Thyroid Function in Relation to Mammary Cancer

Abstract

THE direct or indirect influence of certain hormones, e.g. stilboestrol and testosterone, on the aetiology of malignancy has been well recognised for many years and has formed the basis of their extensive use in the management of this disease, particularly in attempting its control in advanced stages. Some of the cancers of breast and of prostate are good examples of tumours which are hormone dependent. But the role that the thyroid hormone plays is still uncertain. Beatson was the first, in 1896, to treat advanced carcinoma of breast with thyroid extract in addition to oophorectomy. Only in the last decade or so the result of a good deal of experimental work and clinical observation has been to suggest that thyroid secretion plays an important part in the evolution of cancer, particularly of the genitalia and the breast. Loeser (1954) states that the incidence of female breast carcinoma is far lower in allergic and hyperthyroid conditions than in hypothyroid women or after thyroidectomy. In his view, it is the low histamine content of the cells of hypothyroid women which increases the tendency to cancer formation. Spencer (1954), discussing iodine availability in cancer incidence, doubts whether a low metabolic rate or insufficiency of thyroid substance can be considered as a primary cause of cancer. He suggests, rather more vaguely, " that thyroid function (or dysfunction) may be associated with the susceptibility or immunity to cancer ". Sommers (1955), after examining autopsies of breast cancer cases and of about an equal number of adult women without cancer, found hyperplastic modification in one or more endocrine glands and their target organs. A noticeable exception was the thyroid gland, in which atrophy occurred more commonly with than without breast cancer. The thyroid atrophy was independent of the body weight. Dargent and Mayer (1955), surveying 71 cases of cancer of various sites, have attempted to demonstrate that thyroid secretion has a definite influence on the evolution of cancer, and warn that surgical treatment of goitre in a case of established malignancy should not be undertaken lightly. Dessaive (1956) in both his experimental work and clinical observations comes to a similar conclusion. From his study of 13,261 cancers seen in Liege it appears that simple thyroid conditions, particularly goitre, constitute a favourable element in the formation of cancer. The effect was found in women much more often than in men, and was especially noticeable in breast carcinoma. He also found that cancers which develop against a background of thyroid deficiency have a worse prognosis, and recommends full investigation before undertaking surgical or other treatment for simple thyroid disorder, in order to exclude the presence of a cancer which at -that time may be

Pituitary-thyroid function in patients with breast cancer.

“…No significant difference was, however, observed between local and side spread breast cancer. Sicker andWaterhouse (1961 , 1967) have shown that there is no statistical difference in radioiodine uptake between the patients with early and late breast cancer nor relationship of thyroid function to the clinical course of these patients. These studies of thyroid function on the patients with breast cancer have no unequivocal evidence.…”

A Clinical Trial of Tri-Iodothyronine as a Hormone Potentiator in Advanced Breast Cancer

“…Several recent papers have investigated a possible relationship between the incidence of breast cancer and decreased activity of the thyroid gland (Loeser, 1954;Sommers, 1955;Ellerker, 1956;Rawson, 1956;Edelstyn, Lyons and Welbourn, 1958;Marques, Bru and Espinosse, 1959;Hortling, Hilsi-Brummer and Bjorresten, 1959;Finley and Bogardus, 1960;Carter and Feldman, 1960;Reeve et al, 1961 ;Sicher and Waterhouse, 1961). The relationship has been investigated by demographic, biochemical and experimental approaches.…”

Thyroid activity in relation to prognosis in mammary cancer.

“…We reviewed the literature in our paper of 1961, and described the early stages of an experimental approach we were making in an attempt to answer the question (Sicher and Waterhouse, 1961 More than one type of relationship between thyroid function and breast cancer has been considered in the recent literature, and it is not always clear what is under investigation in a particular study. The hypothesis that hyperfunction of the thyroid gland is associated with a reduced incidence of breast cancer is supported by Humphrey and Swerdlow (1964) who found no case of breast cancer among 196 patients with hyperthyroidism followed for 12 years.…”