Thyroid Problems Six years ago I was treated for breast cancer with a lumpectomy and radiation. Three years later I was diagnosed with a goiter. My endocrinologist said she has seen a number of women who had breast cancer who went on to develop thyroid cancer and recommended that I have my thyroid removed. Is there a link between breast cancer and thyroid cancer? The thyroid is a gland located in the neck, below the Adam's apple. It makes and stores hormones that help regulate heart rate, blood pressure, body temperature, and the rate at which food is converted into energy. A goiter is another name for an enlarged thyroid gland. This type of thyroid problem is very common.
To date, at least four published studies have looked at the risk of developing thyroid cancer after being treated for breast cancer. One of these studies, published in 2001, looked specifically at the risk of developing thyroid cancer after breast cancer in women who received radiation treatment. In this large study, the authors identified 194,798 women who were diagnosed with invasive breast cancer and compared those who had had radiation with those who had not. The study found that the women who had breast cancer—whether or not they had radiation—were at no greater risk for developing thyroid cancer than were women who had not had breast cancer.
Other studies have looked at whether there is a relationship between having had breast cancer and developing an enlarged thyroid. A 1996 study evaluated thyroid size in 200 women with breast cancer and 354 women with benign breast disease and compared both groups to women who had no signs of breast cancer or breast disease. They found that the mean thyroid size was larger in the group of women who had had breast cancer or breast disease than it was in women without breast cancer or breast disease. This research supports an association, but it cannot say that the breast cancer caused the enlarged thyroid.
Thyroid cancer typically shows up as a nodule in a normal-sized thyroid, not as a goiter. Thyroid cancer is relatively uncommon, but it is more likely to occur in women (about 17,640 women and 5,960 men are diagnosed with the disease each year), although the prognosis is worse in men.
If you have symptoms that your doctor thinks indicate you may have thyroid cancer, a thyroid scan or an ultrasound can be done. Your doctor may also take a sample of fluid from the tumor. This is called a fine needle aspiration biopsy. A biopsy is the only way to be positive that cancer is present. If the biopsy shows you have cancer, your doctor may order additional tests, such as CT scans, an MRI, or more thyroid scans. These tests will help your healthcare team to determine what type of thyroid cancer it is and to assess how far it has spread. Reference:
Adjadj E, et al. The Risk of Multiple Primary Breast and Thyroid Carcinomas. Cancer 2003 Sep 15;98(6):1309–17. Chen AY, et al. The Development of Breast Carcinoma in Women with Thyroid Carcinoma. Cancer 2001 Jul 15;92(2):225–31.
Huang J, et al. Risk of Thyroid Carcinoma in a Female Population After Radiotherapy for Breast Carcinoma. Cancer 2001 Sep 15;92(6):1411–18.
Sadetzki S, et al. Second Primary Breast and Thyroid Cancers (Israel). Cancer Causes and Control 2003 May;14(4):367–75.
Smyth PP, et al. A Direct Relationship Between Thyroid Enlargement and Breast Cancer. Journal of Clinical Endocrinology and Metabolism 1996 Mar;81(3):937-41
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