Risk factors for secondary thyroid cancer in patients with breast cancer : a propensity‑matched SEER analysis

Abstract

Abstract With the rapid development of imaging technology and comprehensive treatment in modern medicine, the early diagnosis rate of breast cancer is constantly improving, and the prognosis is also improving; With the prolongation of the survival period of breast cancer patients, the risk of multiple primary cancers may increase. Since both breast and thyroid are Hormone receptor sensitive organs, which are regulated by hypothalamus pituitary target gland endocrine axis, changes in body endocrine status may lead to the occurrence of these two diseases in succession or simultaneously. The clinical data and survival results of breast cancer patients registered in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2020 were extracted. After matching the data with propensity scores, patients were divided into a training group and a validation group using a 7:3 ratio. Univariate and multivariate COX proportional regression analysis is used to determine independent risk factors for secondary thyroid cancer and construct a column chart prediction model. Age, ethnicity, whether radiotherapy, tumor primary location, N stage, M stage were screened by Cox regression as independent factors affecting secondary thyroid cancer in patients with breast cancer patients, and a risk factor nomogram was established to predict patients' three- and five-year survival rates. The AUC values for three and five years in the training set were 0.713, 0.707, and the c -index was 0.693 (95% CI 0.67144, 0.71456), and the AUC values for three and five years in the validation set were 0.681, 0.681, and the c -index was 0.673 (95% CI 0.64164, 0.70436), respectively.