Li Tao, Lu Bin, Zhang Yantao, Zhang Peng, Qi Jun, Sun Yong
Department of Thyroid and Breast Surgery, People's Hospital Affiliated To Shandong First Medical University, Jinan, Shandong, 271199, People's Republic of China.
Cancer Manag Res. 2025 May 24;17:997-1004. doi: 10.2147/CMAR.S505310. eCollection 2025.
To characterize the distinct clinicopathological patterns and identify independent risk factors in synchronous breast-thyroid dual primary malignancies (DBTMs), a rare yet clinically significant entity.
In this retrospective case-control study (2019.03-2021.12), 58 DBTM patients were compared with 89 age-matched solitary breast cancer controls. Comprehensive clinicopathological parameters including hormone receptor status and molecular profiles were analyzed. Multivariable logistic regression identified prognostic determinants with 2-year follow-up for recurrence/metastasis and survival outcomes.
Statistically significant differences were observed in age, BMI, menopausal status, ER, PR, and HER-2 status between the study and control groups (P < 0.05). During the 2-year follow-up, the study group had 12 cases of recurrence or metastasis and 5 deaths, while the control group had 9 cases of recurrence or metastasis and 2 deaths (P < 0.05). Univariate analysis indicated that age, breast cancer stage, and ER status were associated with overall survival in patients with synchronous primary breast and thyroid cancer. Additionally, age, breast cancer stage, ER status, menopausal status, and a family history of breast cancer were significantly associated with recurrence or metastasis (P < 0.05). Multivariate logistic regression analysis identified age, ER positivity, and a family history of breast cancer as independent risk factors for synchronous primary breast and thyroid cancer (P < 0.05).
This first matched case-control analysis reveals that synchronous DBTMs represent a unique clinical subgroup with aggressive biological behavior. The identified triad of young age, ER positivity, and familial predisposition provides a risk stratification framework for dual-cancer screening and targeted surveillance strategies.
描述同步性乳腺-甲状腺双原发恶性肿瘤（DBTMs）这一罕见但具有临床意义的实体的不同临床病理模式，并确定独立危险因素。
在这项回顾性病例对照研究（2019.03 - 2021.12）中，将58例DBTM患者与89例年龄匹配的孤立性乳腺癌对照者进行比较。分析了包括激素受体状态和分子特征在内的综合临床病理参数。多变量逻辑回归确定了复发/转移和生存结局的2年随访预后决定因素。
研究组和对照组在年龄、体重指数、绝经状态、雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER-2）状态方面存在统计学显著差异（P < 0.05）。在2年随访期间，研究组有12例复发或转移，5例死亡，而对照组有9例复发或转移，2例死亡（P < 0.05）。单因素分析表明，年龄、乳腺癌分期和ER状态与同步性原发性乳腺癌和甲状腺癌患者的总生存相关。此外，年龄、乳腺癌分期、ER状态、绝经状态和乳腺癌家族史与复发或转移显著相关（P < 0.05）。多变量逻辑回归分析确定年龄、ER阳性和乳腺癌家族史为同步性原发性乳腺癌和甲状腺癌的独立危险因素（P < 0.05）。
这项首次匹配病例对照分析表明，同步性DBTMs代表了一个具有侵袭性生物学行为的独特临床亚组。确定的年轻、ER阳性和家族易感性三联征为双癌筛查和靶向监测策略提供了风险分层框架。
