Thyroid volume changes following adjuvant radiation therapy for breast cancer

Roberson, John; Huang, Hanchun; Noldner, Collin; Hou, Wei; Mani, Kartik; Valentine, Edward S.; Ryu, Samuel; Stessin, A.

doi:10.1016/j.ctro.2022.100566

Cited by 3 publications

(5 citation statements)

References 28 publications

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“…The higher risk for hypothyroidism in breast cancer patients treated with radiotherapy including regional lymph nodes is in accordance with previous studies [6,7,19]. The pathophysiological mechanism of this association, through direct thyroid cell injury or indirect due to damage in small thyroid vessels, has been described [20] and is further supported by dosimetric data showing higher mean radiation dose to the thyroid gland in patients treated with radiotherapy including regional lymph nodes compared to patients with radiotherapy only to breast / chest wall [19] and a dose-dependent association between dose to the thyroid gland and decreased thyroid volume [11]. The present study strengthens the current evidence by overcoming some of the main limitations of previous studies [21].…”

Section: Discussionsupporting

confidence: 89%

“…In breast cancer patients, radiation therapy to the supraclavicular lymph nodes has been associated with increased risk for hypothyroidism [6,7]. Some studies suggest a potential impact of systemic treatment to the risk of hypothyroidism in breast cancer patients as well [8][9][10][11][12][13][14]. However, the results from these studies are contradictory and inconclusive due to the small sample size [8, 10,14], the lack of populationbased data, and the lack of information on speci c treatment approaches [10,11,13].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Digkas

Smith

Wennstig

et al. 2023

Preprint

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Purpose An increased incidence of hypothyroidism among breast cancer survivors has been observed in earlier studies. The impact of the postoperative treatment modalities and their potential interplay on hypothyroidism development needs to be studied.Methods We conducted a population- and registry- based study using the Breast Cancer Data Base Sweden (BCBaSe) including females diagnosed with breast cancer between 2006 and 2012. In total, 21,268 female patients diagnosed with early breast cancer between 2006 and 2012, with no previous prescription of thyroid hormones and no malignant diagnosis during the last ten years before breast cancer diagnosis, were included in the final analysis.Results During the follow-up (median follow-up time 7.9 years), 1,212 patients (5.7%) developed hypothyroidism at a median time of 3.45 years from the index date. No association of the systemic oncological treatment in terms of either chemotherapy or endocrine therapy and hypothyroidism development could be identified. A higher risk (HR 1.68;95% CI:1.42–1.99) of hypothyroidism identified among patients treated with radiation treatment of the regional lymph nodes whereas no increased risk in patients treated only with radiation therapy to the breast/chest-wall was found (HR:1.01; 95% CI:0.86–1.19). The risk of hypothyroidism in the cohort treated with radiotherapy of the regional lymph nodes was present irrespective of the use of adjuvant chemotherapy treatment.Conclusions Based on the results of our study, the implementation of hypothyroidism surveillance among the breast cancer survivors treated with radiotherapy of the regional lymph nodes can be considered as reasonable in the follow-up program.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Digkas

Smith

Wennstig

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The higher risk for hypothyroidism in breast cancer patients treated with radiotherapy including regional lymph nodes is in accordance with previous studies [ 6 , 7 , 19 ]. The pathophysiological mechanism of this association, through direct thyroid cell injury or indirect due to damage in small thyroid vessels, has been described [ 20 ] and is further supported by dosimetric data showing higher mean radiation dose to the thyroid gland in patients treated with radiotherapy including regional lymph nodes compared to patients with radiotherapy only to breast / chest wall [ 19 ] and a dose-dependent association between dose to the thyroid gland and decreased thyroid volume [ 11 ]. The present study strengthens the current evidence by overcoming some of the main limitations of previous studies [ 21 ].…”

Section: Discussionmentioning

confidence: 91%

“…Some studies suggest a potential impact of systemic treatment to the risk of hypothyroidism in breast cancer patients as well [ 8 – 14 ]. However, the results from these studies are contradictory and inconclusive due to the small sample size [ 8 , 10 , 14 ], the lack of population-based data, and the lack of information on specific treatment approaches [ 10 , 11 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Digkas,

Smith,

Wennstig

et al. 2023

Breast Cancer Res Treat

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Purpose An increased incidence of hypothyroidism among breast cancer survivors has been observed in earlier studies. The impact of the postoperative treatment modalities and their potential interplay on hypothyroidism development needs to be studied. Methods We conducted a population- and registry-based study using the Breast Cancer Data Base Sweden (BCBaSe) including females diagnosed with breast cancer between 2006 and 2012. In total, 21,268 female patients diagnosed with early breast cancer between 2006 and 2012, with no previous prescription of thyroid hormones and no malignant diagnosis during the last ten years before breast cancer diagnosis, were included in the final analysis. Results During the follow-up (median follow-up time 7.9 years), 1212 patients (5.7%) developed hypothyroidism at a median time of 3.45 years from the index date. No association of the systemic oncological treatment in terms of either chemotherapy or endocrine therapy and hypothyroidism development could be identified. A higher risk (HR 1.68;95% CI 1.42–1.99) of hypothyroidism identified among patients treated with radiation treatment of the regional lymph nodes whereas no increased risk in patients treated only with radiation therapy to the breast/chest wall was found (HR 1.01; 95% CI 0.86–1.19). The risk of hypothyroidism in the cohort treated with radiotherapy of the regional lymph nodes was present irrespective of the use of adjuvant chemotherapy treatment. Conclusions Based on the results of our study, the implementation of hypothyroidism surveillance among the breast cancer survivors treated with radiotherapy of the regional lymph nodes can be considered as reasonable in the follow-up program.

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“…Specifically, irradiation to the supraclavicular field was associated with an increased risk of hypothyroidism compared with radiation to the breast and chest wall only [17] , [19] , [21] , [34] , with a pooled relative risk of 69 %, according to a recent meta -analysis [35] . Additionally, radiation-induced thyroid volume reduction [36] , [37] , [38] or a smaller thyroid volume was associated with a higher incidence of radiation-induced hypothyroidism [23] . Female sex [39] , [40] or systemic therapy [17] , [40] , [41] may also contribute to an increased risk.…”

Section: Discussionmentioning

confidence: 93%

Normal tissue complication probability models of hypothyroidism after radiotherapy for breast cancer

Park,

Cho,

Chang

et al. 2024

Clinical and Translational Radiation Oncology

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Thyroid volume changes following adjuvant radiation therapy for breast cancer

Cited by 3 publications

References 28 publications

Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Incidence and risk factors of hypothyroidism after treatment for early breast cancer: a population-based cohort study

Normal tissue complication probability models of hypothyroidism after radiotherapy for breast cancer

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