Hypothyroidism and hyperthyroidism and breast cancer risk: a nationwide cohort study

ObjectiveThe association between thyroid disease and breast cancer risk remains unclear. We, therefore examined the association between hypothyroidism, hyperthyroidism and breast cancer risk.DesignThis was a population-based cohort study.MethodsUsing nationwide registries, we identified all women in Denmark with a first-time hospital diagnosis of hypothyroidism or hyperthyroidism, 1978–2013. We estimated the excess risk of breast cancer among patients with hypothyroidism or hyperthyroidism compared with the expected risk in the general population, using standardized incidence ratios (SIRs) as a measure of risk ratio. Breast cancer diagnoses in the first 12 months following diagnosis of thyroid disease were excluded from the calculations to avoid diagnostic work-up bias.ResultsWe included 61 873 women diagnosed with hypothyroidism and 80 343 women diagnosed with hyperthyroidism. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8–9.5 years) for hypothyroidism and 7.4 years (IQR: 3.1–13.5 years) for hyperthyroidism. Hyperthyroidism was associated with a slightly increased breast cancer risk compared with the general population (SIR: 1.11, 95% CI: 1.07–1.16), which persisted beyond 5 years of follow-up (SIR: 1.13, 95% CI: 1.08–1.19). In comparison, hypothyroidism was associated with a slightly lower risk of breast cancer (SIR: 0.94, 95% CI: 0.88–1.00). Stratification by cancer stage at diagnosis, estrogen receptor status, age, comorbidity, history of alcohol-related disease and clinical diagnoses of obesity produced little change in cancer risk.ConclusionsWe found an increased risk of breast cancer in women with hyperthyroidism and a slightly decreased risk in women with hypothyroidism indicating an association between thyroid function level and breast cancer risk.

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Breast Cancer Screening in Women Previously Treated for Hodgkin’s Disease: A Prospective Cohort Study

Journal of Clinical Oncology ◽

10.1200/jco.2002.08.031 ◽

2002 ◽

Vol 20 (8) ◽

pp. 2085-2091 ◽

Cited By ~ 84

Author(s):

Lisa Diller ◽

Cheryl Medeiros Nancarrow ◽

Kitt Shaffer ◽

Ursula Matulonis ◽

Peter Mauch ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Prospective Cohort ◽

Ductal Carcinoma ◽

Breast Cancers ◽

Node Negative ◽

Increased Risk

PURPOSE: Young women who are exposed to chest irradiation for Hodgkin’s disease (HD) are at increased risk of breast cancer; this study investigated patient awareness of breast cancer risk and patient screening behavior and assessed the utility of mammographic screening in HD survivors. PATIENTS AND METHODS: This is a prospective cohort study of 90 female long-term survivors of HD who had been treated ≥ 8 years previously with mantle irradiation (current age, 24 to 51 years). Participants completed surveys of their perceptions of breast cancer risk and screening behaviors and received written recommendations for breast examinations and mammography. Annual follow-up was conducted through medical records, telephone, and/or mailed questionnaires. RESULTS: At baseline, women were often unaware of their increased risk of breast cancer; 40% (35 of 87) reported themselves to be at equal or lower risk than women of the same age. Only 47% (41 of 87) reported having had a mammogram in the previous 24 months. Women who had received information from an oncologist were more likely to assess correctly their risk than women who received information from other sources (P < .001). Ten women developed 12 breast cancers (ductal carcinoma-in-situ [n = 2], invasive ductal carcinoma [n = 10]) during the study; two were diagnosed at study entry, and 10 during follow-up (median, 3.1 years). All cancers were evident on mammogram, and eight of 10 invasive cancers were node negative. CONCLUSION: Practitioners who care for women after HD therapy need to educate patients regarding their risks and begin early screening. Screening by mammography can detect small, node-negative breast cancers in these patients.

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Risk of primary gastrointestinal cancers following incident non-metastatic breast cancer: a Danish population-based cohort study

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000413 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000413

Author(s):

Kasper Adelborg ◽

Dóra Körmendiné Farkas ◽

Jens Sundbøll ◽

Lidia Schapira ◽

Suzanne Tamang ◽

...

Keyword(s):

Breast Cancer ◽

Colon Cancer ◽

Cohort Study ◽

Metastatic Breast Cancer ◽

Stomach Cancer ◽

Metastatic Breast ◽

Population Based ◽

Gastrointestinal Cancers ◽

Increased Risk

ObjectiveWe examined the risk of primary gastrointestinal cancers in women with breast cancer and compared this risk with that of the general population.DesignUsing population-based Danish registries, we conducted a cohort study of women with incident non-metastatic breast cancer (1990–2017). We computed cumulative cancer incidences and standardised incidence ratios (SIRs).ResultsAmong 84 972 patients with breast cancer, we observed 2340 gastrointestinal cancers. After 20 years of follow-up, the cumulative incidence of gastrointestinal cancers was 4%, driven mainly by colon cancers. Only risk of stomach cancer was continually increased beyond 1 year following breast cancer. The SIR for colon cancer was neutral during 2–5 years of follow-up and approximately 1.2-fold increased thereafter. For cancer of the oesophagus, the SIR was increased only during 6–10 years. There was a weak association with pancreas cancer beyond 10 years. Between 1990–2006 and 2007–2017, the 1–10 years SIR estimate decreased and reached unity for upper gastrointestinal cancers (oesophagus, stomach, and small intestine). For lower gastrointestinal cancers (colon, rectum, and anal canal), the SIR estimate was increased only after 2007. No temporal effects were observed for the remaining gastrointestinal cancers. Treatment effects were negligible.ConclusionBreast cancer survivors were at increased risk of oesophagus and stomach cancer, but only before 2007. The risk of colon cancer was increased, but only after 2007.

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Recalibration of the Gail model for predicting invasive breast cancer risk in Spanish women: a population-based cohort study

Breast Cancer Research and Treatment ◽

10.1007/s10549-013-2428-y ◽

2013 ◽

Vol 138 (1) ◽

pp. 249-259 ◽

Cited By ~ 13

Author(s):

Roberto Pastor-Barriuso ◽

Nieves Ascunce ◽

María Ederra ◽

Nieves Erdozáin ◽

Alberto Murillo ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Invasive Breast Cancer ◽

Population Based ◽

Gail Model ◽

Spanish Women

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Night work and breast cancer risk in a general population prospective cohort study in The Netherlands

European Journal of Epidemiology ◽

10.1007/s10654-014-9938-8 ◽

2014 ◽

Vol 29 (8) ◽

pp. 577-584 ◽

Cited By ~ 21

Author(s):

Lando L. J. Koppes ◽

Goedele A. Geuskens ◽

Anjoeka Pronk ◽

Roel C. H. Vermeulen ◽

Ernest M. M. de Vroome

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Breast Cancer Risk ◽

General Population ◽

Cancer Risk ◽

The Netherlands ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Night Work

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Physical activity and risk of postmenopausal breast cancer defined by hormone receptor status and histology: A large prospective cohort study with 18 years of follow up

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.1002 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 1002-1002 ◽

Cited By ~ 1

Author(s):

A. Bardia ◽

A. H. Wang ◽

L. C. Hartmann ◽

J. E. Olson ◽

C. M. Vachon ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Risk Factors ◽

Cohort Study ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cancer Incidence ◽

Breast Cancer Incidence ◽

Histological Subtypes

1002 Background: Physical activity is a modifiable breast cancer risk factor, perhaps mediating risk reduction through regulation of estrogen metabolism. Evidence regarding effect of physical activity is conflicting partly because breast cancer is a heterogenous constellation of different tumor subtypes with differing etiologies. No prospective study has examined the relationship between physical activity and breast cancer incidence based on ER/PR status or histological subtype. Objective: Examine effect of physical activity on breast cancer incidence based on ER/PR status and histological subtypes of breast cancer. Methods: The Iowa Women’s Health Study is a prospective cohort study of postmenopausal women (N=41,837). Physical activity was self-reported on baseline questionnaire, and three levels (high, medium and low) were defined. Breast cancer incidence, histologic subtype and ER/PR status, through 18 years of follow-up, were ascertained by linkage with the Iowa SEER Cancer Registry. Cox proportional hazards models were used to estimate multivariate relative risks (RRs) and 95% confidence intervals (CIs) of breast cancer, adjusting for other breast cancer risk factors. Results: During 554,819 person-years of follow-up, 2548 incident cases of breast cancer were observed. High physical activity was associated with decreased risk for breast cancer (RR 0.91, 95 % CI 0.81–1.01) compared to low activity. The protective effect was most marked in ER+/PR− (RR 0.66, CI 0.46–0.94), intermediate in ER−/PR− (RR 0.80, CI 0.56–1.15), weakest in ER+/PR+ (RR 0.94, CI 0.81–1.08), and elevated in ER-/PR+ (RR 1.42, CI 0.67–3.01) tumors. Higher physical activity was also associated with a decreased risk of invasive ductal/lobular carcinoma (RR 0.90, CI 0.80–1.02), but not with invasive breast cancer with a favorable histology (RR 1.19, CI 0.78–1.81). Conclusions: Higher physical activity was associated with a 10% decreased risk of breast cancer. Unexpectedly, risk reduction was most marked in PR- tumors, particularly ER+/PR-, and the more aggressive histologic forms. Further studies are needed to confirm these findings, and also evaluate other risk factors based on ER/PR status and histological subtypes. No significant financial relationships to disclose.

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Cancer Risk in Patients with Autoimmune Hepatitis: A Nationwide Population-Based Cohort Study with Histopathology

American Journal of Epidemiology ◽

10.1093/aje/kwab119 ◽

2021 ◽

Author(s):

Rajani Sharma ◽

Elizabeth C Verna ◽

Tracey G Simon ◽

Jonas Söderling ◽

Hannes Hagström ◽

...

Keyword(s):

Cohort Study ◽

General Population ◽

Cancer Risk ◽

Autoimmune Hepatitis ◽

Cox Regression ◽

Population Based ◽

Swedish Population ◽

Non Melanoma Skin Cancer ◽

Incident Cancer ◽

Increased Risk

Abstract We aimed to determine the risk of incident cancer in autoimmune hepatitis (AIH) compared to the general population and siblings. AIH was defined by the presence of a medical diagnosis of AIH and a liver biopsy in a nationwide Swedish population-based cohort study. We identified 5,268 adults with AIH diagnosed 1969-2016 and 22,996 matched general population reference individuals and 4,170 sibling comparators. Using Cox regression, hazard ratios (HRs) were determined for any incident cancer and sub-types determined from the Swedish Cancer Register. During follow-up, a cancer diagnosis was made in 1,119 individuals with AIH (17.2/1000 person-years) and 4,450 reference individuals (12.0/1000 person-years). This corresponded to an HR of 1.53 (95%CI: 1.42,1.66). Cancer risk was highest in those with cirrhosis. There was a 29.18-fold increased risk of hepatocellular carcinoma (HCC) (95%CI, 17.52,48.61). The annual incidence risk of HCC in individuals with AIH who had cirrhosis was 1.1% per year. AIH was also linked to non-melanoma skin cancer (HR=2.69) and lymphoma (HR=1.89). Sibling analyses yielded similar risk estimates for any cancer (HR=1.84) and HCC (HR=23.10). AIH is associated with an increased risk of any cancer, in particular, HCC and extra-hepatic malignancies. The highest risk for cancer, especially HCC, is in patients with cirrhosis.

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Abstract GS2-01: Age-related breast cancer risk estimates for the general population based on sequencing of cancer predisposition genes in 19,228 breast cancer patients and 20,211 matched unaffected controls from US based cohorts in the CARRIERS study

10.1158/1538-7445.sabcs18-gs2-01 ◽

2019 ◽

Author(s):

FJ Couch ◽

C Hu ◽

SN Hart ◽

RD Gnanaolivu ◽

J Lilyquist ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

General Population ◽

Cancer Risk ◽

Cancer Patients ◽

Population Based ◽

Cancer Predisposition ◽

Breast Cancer Patients ◽

Age Related ◽

Predisposition Genes

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Breast cancer risk in hyperprolactinemia: a population-based cohort study and meta-analysis of the literature

Acta Endocrinologica ◽

10.1530/eje-15-0282 ◽

2015 ◽

Vol 173 (2) ◽

pp. 269-273 ◽

Cited By ~ 9

Author(s):

O M Dekkers ◽

V Ehrenstein ◽

M Bengtsen ◽

D Kormendine Farkas ◽

A M Pereira ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Meta Analysis ◽

Population Based ◽

Incidence Rates ◽

Increased Risk ◽

Combining Data ◽

First Time ◽

Time Diagnosis

ObjectiveTo enhance the precision of the risk estimate for breast cancer in hyperprolactinemia patients by collecting more data and pooling our results with available data from former studies in a meta-analysis.DesignPopulation-based cohort study and meta-analysis of the literature.MethodsUsing nationwide registries, we identified all patients with a first-time diagnosis of hyperprolactinemia during 1994–2012 including those with a new breast cancer diagnoses after the start of follow-up. We calculated standardised incidence ratios (SIRs) as a measure of relative risk (RR) using national cancer incidence rates. We performed a meta-analysis, combining data from our study with data in the existing literature.ResultsWe identified 2457 patients with hyperprolactinemia and 20 breast cancer cases during 19 411 person-years of follow-up, yielding a SIR of 0.99 (95% CI 0.60–1.52). Data from two additional cohort studies were retrieved and analyzed. When the three risk estimates were pooled, the combined RR was 1.04 (95% CI 0.75–1.43).ConclusionsWe found no increased risk of breast cancer among patients with hyperprolactinemia.

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