significantly lower than that in patients with benign breast disease(2.86±0.43 pg/ ml,p < 0.05).The total thyroxine(TT4)levels(6.24±1.12ug/d L)and free thyroxine(FT4)levels(0.95±0.11ng/d L)in breast cancer patients after adjuvant chemotherapy were significantly lower than those in patients with newly diagnosed breast cancer(p < 0.05).2.The incidence of thyroid nodules was 58.13%(50/86)in patients with newly diagnosed breast cancer,which was significantly higher than that in patients with benign breast disease(42.28%(63/149).There was a statistical difference between the two groups(p < 0.05).The incidence of thyroid nodules in patients with breast cancerafter adjuvant chemotherapy was 71.84%(74/103),significantly higher than that in patients with newly diagnosed breast cancer(58.13%(50/86),and there was a statistical difference between the two groups(p < 0.05).3.There was no statistically significant difference in the incidence of thyroid nodules with ti-rads ?4 between the newly diagnosed breast cancer patients and the benign breast disease patients(p=0.603),which were 9.30%(8/86)and 7.38%(11/149),respectively.There was no significant difference in the proportion of ti-rads ?4 thyroid nodules in thyroid nodules between the two groups(p=0.837),which were 16%(8/50)and 17.4%(11/63),respectively.The incidence of thyroid nodules with ti-rads ?4 was not statistically different from that after adjuvant chemotherapy for breast cancer(p=0.924),which were 9.30%(8/86)and 9.70%(10/103),respectively.There was no significant difference in the proportion of thyroid nodule with ti-rads ?4 between the two groups(p=0.700),which were 16%(8/50)and 13.51%(10/74),respectively.Conclusions:1.The thyroid function of patients with newly diagnosed breast cancer was lower than that of patients with benign breast disease.2.Thyroid function of breast cancer patients after adjuvant chemotherapy was significantly reduced compared with that at the initial diagnosis,suggesting that chemotherapy may damage thyroid function of breast cancer patients.3.The incidence of thyroid nodules in breast cancer patients and breast cancer patients after adjuvant chemotherapy is significantly higher than that of benign breast disease and before chemotherapy,suggesting that the occurrence of thyroid nodules may be correlated with breast cancer and chemotherapy.