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接受乳腺癌手术的女性组织学确诊甲状腺疾病的发生:文献综述与病例系列

Development of Histologically Verified Thyroid Diseases in Women Operated for Breast Cancer: A Review of the Literature and a Case Series.

作者信息

Fama' Fausto, Sindoni Alessandro, Sun Hui, Kim Hoon Yub, Geraci Girolamo, Colonna Michele Rosario, Mazzeo Carmelo, Brenta Gabriela, Galeano Mariarosaria, Benvenga Salvatore, Dionigi Gianlorenzo

机构信息

Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital "G. Martino" of Messina, 98125 Messina, Italy.

Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.

出版信息

J Clin Med. 2022 Jun 1;11(11):3154. doi: 10.3390/jcm11113154.

Abstract

BACKGROUND

The possible relationships between breast and thyroid diseases have been reported in the literature. The purpose of our study was to evaluate the occurrence of histologically verified thyroid pathologies in women who were diagnosed with breast cancer and, after mastectomy/quadrantectomy complemented by oncological treatment, were thyroidectomized based on their periodic thyroid evaluation.

PATIENTS AND METHODS

Our series consist of 31 women with a mean age of 62.9 ± 10.9 years (range, 45-81) treated for breast cancer (18 right-sided, 11 left-sided, and 2 bilateral), of whom 29 were thyroidectomized, since two women who developed Graves' disease refused thyroidectomy. These 31 women belong to a cohort of 889 women who referred to the Breast Surgery Unit of our university hospital during the period January 2010 through December 2020.

RESULTS

The mean time interval between breast cancer and thyroid pathologies was 48.1 ± 23.4 months (range, 12-95). The final diagnosis at histopathology was infiltrating ductal breast carcinoma in 26 women (with 2/26 patients having bilateral carcinoma) and infiltrating lobular breast carcinoma in the other 5 women. Ten of the twenty-nine thyroidectomized women (34.5%) had a thyroid malignancy on histology: five papillary carcinomas, three papillary micro-carcinomas and two follicular carcinomas. Two of the five women with papillary carcinoma also had histological evidence of chronic lymphocytic thyroiditis/Hashimoto's thyroiditis, which was also detected in another five women with benign thyroid diseases.

CONCLUSIONS

We suggest that breast cancer survivors should be made aware of the possible increased risk of thyroid pathologies (including thyroid malignancy) so that they can undergo screening and follow-up.

摘要

背景

文献中已报道了乳腺疾病与甲状腺疾病之间可能存在的关系。我们研究的目的是评估经组织学证实的甲状腺病变在被诊断为乳腺癌且在乳房切除术/象限切除术后辅以肿瘤治疗、基于定期甲状腺评估而接受甲状腺切除术的女性中的发生率。

患者与方法

我们的研究系列包括31名平均年龄为62.9±10.9岁(范围45 - 81岁)的乳腺癌女性患者(18例右侧、11例左侧、2例双侧),其中29例行甲状腺切除术,因为2例患格雷夫斯病的女性拒绝甲状腺切除术。这31名女性属于2010年1月至2020年12月期间转诊至我校医院乳腺外科的889名女性队列。

结果

乳腺癌与甲状腺病变之间的平均时间间隔为48.1±23.4个月(范围12 - 95个月)。组织病理学最终诊断为浸润性导管癌的有26名女性(其中2/26患者为双侧癌),另外5名女性为浸润性小叶癌。29例接受甲状腺切除术的女性中有10例(34.5%)组织学检查发现甲状腺恶性肿瘤:5例乳头状癌、3例乳头状微癌和2例滤泡状癌。5例乳头状癌女性中有2例也有慢性淋巴细胞性甲状腺炎/桥本甲状腺炎的组织学证据,另外5例良性甲状腺疾病女性中也检测到了该病变。

结论

我们建议乳腺癌幸存者应意识到甲状腺病变(包括甲状腺恶性肿瘤)风险可能增加,以便她们能够接受筛查和随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63d8/9181259/dc36f1e683b0/jcm-11-03154-g001.jpg

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