Endocrine Abstracts

The endocrine and reproductive systems of women work in close relationship and moderates the functional state of visceral systems. In patients with concomitant diseases and breast cancer (BC), some hypofunction of the thyroid gland (TG) was revealed and there is a direct dependence of the decrease in functional activity on the progression and luminal forms of pathological changes in the mammary gland. However, the effect of antitumor methods of treatment in BC on the clinical and morphological structure and function of the TG has not been practically studied.

Purpose: to determine the methods of correcting functional changes in the TG in BC patients by retrospective analysis.

Material and methods: The following gradations of the functional state of the TG in BC were the subject of the study: volume and size, parenchyma structure, hormonal status indicators, local cytomorphological structure of the parenchyma. The object of the study were 38 patients with verified BC: II - and III - stages. The age of patients ranged from 34 to 68 years. Patients received antitumor therapy in accordance with the standards: polychemotherapy - 31, hormone therapy-5 and immuno-chemotherapy-2. Ultrasound, MSCT, the study of biochemical parameters and thyroid hormones, cytomorphology of fine-needle biopsy of the thyroid parenchyma were used to study the studied gradations.

Results: There was a change in the average volume and flatness of the contours depending on the stage of breast cancer, histological type and differentiation of the tumor process. At the same time, a statistically significant decrease in the functional (based on the study of hormones) thyroid activity from 23 to 35% was established against the background of the appearance of new heterogeneous areas in the thyroid parenchyma. Most often, these changes were characteristic of patients aged >50 years and receiving polychemotherapy (+immunotherapy). In contrast, in patients with a hormone-dependent form of BC, functional changes in the TG turned out to be insignificant on the background of specific therapy and did not require special correction. The cytomorphological picture of local changes in the study of fine-needle biopsy specimens in 17 patients showed the absence of polymorphism and atypical changes. In 8 patients with breast cancer, there was a parallel development of nodular goiter during polychemotherapy. Thus, the analysis of the obtained results showed the presence and correlation dependence of local changes in the thyroid gland on the stage of BC and the type of therapy.