Pedraza-Flechas Ana María, Lope Virginia, Vidal Carmen, Sánchez-Contador Carmen, Santamariña Carmen, Pedraz-Pingarrón Carmen, Moreo Pilar, Ascunce Nieves, Miranda-García Josefa, Llobet Rafael, Aragonés Nuria, Salas-Trejo Dolores, Pollán Marina, Pérez-Gómez Beatriz
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública), CIBERESP, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
Breast. 2017 Aug;34:12-17. doi: 10.1016/j.breast.2017.04.011. Epub 2017 Apr 26.
The association between breast cancer (BC) and thyroid disorders has been widely explored with unclear results. Mammographic density (MD) is one of the strongest risk factor for BC. This study explores the relationship between thyroid diseases and MD in Spanish women.
MATERIALS & METHODS: This cross-sectional study covered 2883 women aged 47-71 years participating in 7 BC screening programs in 2010. They allowed access to their mammograms, had anthropometrical-measures taken, and answered a telephonic epidemiological interview which included specific questions on thyroid diseases. Percentage of MD was assessed with a semiautomatic-computer tool (DM-scan) by two trained radiologists. We calculated the geometric mean of MD percentages (mean MD). Multivariable mixed linear regression models with random screening-center-specific intercepts were fitted, using log-transformed percentage of MD as dependent variable and adjusting for age, body mass index, menopausal status and other confounders. e represents the relative increase of mean MD.
13.9% of the participants reported personal history of thyroid disease. MD was not associated to hyperthyroidism (e:1.05, 95%CI: 0.82-1.36), hypothyroidism (e:1.02, 95%CI: 0.75-1.38), thyroid nodules (e:1.01, 95%CI: 0.85-1.19) or thyroid cancer (e:1.03, 95%CI: 0.56-1.92). However, women with goiter had lower MD (mean MD: 13.4% vs mean MD: 10.6%; e:0.79, 95%CI: 0.64-0.98) and those with Hashimoto thyroiditis had higher MD (mean MD: 13.3% vs mean MD: 25.8%; e:1.94, 95%CI: 1.00-3.77).
Functional thyroid disorders were not related to MD. However, MD was lower in women with goiter and higher in those reporting Hashimoto's thyroiditis. These relationships should be confirmed in future studies.
乳腺癌（BC）与甲状腺疾病之间的关联已得到广泛研究，但结果尚不清楚。乳腺X线密度（MD）是乳腺癌最强的危险因素之一。本研究探讨西班牙女性甲状腺疾病与MD之间的关系。
这项横断面研究涵盖了2010年参加7项乳腺癌筛查项目的2883名年龄在47 - 71岁之间的女性。她们同意提供乳腺X线照片，接受人体测量，并回答了一次电话流行病学访谈，其中包括关于甲状腺疾病的具体问题。两名经过培训的放射科医生使用半自动计算机工具（DM - scan）评估MD百分比。我们计算了MD百分比的几何平均值（平均MD）。使用以MD百分比的对数转换值作为因变量，并对年龄、体重指数、绝经状态和其他混杂因素进行调整，拟合了具有随机筛查中心特定截距的多变量混合线性回归模型。e表示平均MD的相对增加。
13.9%的参与者报告有甲状腺疾病个人史。MD与甲状腺功能亢进（e：1.05，95%CI：0.82 - 1.36）、甲状腺功能减退（e：1.02，95%CI：0.75 - 1.38）、甲状腺结节（e：1.01，95%CI：0.85 - 1.19）或甲状腺癌（e：1.03，95%CI：0.56 - 1.92）均无关联。然而，患有甲状腺肿的女性MD较低（平均MD：13.4%对平均MD：10.6%；e：0.79，95%CI：0.64 - 0.98），而患有桥本甲状腺炎的女性MD较高（平均MD：13.3%对平均MD：25.8%；e：1.94，95%CI：1.00 - 3.77）。
甲状腺功能紊乱与MD无关。然而，患有甲状腺肿的女性MD较低，而报告有桥本甲状腺炎的女性MD较高。这些关系应在未来的研究中得到证实。
