Dear Jamshid,

As you mentioned, before 2004 Conflicting results regarding the clinical

correlation between breast cancer and thyroid diseases have been reported. However, the following study revealed that  goiter prevalence and thyroid antibody levels were found to be increased in breast cancer patients and thyroid functions should be monitored.

Eur J Gen Med 2004; 1(2): 11-14

ANTITHYROID ANTIBODY LEVELS IN PATIENTS WITH BREAST

CANCER

Haluk Dülger1 , Süleyman Alıcı2 , Ekrem Algün3 , Ömer Etlik4 , Mehmet Sayarlıoğlu5 , Ekrem Doğan5 , Hayriye Sayarlıoğlu5 , M. Ramazan Şekeroğlu1 Yüzüncü Yıl University, Faculty of Medicine, Departments of Biochemistry1

, Medical

Oncology 2, Endocrinology3

, Radiology4

and Internal Medicine5

ORIGINAL ARTICLE

Breast cancer is a hormone-dependent neoplasm. Conflicting results regarding the clinical correlation between breast cancer and thyroid diseases have been reported. The aim of this study was to determine the goiter prevalence, thyroid hormones and antithyroid antibody levels in patients with breast cancer. For this purpose, thyroid ultrasonography was performed and serum levels of free triiodothyronine (FT3 ), free thyroxine (FT4 ), thyroid-stimulating hormone (TSH),

anti-thyroid peroxidase antibodies (anti-TPO ab) and anti-thyroglobulin antibodies (anti-TG ab) were determined in 50 operable breast cancer patients at the time of diagnosis and 30 healthy individuals as control group. Goiter prevalence was found to be significantly higher in the study group (50% vs 10%). FT3 , FT4 , and TSH levels of patients were not different compared to controls, whereas anti-TPO ab and anti-TG ab levels were significantly higher in patients than in the control group. In conclusion, goiter prevalence and thyroid antibody levels were found to be

increased in breast cancer patients and thyroid functions should be monitored.

Key words: Breast cancer, thyroid peroxidase, thyroglobulin antibodies

To view the full paper, please see attached file.

Hoping this will be helpful,

Rafik

It is known fact that thyroid function is deranged in breast cancer patients. Many time we seen diffuse increased F-18 FDG uptake in thyroid gland in breast cancer patient while doing whole body PET.CT scan. But whether presence of anti TPO antibodies affect prognosis of breast cancer is debatable issue. The presence of Sodium iodide symporters in breast tissue and their raised expression in breast cancer could be the link to thyroid antibodies. In fact this principle can be used for molecular imaging breast cancer also. This is a very exciting fact and should be researched further.

One article published  by Szychta et al.: TSH receptor antibodies have predictive value for breast cancer – retrospective analysis. Thyroid Research 2013; 6:8 proposed a strong relationship between Graves' disease and breast cancer and that TSHR-Ab can be a positive determinant for breast cancer. However, much larger study - prospective type is required to confirm the results. The paper talk about the screening Graves' disease patient for breast cancer but does not talk about prognosis of breast cancer patients with thyroid antibodies.

I found one article authored by you (Farahati J et al. Anti-thyroid peroxidase antibodies are associated with the absence of distant metastases in patients with newly diagnosed breast cancer. Clin Chem Lab Med. 2012 ;50(4):709-14) saying that it has favorable outcome. It has to be studied at much larger level to be used as prognostic marker.

Hope the best..

Thank you very much for this interesting topic ! Most of the patients are under diagnosed for Hashimotto ( Autoimmune thyroiditis)!, which need further research !

This topic is highly debated and conflicting results have been produced. The most relevant papers about the impact of thyroid autoantibodies (mainly considering autoantibodies to thyroid peroxidase = TPOAb) studied with a prospect approach (5-year survival) are the following:

- Smyth et al. 1998 Serum Thyroid Peroxidase Autoantibodies, Thyroid Volume, and Outcome in Breast Carcinoma. http://dx.doi.org/10.1210/jcem.83.8.5049#sthash.sbW8bbsb.dpuf 

- Fiore et al. 2007 Favorable predictive value of thyroid autoimmunity in high aggressive breast cancer. http://dx.doi.org/10.1007/BF03350810

- Jiskra et al 2007 Thyroid autoimmunity occurs more frequently in women with breast cancer compared to women with colorectal cancer and controls but it has no impact on relapse-free and overall survival. Oncol Rep 2007;18(6):1603-11

The first two (Smyth and Fiore) reported a significantly improved survival (both disease free and overall) in patients with breast cancer positive for TPOAb compared with breast cancer patients TPOAb negative. However Jiskra did not confirm these results, showing that TPOAb have an absence of prognostic impact on breast cancer prognosis.

- Farahati et al 2012; Anti-thyroid peroxidase antibodies are associated with the absence of distant metastases in patients with newly diagnosed breast cancer. Clin Chem Lab Med 2012;50(4):709-14. Farahati showed absence of distant metastasis among TPOAb positive patients with breast cancer compared with TPOAb negative patients (6.6% metastasis prevalence).

I and my research group (Thyroid Research Group, Cardiff, UK) in collaboration with the Institute of Cancer Research - Statistics Unit (London, UK) and the Velindre Breast Cancer Centre (Cardiff, UK) have just finished to analyse the data from a big cohort of women (n' 1974) affected with breast cancer previously enrolled in the TACT trial (CRUK01/001) in order to analyse the impact of TPOAb on breast cancer prognosis in a large cohort.

Despite the large majority of previous studies (cited above) were suggestive for a positive impact of TPOAb on breast cancer prognosis, surprisingly we did not find any significant impact of TPOAb on breast cancer prognosis in terms of overall and disease free survival and time to relapse.

I am finishing to write the relative paper and hopefully it will be published shortly.