High Incidence and Prevalence of Papillary Thyroid Cancer in Breast Cancer Patients
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Purpose: Breast and thyroid cancers are the two most commonly diagnosed cancers in women. Many studies have described an increased risk of thyroid cancer in breast cancer patients. This may be related to hormonal exposure, genetic susceptibility, detection bias, and cancer treatment. We thus performed a retrospective descriptive study which aimed to assess the incidence and prevalence of thyroid cancer in breast cancer patients. Methods: We reviewed electronic medical records of breast cancer patients who had undergone surgery between January 2013 and December 2017 in a single tertiary hospital. Patients with recurrent breast cancer, distant metastases, or previous history of thyroidectomy were excluded. A total of 966 patients were enrolled. Results: A total of 37 (3.8%) patients were diagnosed with both breast and thyroid cancers during 46 months of median follow up. There were 28 (75.7%) synchronous cases diagnosed within 1 year, and 9 (24.3%) metachronous cases diagnosed after 1 year. The median age was 49 years (range, 30–65 years); 34 (91.9%) had thyroid microcarcinoma of less than 1 cm. The incidence and prevalence of thyroid cancer were 2.05 (95% confidence interval [CI], 0.93–3.61) times and 1.41 (95% CI, 0.93–1.98) times higher than those of general population, respectively. Conclusions: The high incidence and prevalence of thyroid cancer among breast cancer patients are mostly attributable to the widespread screening with ultrasonography. Treatment strategies can be individualized with respect to the tumor characteristics, the patient's preference, and surgical resources.
Abstract
Purpose: Breast and thyroid cancers are the two most commonly diagnosed cancers in women. Many studies have described an increased risk of thyroid cancer in breast cancer patients. This may be related to hormonal exposure, genetic susceptibility, detection bias, and cancer treatment. We thus performed a retrospective descriptive study which aimed to assess the incidence and prevalence of thyroid cancer in breast cancer patients. Methods: We reviewed electronic medical records of breast cancer patients who had undergone surgery between January 2013 and December 2017 in a single tertiary hospital. Patients with recurrent breast cancer, distant metastases, or previous history of thyroidectomy were excluded. A total of 966 patients were enrolled. Results: A total of 37 (3.8%) patients were diagnosed with both breast and thyroid cancers during 46 months of median follow up. There were 28 (75.7%) synchronous cases diagnosed within 1 year, and 9 (24.3%) metachronous cases diagnosed after 1 year. The median age was 49 years (range, 30–65 years); 34 (91.9%) had thyroid microcarcinoma of less than 1 cm. The incidence and prevalence of thyroid cancer were 2.05 (95% confidence interval [CI], 0.93–3.61) times and 1.41 (95% CI, 0.93–1.98) times higher than those of general population, respectively. Conclusions: The high incidence and prevalence of thyroid cancer among breast cancer patients are mostly attributable to the widespread screening with ultrasonography. Treatment strategies can be individualized with respect to the tumor characteristics, the patient's preference, and surgical resources.
참고문헌 (22)
- Annual Report of Cancer Statistics in Korea in 2017, "Korea Central Cancer Registry, National Cancer Center", Ministry of Health and Welfare, ~ (2019)
- 정상희, "유방암 환자에서 타장기에 발생한 원발성 악성종양의 임상적 특성", Journal of Breast Cancer, 10(4), pp.263~268 (2007), 한국유방암학회
- 김봉균, "Clinical Characteristics and Prognosis Associated with Multiple Primary Cancers in Breast Cancer Patients", Journal of Breast Cancer, 21(1), pp.62~69 (2018), 한국유방암학회[DOI]
- 김진영, "Metachronous Double Primary Cancer after Treatment of Breast Cancer", Cancer Research and Treatment, 47(1), pp.64~71 (2015), 대한암학회[DOI]
- 이장희, "Characteristics and Survival of Breast Cancer Patients with Multiple Synchronous or Metachronous Primary Cancers", Yonsei Medical Journal, 56(5), pp.1213~1220 (2015), 연세대학교의과대학[DOI]
- Zhang L, "Characteristics and survival of patients with metachronous or synchronous double primary malignancies : breast and thyroid cancer", Oncotarget, 7, pp.52450~52459 (2016)
- Nielsen SM, "The breast-thyroid cancer link : a systematic review and meta-analysis", Cancer Epidemiol Biomarkers Prev, 25, pp.231~238 (2016)
- Park JS, "Sonographic screening for thyroid cancer in females undergoing breast sonography", AJR Am J Roentgenol, 186, pp.1025~1028 (2006)
- HaeKyungLee, "Diagnosis of Occult Thyroid Carcinoma by Ultrasonography", Yonsei Medical Journal, 44(6), pp.1040~1044 (2003), 연세대학교의과대학
- An JH, "A possible association between thyroid cancer and breast cancer", Thyroid, 25, pp.1330~1338 (2015)
- Lei K, "Breast cancer prognosis is better in patients who develop subsequent metachronous thyroid cancer", PLoS One, 14, pp.e0215948~ (2019)
- 김주형, "Comparison of characteristics in patients with both thyroid and breast cancer: Based on order of incidence", 대한종양외과학회지, 13(1), pp.1~9 (2017), 대한종양외과학회
- Roman BR, "The thyroid cancer epidemic, 2017 perspective", Curr Opin Endocrinol Diabetes Obes, 24, pp.332~336 (2017)
- Youngwirth LM, "Extrathyroidal extension is associated with compromised survival in patients with thyroid cancer", Thyroid, 27, pp.626~631 (2017)
- Kim SK, "Predictive factors for lymph node metastasis in papillary thyroid microcarcinoma", Ann Surg Oncol, 23, pp.2866~2873 (2016)
- Miyauchi A, "Clinical trials of active surveillance of papillary microcarcinoma of the thyroid", World J Surg, 40, pp.516~522 (2016)
- Kwon H, "Active surveillance for patients with papillary thyroid microcarcinoma : a single center's experience in Korea", J Clin Endocrinol Metab, 102, pp.1917~1925 (2017)
- Tuttle RM, "Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance", JAMA Otolaryngol Head Neck Surg, 143, pp.1015~1020 (2017)
- Oh HS, "Active surveillance of low-risk papillary thyroid microcarcinoma : a multi-center cohort study in Korea", Thyroid, 28, pp.1587~1594 (2018)
- Haugen BR, "2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer", Thyroid, 26, pp.1~133 (2016)
- Brito JP, "A clinical framework to facilitate risk stratification when considering an active surveillance alternative to immediate biopsy and surgery in papillary microcarcinoma", Thyroid, 26, pp.144~149 (2016)
- 박진우, "분화갑상선암의 수술적 치료 권고안", Journal of Endocrine Surgery, 17(1), pp.1~18 (2017), 대한내분비외과학회