Skip to main content

Advertisement

SpringerLink
Log in

Autoimmune hypothyroidism and breast cancer in the elderly

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose To determine whether autoimmune hypothyroidism (AIHT) influences breast cancer (BRCA) incidence or all-cause survival. Methods Administrative data were used to identify elderly women living in Ontario, Canada with and without AIHT based on prescriptions for levothyroxine (LT4) (N = 178,186). Women were followed from April 1, 1994–March 31, 2003 for BRCA outcomes. Results The incidence of BRCA was similar in LT4 users and a propensity-matched cohort of non-users (adjusted HR = 0.99; 95% CI: 0.92–1.07). All-cause mortality was significantly lower in LT4 users compared to non-users (HR 0.95; 95% CI: 0.93–0.97, P < 0.001), as was all-cause mortality following BRCA diagnosis (HR 0.87; 95% CI: 0.77–0.98, P = 0.02). Conclusions LT4 use, as a surrogate for AIHT, is not a risk factor for BRCA in elderly women. The small survival advantage noted among LT4 users who developed BRCA likely represents a ‘healthy user’ effect. Further study is needed to investigate whether autoimmunity in general is related to BRCA development or related outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Baum M, Schipper H (2005) Epidemiology. In: Baum M, Schipper H (eds) Breast cancer, 3rd edn. Health Press Ltd, Abingdon, pp 7–15

    Google Scholar 

  2. American Cancer Society (2008) Cancer facts and figures 2008. http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf. Accessed 1 May 2008

  3. Beatson GT (1896) On the treatment of inoperable cases of carcinoma of the mamma: suggestions for a new method of treatment, with illustrative cases. Lancet 2:104–110. doi:10.1016/S0140-6736(01)72307-0

    Article  Google Scholar 

  4. Turken O, Narin Y, Demirbas S, Onde ME, Sayan O, Kandemir EG et al (2003) Breast cancer in association with thyroid disorders. Breast Cancer Res 5:R110–R113. doi:10.1186/bcr609

    Article  PubMed  Google Scholar 

  5. Giustarini E, Pinchera A, Fierabracci P, Roncella M, Fustaino L, Mammoli C et al (2006) Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery. Eur J Endocrinol 154:645–649. doi:10.1530/eje.1.02108

    Article  PubMed  CAS  Google Scholar 

  6. Simon MS, Tang MTC, Bernstein L, Norman SA, Weiss L, Burkman RT et al (2002) Do thyroid disorders increase the risk of breast cancer? Cancer Epidemiol Biomarkers Prev 11:1574–1578

    PubMed  Google Scholar 

  7. Weiss H, Brinton LA, Potischman NA, Brogan D, Coates RJ, Gammon MD et al (1999) Breast cancer risk in young women and history of selected medical conditions. Int J Epidemiol 28:816–823. doi:10.1093/ije/28.5.816

    Article  PubMed  CAS  Google Scholar 

  8. Cengiz O, Bozkurt B, Unal B, Yildirim O, Karabeyoglu M, Eroglu A et al (2004) The relationship between prognostic factors of breast cancer and thyroid disorders in Turkish women. J Surg Oncol 87:19–25. doi:10.1002/jso.20071

    Article  PubMed  Google Scholar 

  9. Cristofanilli M, Yamamura Y, Kau S, Bevers T, Strom S, Patangan M et al (2005) Thyroid hormone and breast carcinoma. Cancer 103:1122–1128. doi:10.1002/cncr.20881

    Article  PubMed  CAS  Google Scholar 

  10. Levy AR, O’Brien BJ, Sellors C, Grootendorst P, Willison D (2003) Coding accuracy of administrative drug claims in the Ontario drug benefit database. Can J Clin Pharmacol 10:67–71

    PubMed  Google Scholar 

  11. McLaughlin JR, Sloan MR, Janovjak DP (1995) Cancer survival in Ontario. The Ontario Cancer Treatment and Research Foundation, Toronto, pp 1–9

    Google Scholar 

  12. Robles SC, Marrett LD, Clarke EA, Risch HA (1988) An application of capture-recapture methods to the estimation of completeness of cancer registration. J Clin Epidemiol 4:495–501. doi:10.1016/0895-4356(88)90052-2

    Article  Google Scholar 

  13. Booth GL, Hux JE (2003) Relationship between avoidable hospitalizations for diabetes mellitus and income level. Arch Intern Med 163:101–106. doi:10.1001/archinte.163.1.101

    Article  PubMed  Google Scholar 

  14. Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619. doi:10.1016/0895-4356(92)90133-8

    Article  PubMed  CAS  Google Scholar 

  15. Rubin DB (2001) Using propensity scores to help design observational studies: application to the tobacco litigation. Health Serv Outcomes Res Methodol 2:169–188. doi:10.1023/A:1020363010465

    Article  Google Scholar 

  16. Rosenbaum PR, Rubin DB (1985) Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat 39:33–38. doi:10.2307/2683903

    Article  Google Scholar 

  17. Jiskra J, Limanova Z, Barkmanova J, Smutek D, Friedmannova Z (2004) Autoimmune thyroid diseases in women with breast cancer and colorectal cancer. Physiol Res 53:693–702

    PubMed  CAS  Google Scholar 

  18. Wapnir I, Van De Rign M, Nowels K, Amenta PS, Walton K, Montgomery K et al (2003) Immunohistochemical profile of the sodium/iodide symporter in thyroid, breast, and other carcinomas using high density tissue microarrays and conventional sections. J Clin Endocrinol Metab 88:1880–1888. doi:10.1210/jc.2002-021544

    Article  PubMed  CAS  Google Scholar 

  19. D’Herbomez M, Wemeau JL (2001) Analysis for the diagnosis of autoimmune thyroid disease: contribution of the laboratory. Ann Biol Clin (Paris) 59:717–723

    Google Scholar 

  20. Neville MC, McFadden TB, Forsyth I (2002) Hormonal regulation of mammary differentiation and milk secretion. J Mammary Gland Biol Neoplasia 1:49–66. doi:10.1023/A:1015770423167

    Article  Google Scholar 

  21. Nogueira CR, Brentani MM (1996) Triiodothreonine mimics the effects of estrogen in breast cancer cell lines. J Steroid Biochem Mol Biol 59:271–279. doi:10.1016/S0960-0760(96)00117-3

    Article  PubMed  CAS  Google Scholar 

  22. Brookhart MA, Patrick AR, Dormuth C, Avorn J, Shrank W, Cadarette SM et al (2007) Adherence to lipid-lowering therapy and the use of preventive health services: an investigation of the healthy user effect. Am J Epidemiol 166:348–354. doi:10.1093/aje/kwm070

    Article  PubMed  Google Scholar 

  23. Weetman AP, McGregor AM (1994) Autoimmune thyroid disease—further developments in our understanding. Endocr Rev 15:788. doi:10.1210/er.15.6.788

    PubMed  CAS  Google Scholar 

  24. Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F et al (1995) The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol (Oxf) 43:55. doi:10.1111/j.1365-2265.1995.tb01894.x

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the assistance of Dr. Muhammad Mamdani and Kathy Sykora for their input on the design and analysis of this study. This work was funded by the Institute for Clinical Evaluative Sciences and the University of Toronto. Dr. Sandhu is supported by Ontario’s Ministry of Health and Long-Term Care. Dr. Booth holds a new investigator award funded by the Ontario Women’s Health Council and the Canadian Institutes of Health Research. Dr. Lipscombe is supported by a Clinician Scientist award from the Canadian Diabetes Association. Dr. Brezden-Masley is supported by St Michael’s Hospital. The Institute for Clinical Evaluative Sciences receives funding from Ontario’s Ministry of Health and Long-Term Care.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Toronto, Toronto, Canada

    Monty K. Sandhu, Christine Brezden-Masley, Lorraine L. Lipscombe & Gillian L. Booth

  2. Division of Endocrinology and Metabolism, St. Michael’s Hospital, 6-147, 61 Queen Street East, Toronto, ON, Canada, M5C 2T2

    Gillian L. Booth

  3. Division of Hematology/Oncology, St. Michael’s Hospital, Toronto, ON, Canada

    Christine Brezden-Masley

  4. The Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Gillian L. Booth

  5. Division of Endocrinology and Metabolism, Women’s College Hospital, Toronto, ON, Canada

    Lorraine L. Lipscombe

  6. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

    Lorraine L. Lipscombe, Branden Zagorski & Gillian L. Booth

Authors
  1. Monty K. Sandhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christine Brezden-Masley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lorraine L. Lipscombe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Branden Zagorski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gillian L. Booth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gillian L. Booth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sandhu, M.K., Brezden-Masley, C., Lipscombe, L.L. et al. Autoimmune hypothyroidism and breast cancer in the elderly. Breast Cancer Res Treat 115, 635–641 (2009). https://doi.org/10.1007/s10549-008-0104-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-008-0104-4

Keywords

Search

Navigation