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Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer

Previous studies have documented an intrinsic association between breast cancer (BC) and thyroid cancer (TC), but the clinical relevance of this relationship is not well defined. In the present study, we specifically investigated the impact of a history of TC on clinical outcomes of BC. We performed...

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Autores principales: Cheng, Weiwei, Shen, Xiaopei, Xing, Mingzhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808426/
https://www.ncbi.nlm.nih.gov/pubmed/31644578
http://dx.doi.org/10.1371/journal.pone.0221093
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author Cheng, Weiwei
Shen, Xiaopei
Xing, Mingzhao
author_facet Cheng, Weiwei
Shen, Xiaopei
Xing, Mingzhao
author_sort Cheng, Weiwei
collection PubMed
description Previous studies have documented an intrinsic association between breast cancer (BC) and thyroid cancer (TC), but the clinical relevance of this relationship is not well defined. In the present study, we specifically investigated the impact of a history of TC on clinical outcomes of BC. We performed a population-based comparative analysis of tumor behaviors and BC-specific mortalities in 427,893 female patients with BC in the USA Surveillance, Epidemiology and End Results 9 database (1973–2013). In this cohort of subjects, 2,569 patients also had a history of differentiated TC (BC/TC), including BC diagnosed before TC (BC-1st) and BC diagnosed after TC (TC-1st), with the median follow-up time of 81 (IQR, 33–160) months. We found that, compared with matched BC-only patients, less aggressive BC tumor behaviors occurred in BC/TC patients, as exemplified by a distant metastasis rate of 7.0% in the former versus 3.3% in the latter (P<0.001). In BC/TC, BC-1st, and TC-1st patients versus their matched BC-only patients, BC-specific mortalities were 11.3% versus 21.0%, 9.9% versus 26.4%, and 12.4% versus 16.9%. These corresponded to hazard ratios (HR) (95% CI) of 0.47 (0.42–0.53), 0.31 (0.26–0.37), and 0.72 (0.61–0.84), respectively (all P<0.001), being lowest in BC-1st patients <50 years old [HR = 0.22 (0.16–0.31)], which remained significant after adjustment for clinicopathological and socioeconomic factors. Estrogen/progesterone receptor expression in BC tumors was significantly higher in patients with BC/TC than matched BC-only patients, providing evidence that BC in the former was biologically unique. Thus, a history of TC, particularly in younger BC-1st patients, may identify BC as a unique disease entity characterized by a decreased disease-specific mortality risk. The results have potentially important clinical and biological implications for BC in this special patient population and encourage further studies to confirm.
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spelling pubmed-68084262019-11-02 Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer Cheng, Weiwei Shen, Xiaopei Xing, Mingzhao PLoS One Research Article Previous studies have documented an intrinsic association between breast cancer (BC) and thyroid cancer (TC), but the clinical relevance of this relationship is not well defined. In the present study, we specifically investigated the impact of a history of TC on clinical outcomes of BC. We performed a population-based comparative analysis of tumor behaviors and BC-specific mortalities in 427,893 female patients with BC in the USA Surveillance, Epidemiology and End Results 9 database (1973–2013). In this cohort of subjects, 2,569 patients also had a history of differentiated TC (BC/TC), including BC diagnosed before TC (BC-1st) and BC diagnosed after TC (TC-1st), with the median follow-up time of 81 (IQR, 33–160) months. We found that, compared with matched BC-only patients, less aggressive BC tumor behaviors occurred in BC/TC patients, as exemplified by a distant metastasis rate of 7.0% in the former versus 3.3% in the latter (P<0.001). In BC/TC, BC-1st, and TC-1st patients versus their matched BC-only patients, BC-specific mortalities were 11.3% versus 21.0%, 9.9% versus 26.4%, and 12.4% versus 16.9%. These corresponded to hazard ratios (HR) (95% CI) of 0.47 (0.42–0.53), 0.31 (0.26–0.37), and 0.72 (0.61–0.84), respectively (all P<0.001), being lowest in BC-1st patients <50 years old [HR = 0.22 (0.16–0.31)], which remained significant after adjustment for clinicopathological and socioeconomic factors. Estrogen/progesterone receptor expression in BC tumors was significantly higher in patients with BC/TC than matched BC-only patients, providing evidence that BC in the former was biologically unique. Thus, a history of TC, particularly in younger BC-1st patients, may identify BC as a unique disease entity characterized by a decreased disease-specific mortality risk. The results have potentially important clinical and biological implications for BC in this special patient population and encourage further studies to confirm. Public Library of Science 2019-10-23 /pmc/articles/PMC6808426/ /pubmed/31644578 http://dx.doi.org/10.1371/journal.pone.0221093 Text en © 2019 Cheng et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Cheng, Weiwei
Shen, Xiaopei
Xing, Mingzhao
Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title_full Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title_fullStr Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title_full_unstemmed Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title_short Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
title_sort decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808426/
https://www.ncbi.nlm.nih.gov/pubmed/31644578
http://dx.doi.org/10.1371/journal.pone.0221093
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