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Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Although it has been proven that radioactive iodine (RAI) treatment is an effective and well-tolerated procedure in patients with differentiated thyroid cancer (DTC), there is still some concern regarding the risk of developing a second primary malignancy after RAI administration. We performed a systematic review and meta-analysis to investigate the risk of primary breast cancer in patients with DTC undergoing RAI therapy.

Methods

A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement.

Results

The final analysis included 14 studies accounting for a total of 200,247 patients with DTC (98,368 treated with RAI and 101,879 not treated with RAI). The relative risk of primary breast cancer in patients with DTC treated with RAI to those not treated with RAI among studies ranged from 0.45 to 2.55, the pooled relative risk was 0.83 (95% confidence interval, 0.70–0.99), and the heterogeneity was 71.5%.

Conclusion

The present meta-analysis indicates that patients with DTC treated with RAI do not have a higher risk of primary breast cancer compared to those not treated with RAI. These findings suggest that RAI therapy does not increase the risk of breast cancer.

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Data Availability

The manuscript represents valid work, and neither this manuscript nor one with substantially similar content under the same authorship has been published or is being considered for publication elsewhere.

Code availability

Not applicable.

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Funding

Open access funding provided by Università degli Studi di Napoli Federico II within the CRUI-CARE Agreement.

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Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy

    Carmela Nappi, Michele Klain, Valeria Cantoni, Roberta Green, Leandra Piscopo, Fabio Volpe, Simone Maurea & Alberto Cuocolo

  2. IRCCS SDN, Naples, Italy

    Mario Petretta

Authors
  1. Carmela Nappi
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  2. Michele Klain
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  3. Valeria Cantoni
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  4. Roberta Green
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  8. Mario Petretta
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  9. Alberto Cuocolo
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Contributions

CN, MK, MP, and AC conceptualized the project; VC, RG, LP, FV, and SM carried out the literature search, screened the studies for appropriateness, and performed a second-step selection of the selected full-published reports based on the eligibility criteria; VC, RG, and MP performed the analyses and prepared the figures, CN, MK, MP, and AC drafted the manuscript, and all the authors revised and critically commented on the paper and approved the final version of the manuscript.

Corresponding author

Correspondence to Alberto Cuocolo.

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Not applicable for a systematic review.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Endocrinology.

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Nappi, C., Klain, M., Cantoni, V. et al. Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 49, 1630–1639 (2022). https://doi.org/10.1007/s00259-021-05625-4

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  • DOI: https://doi.org/10.1007/s00259-021-05625-4

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