Nodüler guatr ve otoimmün troid hastalıklarında benign meme patolojileri sıklığı

Abstract

Tiroid hastahklan ile benign ve malign meme hastahklan arasmdaki i1i~kiye dairkamtlar giderek artmaktadtr. Benign meme hastahklannda tiroid hastahklan slkhgmmarttlgl ve farkh tiroid hastahklannm da benign ve malign meme hastahklan ve buhastahklann sonlamml ile i1i~kili oldugu gosterilmi~tir. Tiroid ve benign meme hastahklanarasmdaki i1i~kiyi ara~tIran c;ah~malarda slkhkla, benign meme hastahklannda tiroidotoimmiinitesi ve fonksiyonlan ara~tmlml~tlr. Bu c;alt;;mada nodUler tiroid hastahgl veHashimoto tiroiditi olan hastalarda benign meme hastahklan slkhgmm ara~tmlmaslamac;lanml;;ttr .<;ah;;maya 71 nodUler tiroid hastahgl olan ve 95 Hashimoto tiroiditi olan hasta vebenzer ya;; arahgmda 72 saghkh birey dahil ediImi;;tir. KatIhmctlann aynntlh klinikdegerlendirmesinin ardmdan serum tiroid stimUle edici hormon, serbest T3, serbest T4,tiroid peroksidaz antikor diizeyleri incelenmi;; ve tiroid ve olasl meme patolojisininbelirlenmesi amaclyla tiroid ve meme ultrasonografisi uyguIanml;;tlr.<;ah;;mada nodUler tiroid hastaIanmn %55.7'sinde, Hashimoto tiroiditi hastalannm%47.4'iinde ve kontrol grubunun %29.2'sinde benign meme hastahgl saptanml;;ttr.NodUler tiroid hastahkIan ve Hashimoto tiroiditinde benign meme hastahkIan slkhgmmanIamh olarak arttIgl gosterilmi;;ti1' (straslyla p<O.Ol ve p<O.Ol). Benign meme hastahklanic;inde en slk olarak basit kist saptanml;;, bunu fibrokistik degi~iklik, miks lezyonIar,benign solid kitle, duktal ektazi ve komplike kist izlemi;;tir. NodUler tiroid hastalanndabasit kist, fibrokistik degi;;ikIik ve miks Iezyon slkhgmm kontrol grubundan daha yiiksekoidugu saptanml;;tIr. Hashimoto tiroiditli hastalarda ise basit kist, fibrokistik degi~iklik,solid kitie ve miks lezyon slkhgmm kontrol grubundan daha yiiksek oldugu bulunmu~ancak aynntIh anaIizde bu bulgu istatistiksel olarak anlamh C;lkmaml;;ttr. Benign memehastahgl saptanan hastalarda tiroid fonksiyonlan ve otoimmiinitesi ile anIamh ili;;kibulunmaml;;tIr (p>O.05).<;ah;;ma sonucu benign meme hastahkIan ve tiroid hastahklan arasmdaki ili;;kiyidestekier niteliktedir. Bu bulgu klinik pratikte nodUler ya da otoimmiin tiroid hastahgl olankadmiarda, olasl meme patolojisi yoniinden de tarama yapllmasl gerekligini ortayakoymasl yoniinden onem ta;;lmaktadtr.Anahtar Kelimeler: NodUler tiroid hastahklan, Hashimoto tiroiditi, Benign memehastahkIanIV

The evidence regarding association between thyroid diseases and benign and malignbreast diseases is increasing. It has been shown that thyroid disorders are more frequent inthose with benign breast diseases and that different thyroid diseases have associations with .benign and malign breast diseases and their outcomes. The studies exploring therelationship between thyroid and breast diseases usually have focused on thyroidautoimmunity and functions. In this study, we aimed to reveal the frequency of benignbreast conditions in patients with nodular thyroid disease and Hashimoto's disease.Seventy-one women with nodular thyroid disease, ninety-five women withHashimoto's disease and seventy-two healthy people as a control group were included inthe study. After a detailed clinical assessment of the participants, serum thyroid stimulatinghormone, free triiodothyronine, free thyroxine and thyroid peroxidase autoantibody levelswere measured, and thyroid and breast ultrasonography were performed by a singleoperator in order to determine thyroid and breast pathology.Benign breast diseases were detected in 55.7 % of patients with nodular thyroiddiseases, in 47.4 % of those with Hashimoto's disease and 29.2 % of control group in thestudy. The results showed that the frequency of benign breast diseases was significantlyhigher in nodular thyroid disease and Hashimoto's disease than the control group (p<O.Oland p<O.Ol respectively). Simple cyst was found to be the most frequent pathology amongbenign breast diseases; fibrocystic changes, mixed lesions, benign solid mass, ductalectasia and complex cyst followed it. Simple cyst, fibrocystic changes and mixed lesionsoccurred significantly more frequently in patients with nodular thyroid diseases than thecontrol group. Simple cyst, fibrocystic changes, benign solid mass and mixed lesions weremore common in patients with Hashimoto's disease than the control group, though it didnot reach statistical significance. No significant relation was found regarding thyroidfunction and autoimmunity in patients diagnosed with benign breast disease (p>O.05).The results of our study supports the association between benign breast diseases andthyroid diseases. An important implication of this finding is demonstration of the necessityof scanning for potential breast pathology in women with nodular or autoimmune thyroiddisease in clinical practice.Key Words: Nodular thyroid disease, Hashimoto's disease, benign breast diseases