Ahn Hwa Young, Min Hye Sook, Yeo Yohwan, Ma Seung Hyun, Hwang Yunji, An Jee Hyun, Choi Hoon Sung, Keam Bhumsuk, Im Seock-Ah, Park Do Joon, Park In Ae, Noh Dong-Young, Youn Yeo-Kyu, Chung June-Key, Cho Bo Youn, Park Sue K, Park Young Joo
Departments of Internal Medicine (H.Y.A., J.H.A., H.S.C., B.K., S.-A.I., D.J.P., Y.J.P.), Pathology (H.S.M., I.A.E.), Preventive Medicine (Y.Y., S.H.M., Y.H., S.K.P.), Surgery (D.-Y.N., Y.-K.Y.), and Nuclear Medicine (J.-K.C.), Seoul National University College of Medicine, Seoul, Republic of Korea 110-744; Department of Internal Medicine (H.Y.A.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea 463-707; Department of Internal Medicine (H.Y.A., B.Y.C.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea 156-755; Department of Biomedical Science (Y.H., S.K.P.), Seoul National University Graduate School, Seoul, Republic of Korea 110-744; Cancer Research Institute (Y.H., D.-Y.N., S.K.P.), Seoul National University, Seoul, Republic of Korea 110-744; and Department of Internal Medicine (H.S.C.), Kangwon National University School of Medicine, Chuncheon, Republic of Korea 200-722.
J Clin Endocrinol Metab. 2015 Sep;100(9):3486-93. doi: 10.1210/JC.2014-2896. Epub 2015 Jul 6.
Previous studies on the extent to which radioactive iodine (RAI) therapy for thyroid cancer increases the risk of subsequently developing breast cancer have given conflicting results.
This study aimed to evaluate the effect of RAI treatment on breast cancer development and recurrence among female patients with primary thyroid cancer.
This was a retrospective cohort study. The risk of subsequent breast cancer associated with RAI and its dose in hazard ratios (HRs) with 95% confidential intervals (CIs) were calculated using time-dependent Cox proportional hazard models.
A total of 6150 patients with thyroid cancer enrolled between 1973 and 2009 were followed until December 2012. Of these, 3631 (59.0%) received RAI therapy. During the follow-up period, 99 primary breast cancers were diagnosed.
Risk of breast cancer development according to RAI therapy and RAI dose during treatment for primary thyroid cancer.
RAI therapy did not significantly increase the incidence of subsequent breast cancer among female patients (hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.22-1.06) when a 2-year latency period was accounted for. High-dose RAI (≥120 mCi) was associated with a reduced incidence of subsequent breast cancer (HR, 0.17; 95% CI, 0.05-0.62) in the cohort with a 2-year latency period.
The long-term follow-up results of this study suggest that RAI treatment for patients with thyroid cancer may not increase the risk or recurrence of breast cancer.
先前关于甲状腺癌放射性碘（RAI）治疗在多大程度上增加随后发生乳腺癌风险的研究结果相互矛盾。
本研究旨在评估RAI治疗对原发性甲状腺癌女性患者乳腺癌发生和复发的影响。
这是一项回顾性队列研究。使用时间依赖性Cox比例风险模型计算与RAI及其剂量相关的后续乳腺癌风险的风险比（HR）及95%置信区间（CI）。
共纳入1973年至2009年间登记的6150例甲状腺癌患者，随访至2012年12月。其中，3631例（59.0%）接受了RAI治疗。随访期间，诊断出99例原发性乳腺癌。
根据原发性甲状腺癌治疗期间的RAI治疗和RAI剂量评估乳腺癌发生风险。
考虑2年潜伏期时，RAI治疗未显著增加女性患者后续乳腺癌的发病率（风险比[HR]，0.49；95%置信区间[CI]，0.22 - 1.06）。在有2年潜伏期的队列中，高剂量RAI（≥120 mCi）与后续乳腺癌发病率降低相关（HR，0.17；95% CI，0.05 - 0.62）。
本研究的长期随访结果表明，甲状腺癌患者接受RAI治疗可能不会增加乳腺癌的风险或复发率。
