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Anders Kjærsgaard

Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study

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Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study. / Falstie-Jensen, Anne Mette; Esen, Buket; Kjærsgaard, Anders; Lorenzen, Ebbe L.; Jensen, Jeanette D.; Reinertsen, Kristin V.; Dekkers, Olaf M.; Ewertz, Marianne; Cronin-Fenton, Deirdre P.

I: Breast Cancer Research, Bind 22, 106, 10.2020.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Falstie-Jensen AM, Esen B, Kjærsgaard A, Lorenzen EL, Jensen JD, Reinertsen KV o.a. Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study. Breast Cancer Research. 2020 okt;22. 106. https://doi.org/10.1186/s13058-020-01337-z

Author

Falstie-Jensen, Anne Mette ; Esen, Buket ; Kjærsgaard, Anders ; Lorenzen, Ebbe L. ; Jensen, Jeanette D. ; Reinertsen, Kristin V. ; Dekkers, Olaf M. ; Ewertz, Marianne ; Cronin-Fenton, Deirdre P. / Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study. I: Breast Cancer Research. 2020 ; Bind 22.

Bibtex

@article{4c07555920ff466e907883c51f4edb8f,
title = "Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study",
abstract = "Background: Breast cancer survivors (BCS) may have increased risk of hypothyroidism, but risk according to treatment modality is unclear. We estimated the incidence of hypothyroidism in women with breast cancer, and according to cancer treatment. Methods: Using nationwide registries, we identified all Danish women aged ≥ 35 years diagnosed with non-metastatic breast cancer (1996–2009). We matched up to five cancer-free women (controls) for each BCS. We excluded women with prevalent thyroid disease. Cancer treatment was chemotherapy with or without radiotherapy (RT) targeting the breast/chest wall only, or also the lymph nodes (RTn). We identified hypothyroidism using diagnostic codes, and/or levothyroxine prescriptions. We calculated the cumulative incidence, incidence rates (IR) per 1000 person-years, and used Cox regression to estimate hazard ratios (HR) and associated 95% confidence intervals (CIs) of hypothyroidism, adjusting for comorbidities. Results: We included 44,574 BCS and 203,306 matched controls with 2,631,488 person-years of follow-up. BCS had a slightly higher incidence of hypothyroidism than controls [5-year cumulative incidence, 1.8% (95%CI = 1.7–1.9) and 1.6% (95%CI = 1.5–1.6), respectively]. The overall IR was 4.45 (95%CI = 4.25–4.67) and 3.81 (95%CI = 3.73–3.90), corresponding to an adjusted HR = 1.17 (95%CI = 1.11–1.24). BCS who received RTn with chemotherapy (HR = 1.74, 95%CI = 1.50–2.02) or without chemotherapy (HR = 1.31, 95%CI = 1.14–1.51) had an elevated risk of hypothyroidism compared with matched controls and compared with BCS who underwent surgery alone [HR = 1.71, 95%CI = 1.45–2.01 and HR = 1.36, 95%CI = 1.17–1.58, respectively]. Conclusions: BCS have an excess risk of hypothyroidism compared with age-matched controls. BCS and those working in cancer survivorship settings ought to be aware that this risk is highest in women treated with radiation therapy to the lymph nodes and chemotherapy.",
keywords = "Breast cancer, Cancer survivorship, Chemotherapy, Hypothyroidism, Late effect, Matched cohort study, Radiation therapy",
author = "Falstie-Jensen, {Anne Mette} and Buket Esen and Anders Kj{\ae}rsgaard and Lorenzen, {Ebbe L.} and Jensen, {Jeanette D.} and Reinertsen, {Kristin V.} and Dekkers, {Olaf M.} and Marianne Ewertz and Cronin-Fenton, {Deirdre P.}",
year = "2020",
month = oct,
doi = "10.1186/s13058-020-01337-z",
language = "English",
volume = "22",
journal = "Breast Cancer Research (Online Edition)",
issn = "1465-5411",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study

AU - Falstie-Jensen, Anne Mette

AU - Esen, Buket

AU - Kjærsgaard, Anders

AU - Lorenzen, Ebbe L.

AU - Jensen, Jeanette D.

AU - Reinertsen, Kristin V.

AU - Dekkers, Olaf M.

AU - Ewertz, Marianne

AU - Cronin-Fenton, Deirdre P.

PY - 2020/10

Y1 - 2020/10

N2 - Background: Breast cancer survivors (BCS) may have increased risk of hypothyroidism, but risk according to treatment modality is unclear. We estimated the incidence of hypothyroidism in women with breast cancer, and according to cancer treatment. Methods: Using nationwide registries, we identified all Danish women aged ≥ 35 years diagnosed with non-metastatic breast cancer (1996–2009). We matched up to five cancer-free women (controls) for each BCS. We excluded women with prevalent thyroid disease. Cancer treatment was chemotherapy with or without radiotherapy (RT) targeting the breast/chest wall only, or also the lymph nodes (RTn). We identified hypothyroidism using diagnostic codes, and/or levothyroxine prescriptions. We calculated the cumulative incidence, incidence rates (IR) per 1000 person-years, and used Cox regression to estimate hazard ratios (HR) and associated 95% confidence intervals (CIs) of hypothyroidism, adjusting for comorbidities. Results: We included 44,574 BCS and 203,306 matched controls with 2,631,488 person-years of follow-up. BCS had a slightly higher incidence of hypothyroidism than controls [5-year cumulative incidence, 1.8% (95%CI = 1.7–1.9) and 1.6% (95%CI = 1.5–1.6), respectively]. The overall IR was 4.45 (95%CI = 4.25–4.67) and 3.81 (95%CI = 3.73–3.90), corresponding to an adjusted HR = 1.17 (95%CI = 1.11–1.24). BCS who received RTn with chemotherapy (HR = 1.74, 95%CI = 1.50–2.02) or without chemotherapy (HR = 1.31, 95%CI = 1.14–1.51) had an elevated risk of hypothyroidism compared with matched controls and compared with BCS who underwent surgery alone [HR = 1.71, 95%CI = 1.45–2.01 and HR = 1.36, 95%CI = 1.17–1.58, respectively]. Conclusions: BCS have an excess risk of hypothyroidism compared with age-matched controls. BCS and those working in cancer survivorship settings ought to be aware that this risk is highest in women treated with radiation therapy to the lymph nodes and chemotherapy.

AB - Background: Breast cancer survivors (BCS) may have increased risk of hypothyroidism, but risk according to treatment modality is unclear. We estimated the incidence of hypothyroidism in women with breast cancer, and according to cancer treatment. Methods: Using nationwide registries, we identified all Danish women aged ≥ 35 years diagnosed with non-metastatic breast cancer (1996–2009). We matched up to five cancer-free women (controls) for each BCS. We excluded women with prevalent thyroid disease. Cancer treatment was chemotherapy with or without radiotherapy (RT) targeting the breast/chest wall only, or also the lymph nodes (RTn). We identified hypothyroidism using diagnostic codes, and/or levothyroxine prescriptions. We calculated the cumulative incidence, incidence rates (IR) per 1000 person-years, and used Cox regression to estimate hazard ratios (HR) and associated 95% confidence intervals (CIs) of hypothyroidism, adjusting for comorbidities. Results: We included 44,574 BCS and 203,306 matched controls with 2,631,488 person-years of follow-up. BCS had a slightly higher incidence of hypothyroidism than controls [5-year cumulative incidence, 1.8% (95%CI = 1.7–1.9) and 1.6% (95%CI = 1.5–1.6), respectively]. The overall IR was 4.45 (95%CI = 4.25–4.67) and 3.81 (95%CI = 3.73–3.90), corresponding to an adjusted HR = 1.17 (95%CI = 1.11–1.24). BCS who received RTn with chemotherapy (HR = 1.74, 95%CI = 1.50–2.02) or without chemotherapy (HR = 1.31, 95%CI = 1.14–1.51) had an elevated risk of hypothyroidism compared with matched controls and compared with BCS who underwent surgery alone [HR = 1.71, 95%CI = 1.45–2.01 and HR = 1.36, 95%CI = 1.17–1.58, respectively]. Conclusions: BCS have an excess risk of hypothyroidism compared with age-matched controls. BCS and those working in cancer survivorship settings ought to be aware that this risk is highest in women treated with radiation therapy to the lymph nodes and chemotherapy.

KW - Breast cancer

KW - Cancer survivorship

KW - Chemotherapy

KW - Hypothyroidism

KW - Late effect

KW - Matched cohort study

KW - Radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=85092887316&partnerID=8YFLogxK

U2 - 10.1186/s13058-020-01337-z

DO - 10.1186/s13058-020-01337-z

M3 - Journal article

C2 - 33050919

AN - SCOPUS:85092887316

VL - 22

JO - Breast Cancer Research (Online Edition)

JF - Breast Cancer Research (Online Edition)

SN - 1465-5411

M1 - 106

ER -