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Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer

DOI: 10.1186/1477-7819-9-88

Keywords: thyroid cancer, breast cancer, second primary malignancy, risk factor

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A total of 101 women surgically treated for papillary thyroid cancer from 1996 to 2009 with subsequent follow-up were interviewed by phone regarding personal risk factors and lifestyle habits. Only 75 questionnaires could be evaluated due to a 25.7% rate of patients not retrieved or refusing the interview. Data analysis was performed using a multivariate logistic model.The standardised incidence ratio (SIR) for breast cancer was 3.58 (95% IC 1.14 - 8.37). Our data suggest a protective effect of multiparity on the development of a SPM of the breast (O.R. 0.15; 95% IC 0.25 - 0.86). Significant associations were not found with other known risk factors including Body Mass Index (BMI), age at first tumour, concurrent metabolic diseases, smoking, physical activity and familiarity.This study confirms that a higher incidence of SPM of the breast is observed in women treated for papillary thyroid cancer. Additionally, this risk is increased by nulliparity, thus a strict breast screening program for nulliparous women treated for thyroid cancer may be advisable.Papillary thyroid cancer is the most commonly observed endocrine neoplasm. Its overall age standardised rate in Italy is 9.1 cases/100.000 persons/year, even if its incidence is higher in women (14.3). The mortality rate is much lower, accounting 0.4 death/100.000 [1]. Because thyroid cancer survivors may live for several decades following diagnosis, they may develop a second primary malignancy (SPM). In a meta-analysis conducted by Subramanian et al., 1409 publications were reviewed, and they found that breast carcinoma is the most frequent SPM in women treated for thyroid carcinoma [2]. Several large studies analysed the incidence of SPM of the breast using cancer registries [3-5], but these studies did not focus on possible risk co-factors, such as the lifestyle or family and past medical history of the women. The present study examined common risk factors for breast carcinoma in a cohort of women surgically treated


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