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Journal of Endocrinological Investigation

, Volume 30, Issue 9, pp 734–738 | Cite as

Favorable predictive value of thyroid autoimmunity in high aggressive breast cancer

  • E. Fiore
  • E. Giustarini
  • C. Mammoli
  • F. Fragomeni
  • D. Campani
  • I. Muller
  • A. Pinchera
  • C. Giani
Original Articles

Abstract

A high incidence of anti-thyroid antibodies (TAb) has been found in patients with breast cancer (BC). The aim of this study was to evaluate the prognostic value of TAb in a group of 47 women submitted to mastectomy for high malignancy degree BC. All patients were evaluated for thyroid disorders after breast surgery and before any anti-tumoral adjuvant therapy. Five yr after BC diagnosis 31/47 (65.9%) patients were alive (survivors group: SG) and 16/47 (34.1%) were dead (deaths group: DG). The overall prevalence of TAb was 15/47 (31.9%): 14/31 (45.1%) in SG and 1/16 (6.2%) in DG (p=0.008). Five-yr mortality was 15/32 (46.9%) in TAb- and 1/15 (6.7%) in TAb+ patients (p=0.01). Eight out of 47 (17.0%) patients had Hashimoto’s thyroiditis and 7 of them (87.5%) were in SG. Estrogen receptor (ER) was measured in 43/47 (91.5%) BC specimens. ER was detected in 19/30 (63.0%) patients in SG and 3/13 (23.1%) in DG (p=0.01). Five-yr mortality was 10/21 (47.6%) in ER- and 3/22 (13.6%) in ER+ patients (p=0.008). Absence of ER expression [odds ratio (OR) 6.54; p=0.006] and absence of TAb (OR 9.37; p=0.03) were related to a higher mortality rate. TAb were detected in 8/21 (38.1%) ER- and in 7/22 (31.8%) ER+ patients; no relation was found between ER expression and TAb positivity (p=ns). Patients with ER+ and TAb+ have a better prognosis and the absence of a significant relationship between these two parameters suggests an independent prognostic role in high malignancy degree BC women.

Key-words

Thyroid autoimmunity anti-thyroperoxidase antibodies autoimmune thyroiditis breast cancer 

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REFERENCES

  1. 1.
    Giani C, Fierabracci P, Bonacci R, et al. Relationship between breast cancer and thyroid disease: relevance of autoimmune thyroid disorders in breast malignancy. J Clin Endocrinol Metab 1996, 81: 990–4.PubMedGoogle Scholar
  2. 2.
    Turken O, Narin Y, DemIrbas S, et al. Breast cancer in association with thyroid disorders. Breast Cancer Res 2003, 5: R110–3.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Jiskra J, Limanova Z, Barkmanova J, Smutek D, Friedmannova Z. Autoimmune thyroid diseases in women with breast cancer and colorectal cancer. Physiol Res 2004, 53: 693–702.PubMedGoogle Scholar
  4. 4.
    Giustarini E, Pinchera A, Fierabracci P, et al. Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery. Eur J Endocrinol 2006,154: 645–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Smyth PP, Shering SG, Kilbane MT, et al. Serumthyroid peroxidase autoantibodies, thyroid volume, and outcome in breast carcinoma. J Clin Endocrinol Metab 1998, 83: 2711–6.PubMedGoogle Scholar
  6. 6.
    Fitzgibbons PL, Page DL, Weaver D, et al. Prognostic factors in breast cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000, 124: 966–78.PubMedGoogle Scholar
  7. 7.
    Fisher ER, Gregorio RM, Fisher B, Redmond C, Vellios F, Sommers SC. The pathology of invasive breast cancer. A syllabus derived from findings of the National Surgical Adjuvant Breast Project (protocol no. 4). Cancer 1975, 36: 1–85.PubMedCrossRefGoogle Scholar
  8. 8.
    Clayton F, Hopkins CL. Pathologic correlates of prognosis in lymph node-positive breast carcinomas. Cancer 1993, 71: 1780–90.PubMedCrossRefGoogle Scholar
  9. 9.
    Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 1998, 11: 155–68.PubMedGoogle Scholar
  10. 10.
    Harvey JM, Clark GM, Osborne CK, Allred DC. Estrogen receptor status by immunohistochemistry is superior to the ligand-binding assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol 1999, 17: 1474–81.PubMedGoogle Scholar
  11. 11.
    Giani C, Campani D, De Negri F, et al. Relationship between progesterone receptor, axillary node status and productive fibrosis in ductal infiltrating carcinoma of the breast. Appl Pathos 1989, 7: 225–32.Google Scholar
  12. 12.
    Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R, Pinchera A. Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab 1991, 72: 209–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Molino A, Micciolo R, Turazza M, et al. Prognostic significance of estrogen receptors in 405 primary breast cancers: a comparison of immunohistochemical and biochemical methods. Breast Cancer Res Treat 1997, 45: 241–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Kuijpens JL, Nyklíctek I, Louwman MW, Weetman TA, Pop VJ, Coebergh JW. Hypothyroidism might be related to breast cancer in post-menopausal women. Thyroid 2005, 15: 1253–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Tazebay UH, Wapnir IL, Levy O, et al. The mammary gland iodide transporter is expressed during lactation and in breast cancer. Nat Med 2000, 6: 871–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Ruf J, Toubert ME, Czarnocka B, Durand-Gorde JM, Ferrand M, Carayon P. Relationship between immunologica structure and biochemical properties of human thyroid peroxidase. Endocrinology 1989, 125: 1211–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Spiotto MT, Fu YX, Schreiber H. Tumor immunity meets autoimmunity: antigen levels and dendritic cell maturation. Curr Opin Immunol 2003, 15: 725–30.PubMedCrossRefGoogle Scholar
  18. 18.
    Spiotto MT, Yu P, Rowley DA, et al. Increasing tumor antigen expression overcomes “ignorance” to solid tumors via crosspresentation by bone marrow-derived stromal cells. Immunity 2002, 17: 737–47.PubMedCrossRefGoogle Scholar
  19. 19.
    Kurts C, Miller JF, Subramaniam RM, Carbone FR, Heath WR. Major histocompatibility complex class I-restricted cross-presentation is biased towards high dose antigens and those released during cellular destruction. J Exp Med 1998, 20, 188: 409–14.CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2007

Authors and Affiliations

  • E. Fiore
    • 1
  • E. Giustarini
    • 1
  • C. Mammoli
    • 1
  • F. Fragomeni
    • 1
  • D. Campani
    • 2
  • I. Muller
    • 1
  • A. Pinchera
    • 1
  • C. Giani
    • 1
  1. 1.Department of Endocrinology and MetabolismUniversity of PisaPisaItaly
  2. 2.Department of Oncology, Unit of PathologyUniversity of PisaPisaItaly

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