Thyroid function and structure variations in female breast cancer patients with diverse pathological characteristics: a retrospective single-center investigation

Background: This study aims to analyze the changes in thyroid structure and function in female breast cancer patients and investigate their relationship with the clinical pathological characteristics of breast cancer. Methods: The data of 169 patients treated at the Breast Surgery Department of Sichuan Province Cancer Hospital between December 2019 and January 2021 were assessed, and their preoperative serum thyroid function tests and thyroid ultrasound image data were collected. The patients were then grouped according to clinical pathological characteristics, such as tumor volume, and the differences in thyroid hormones, thyroid autoantibodies related to immunity, detection of thyroid nodules by ultrasound, and the Thyroid Imaging Reporting and Data System (TI-RADS) classification of the detected nodules were compared. Additionally, we analyzed the correlation of these variables with the patients’ clinical pathological characteristics. Results: Among patients with detected thyroid nodules, significant statistical differences in the TI-RADS classification of thyroid nodules found in relation to age, estrogen receptor (ER) expression, human epidermal growth factor receptor 2 (HER2) expression, histological grading and lymphovascular invasion (p < 0.05). Furthermore, a positive correlation was observed between the TI-RADS classification level of thyroid nodules and the ER expression level (G = 0.511, p < 0.001), and a negative correlation was observed with histological grading (G = −0.526, p = 0.006). However, there is no clear correlation between age groups, HER2 expression, lymphovascular invasion and the TI-RADS classification level (p > 0.05), and no significant differences found in serum thyroid hormone levels and thyroid autoantibodies among breast cancer patients with different pathological characteristics (p > 0.05). Conclusions: Newly diagnosed breast cancer patients did not show notable differences in thyroid function. However, changes in thyroid structure were observed, which correlated with certain clinical pathological characteristics used to evaluate the severity of breast cancer and formulate treatment plans.

Breast cancer; Pathological characteristics; Thyroid nodules; Estrogen receptor; Thyroid function

[1] Zhang X, Dong XP, Guan YJ, Ren M, Guo DL, He YT. Research progress on epidemiological trend and risk factors of female breast cancer. Cancer Research on Prevention and Treatment. 2021; 48: 87–92. (In Chinese)

[2] Wang B, Li YZ. Treatment and ethical thinking of fertility preservation in young breast cancer patients. Chinese Medical Ethics. 2021; 34: 88–92. (In Chinese)

[3] Gago-Dominguez M, Castelao JE. Role of lipid peroxidation and oxidative stress in the association between thyroid diseases and breast cancer. Critical Reviews in Oncology/Hematology. 2008; 68: 107–114.

[4] Expert Consensus Committee on diagnosis, Treatment and fertility management of young breast cancer in China. Chinese consensus guidelines for breast cancer in young women: clinical practice and fertility preservation. Chinese Journal of Oncology. 2019; 41: 486–495. (In Chinese)

[5] Zhou B, Ji K, Xin L, Zhang H, Xu L, Li T, et al. Updates and interpretations of the 8th edition of AJCC breast cancer staging system. Chinese Journal of Practical Surgery. 2017; 37: 10–14. (In Chinese)

[6] Chinese Society of Clinical Oncology Guidelines Working Committee. Breast cancer diagnosis and treatment guidelines of Chinese society of clinical oncology. People’s Medical Publishing House: Beijing. 2022.

[7] Tarantino P, Hamilton E, Tolaney SM, Cortes J, Morganti S, Ferraro E, et al. Her2-low breast cancer: pathological and clinical landscape. Journal of Clinical Oncology. 2020; 38: 1951–1962.

[8] Guidelines for HER2 Testing in Breast Cancer (2019 Edition) Writing Group. Guideline for HER2 detection in breast cancer, the 2019 version. Chinese Journal of Pathology. 2019; 48: 169–175. (In Chinese)

[9] Breast Cancer Expert Committee of Chinese Society of Clinical Oncology, Breast Cancer Professional Committee of Chinese Anti-Cancer Association. Expert consensus on clinical diagnosis and treatment of HER2-positive breast cancer, the 2019 version. National Medical Journal of China. 2021; 101: 1226–1231. (In Chinese)

[10] Mei F, Liu JY, Xue WC. Histological grading of invasive breast carcinoma: Nottingham histological grading system. Chinese Journal of Pathology. 2019; 48: 659–664. (In Chinese)

[11] Superficial Organ and Vascular Study Group of Ultrasound Medical Branch of Chinese Medical Association, China Thyroid and Breast Ultrasound Artificial Intelligence Alliance. 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS. Chinese Journal of Ultrasonography. 2021; 30: 185–200. (In Chinese)

[12] Hercbergs A. Hypothyroidism and tumor regression. The New England Journal of Medicine. 1988; 319: 1351–1352.

[13] Li Z, Feng F, Shen CW, Abudula A. Analysis of the detection rate of thyroid nodule and related risk factors of health check-up of women in Mingdong Hospital. Journal of Ningde Teachers College. 2022; 34: 288–294,321. (In Chinese)

[14] Gong Z, Yang S, Wei M, Vlantis AC, Chan JYK, van CA, et al. The isoforms of estrogen receptor alpha and beta in thyroid cancer. Frontiers in Oncology. 2022; 12: 916804.

[15] Kim YA, Kim YA, Cho SW, Song YS, Min HS, Park IA, et al. Increased expression of thyroid hormone receptor alpha and estrogen receptor alpha in breast cancer associated with thyroid cancer. European Journal of Surgical Oncology. 2021; 47: 1316–1323.

[16] Zhao J, Li J, Feng J. Research progress on the role of deubiquitinating enzyme in ER-positive breast cancer. Journal of Hubei University of Medicine. 2022; 41: 316–319. (In Chinese)

[17] Dong S, Song XS, Pang L, Liu J. Expression of sex hormones and their receptors in female patients with different types of thyroid nodules. Chinese Journal of Endocrine Surgery. 2017; 11: 29–33. (In Chinese)

[18] Xu L, Gou X, Yang J, Jiang R, Jiang X, Chen GG, et al. Methylation of ERβ 5′-untranslated region attenuates its inhibitory effect on ERα gene transcription and promotes the initiation and progression of papillary thyroid cancer. The FASEB Journal. 2021; 35: e21516.

[19] Wilson FR, Coombes ME, Wylie Q, Yurchenko M, Brezden-Masley C, Hutton B, et al. Herceptin® (trastuzumab) in HER2-positive early breast cancer: protocol for a systematic review and cumulative network meta-analysis. Systematic Reviews. 2017; 6: 196.

[20] Zhan S, Wang T, Li J, Zhu H, Ge W, Li J. Asporin interacts with HER2 to promote thyroid cancer metastasis via the MAPK/EMT signaling pathway. Frontiers in Oncology. 2022; 12: 762180.

[21] Dai YJ, Qiu YB, Jiang R, Xu M, Zhao L, Chen GG, et al. Concomitant high expression of ERα36, EGFR and HER2 is associated with aggressive behaviors of papillary thyroid carcinomas. Scientific Reports. 2017; 7: 12279.

[22] Ren YX, Liao M, Yang J, Wang XL, Li XJ. Expression and clinical significance of ER and HER-2 in papillary thyroid cancer. Journal of Kunming Medical University. 2020; 41: 43–48. (In Chinese)

[23] Ren YX, Liao M, Yang J, Wang XL, Li XJ. Expression and clinical pathological significance of ER, HER-2 in thyroid papillary carcinoma with breast cancer. Proceedings of the 2019 China Cancer Congress. Chongqing. 16 August 2019. China Anticancer Association: Chongqing. 2019.

[24] Bai J, Chen WB, Zhang XY, Kang XN, Jin LJ, Zhang H, et al. HIF-2α regulates CD44 to promote cancer stem cell activation in triple-negative breast cancer via PI3K/AKT/mTOR signaling. World Journal of Stem Cells. 2020; 12: 87–99.

[25] Zhang R, Zhao J, Zhao L. EPAS1/HIF-2α acts as an unanticipated tumor-suppressive role in papillary thyroid carcinoma. International Journal of General Medicine. 2023; 16: 2165–2174.

[26] Mori N, Mugikura S, Takasawa C, Miyashita M, Shimauchi A, Ota H, et al. Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer. European Radiology. 2016; 26: 331–339.

[27] Wang CN, Wu XY, Lin XL, Lin ZF, Feng R, Wang JB. Relationship between HPK1, PI3K expression and 5-year prognosis of patients with breast cancer after radical mastectomy. Journal of Clinical and Experimental Medicine. 2022; 21: 1286–1290. (In Chinese)

[28] Zhang S, Zhang D, Gong M, Wen L, Liao C, Zou L. High lymphatic vessel density and presence of lymphovascular invasion both predict poor prognosis in breast cancer. BMC Cancer. 2017; 17: 335.

[29] Zhong YM, Tong F, Shen J. Lympho-vascular invasion impacts the prognosis in breast-conserving surgery: a systematic review and meta-analysis. BMC Cancer. 2022; 22: 102.

[30] Chen JW, Li J, Ma SM, Wu M. Correlation analysis between axillary lymph node metastasis and preoperative MRI as well as clinicopathological features in early invasive breast cancer. Journal of China Clinic Medical Imaging. 2020; 31: 618–623,654. (In Chinese)

[31] Ni-jia-ti M, Ai-hai-ti D, Huo-jia A, Wu-mai-er P, A-bu-li-zi A, Shi Y, et al. Development of a risk-stratification scoring system for predicting lymphovascular invasion in breast cancer. BMC Cancer. 2020; 20: 94.

[32] Zhu HY, Chen JM, Ge YQ, Shao Y, Gao J, Li Y. Preoperative prediction of lymphovascular invasion in invasive breast cancer with MRI radiomics. Chinese Journal of Medical Imaging. 2020; 28: 825–830. (In Chinese)

[33] Pan ZJ, Chen WB. Research progress of magnetic resonance imaging predict lymphovascular invasion in breast cancer. China Medical and Pharmacy. 2022; 12: 65–68,83. (In Chinese)