Subclinical Hypothyroidism in Patients with Newly Diagnosed Breast Cancer
Received Date : 14 Oct 2020
Accepted Date : 02 Mar 2021
Available Online : 10 Mar 2021
Doi: 10.37047/jos.2020-79561 - Article's Language: EN
J Oncol Sci. 2021;7(1):15-9
This is an open access article under the CC BY-NC-ND license
Objective: The association between thyroid function and breast cancer is controversial and has been studied for more than 50 years in both animals and humans with mixed results. The type of relationship between hypothyroidism and the risk of breast cancer remains to be elucidated. Subclinical hypothyroidism (SCH) may have a role in breast cancer development. In this study, the prevalence of SCH was investigated in patients with newly diagnosed breast cancer at a single center. Material and Methods: A total of 910 breast cancer patients were screened, and 403 women (mean age, 55.7±10.7 years) were included for the analysis. The staging of breast cancer patients was based on The Staging Manual of the American Joint Committee on Cancer. SCH was defined as elevated TSH (normal range: 0.25-4.55 μIU/mL) with normal free T4 (normal range: 11.5-22.7 pmol/L) and normal free T3 (normal range: 3.5-6.5 pmol/L) concentrations and these were used to compare SCH-positive (n=46) and SCH-negative (n=357) patients. Results: The prevalence of SCH among newly diagnosed breast cancer patients was 11.4%. SCH-positive and SCH-negative patients were comparable in terms of menopausal status and tumor grade. Conclusion: The rate of SCH among newly diagnosed breast cancer patients in this study indicates that SCH may be a coincidental condition in breast cancer patients.
  1. American Cancer Society. Selected cancers. Global Cancer Facts & Figures. 4th ed. Atlanta: American Cancer Society. 2018, p.12. [Link] 
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. Erratum in: CA Cancer J Clin. 2020;70(4):313. [Crossref]  [PubMed] 
  3. Smyth PP. The thyroid and breast cancer. Curr Opin Endocrinol Diabetes Obes. 2016;23(5):389-393. [Crossref]  [PubMed] 
  4. Kapdi CC, Wolfe JN. Breast cancer. Relationship to thyroid supplements for hypothyroidism. JAMA. 1976;236(10):1124-1127. [Crossref]  [PubMed] 
  5. Angelousi AG, Anagnostou VK, Stamatakos MK, Georgiopoulos GA, Kontzoglou KC. Mechanisms in endocrinology: primary HT and risk for breast cancer: a systematic review and meta-analysis. Eur J Endocrinol. 2012;166(3):373-381. [Crossref]  [PubMed] 
  6. Hardefeldt PJ, Eslick GD, Edirimanne S. Benign thyroid disease is associated with breast cancer: a meta-analysis. Breast Cancer Res Treat. 2012;133(3):1169-1177. [Crossref]  [PubMed] 
  7. Fang Y, Yao L, Sun J, et al. Does thyroid dysfunction increase the risk of breast cancer? A systematic review and meta-analysis. J Endocrinol Invest. 2017;40(10):1035-1047. [Crossref]  [PubMed] 
  8. Wang B, Lu Z, Huang Y, Li R, Lin T. Does hypothyroidism increase the risk of breast cancer: evidence from a meta-analysis. BMC Cancer. 2020;20(1):733. [Crossref]  [PubMed]  [PMC] 
  9. Gómez-Izquierdo J, Filion KB, Boivin JF, Azoulay L, Pollak M, Yu OHY. Subclinical hypothyroidism and the risk of cancer incidence and cancer mortality: a systematic review. BMC Endocr Disord. 2020;20(1):83. [Crossref]  [PubMed]  [PMC] 
  10. Kuijpens JL, Nyklíctek I, Louwman MW, Weetman TA, Pop VJ, Coebergh JW. Hypothyroidism might be related to breast cancer in post-menopausal women. Thyroid. 2005;15(11):1253-1259. [Crossref]  [PubMed] 
  11. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, eds. AJCC cancer staging manual. 7th. New York, NY: Springer; 2010. [Link] 
  12. Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2):228-238. [Crossref]  [PubMed] 
  13. Pérez-Campos Mayoral L, Hernández-Huerta MT, Mayoral-Andrade G, et al. TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population. Int J Endocrinol. Jun 2020;2020:2698627. [Crossref]  [PubMed]  [PMC] 
  14. Biondi B, Cappola AR, Cooper DS. Subclinical Hypothyroidism: A Review. JAMA. 2019;322(2):153-160. [Crossref]  [PubMed] 
  15. Liu YC, Yeh CT, Lin KH. Molecular Functions of Thyroid Hormone Signaling in Regulation of Cancer Progression and Anti-Apoptosis. Int J Mol Sci. 2019;20(20):4986. Erratum in: Int J Mol Sci. 2020;21(9): [Crossref]  [PubMed]  [PMC] 
  16. Bolf EL, Gillis NE, Barnum MS, et al. The Thyroid Hormone Receptor-RUNX2 Axis: A Novel Tumor Suppressive Pathway in Breast Cancer. Horm Cancer. 2020;11(1):34-41. [Crossref]  [PubMed] 
  17. López-Mateo I, Alonso-Merino E, Suarez-Cabrera C, et al. Thyroid Hormone Receptor β Inhibits Self-Renewal Capacity of Breast Cancer Stem Cells. Thyroid. 2020;30(1):116-132. [Crossref]  [PubMed]  [PMC] 
  18. Shao W, Kuhn C, Mayr D, et al. Cytoplasmic and Nuclear Forms of Thyroid Hormone Receptor β1 Are Inversely Associated with Survival in Primary Breast Cancer. Int J Mol Sci. 2020;21(1):330. [Crossref]  [PubMed]  [PMC] 
  19. MacMahon B, Cole P, Lin TM, et al. Age at first birth and breast cancer risk. Bull World Health Organ. 1970;43(2):209-221. [PubMed]  [PMC] 
  20. Wu AH, Ziegler RG, Pike MC, et al. Menstrual and reproductive factors and risk of breast cancer in Asian-Americans. Br J Cancer. 1996;73(5):680-686. [Crossref]  [PubMed]  [PMC] 
  21. Anderson KN, Schwab RB, Martinez ME. Reproductive risk factors and breast cancer subtypes: a review of the literature. Breast Cancer Res Treat. 2014;144(1):1-10. [Crossref]  [PubMed]  [PMC] 
  22. Weng CH, Okawa ER, Roberts MB, et al. Breast Cancer Risk in Postmenopausal Women with Medical History of Thyroid Disorder in the Women's Health Initiative. Thyroid. 2020;30(4):519-530. [Crossref]  [PubMed]  [PMC] 
  23. Tseng FY, Lin WY, Li CI, Li TC, Lin CC, Huang KC. Subclinical hypothyroidism is associated with increased risk for cancer mortality in adult Taiwanese-a 10 years population-based cohort. PLoS One. 2015;10(4):e0122955. [Crossref]  [PubMed]  [PMC] 
  24. Ergin AB, Bena J, Nasr CE. Hypothyroidism and hyponatremia: simple association or true causation. Open J Thyroid Res 2017;1(1):012-016. [Crossref] 
  25. Ogu I, Surindan S, Shapiro JI. Hyponatremia in hypothyroid disorders: current understanding. JSM Thyroid Disord Manag 2017;2(2):1014. [Link] 
  26. Liamis G, Filippatos TD, Liontos A, Elisaf MS. Management of endocrine disease: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment. Eur J Endocrinol. 2017;176(1):R15-R20. [Crossref]  [PubMed] 
  27. Chiappa C, Rovera F, Rausei S, et al. Breast cancer and thyroid diseases: analysis of 867 consecutive cases. J Endocrinol Invest. 2017;40(2):179-184. [Crossref]  [PubMed]