Abstract
Background: Breast cancer has the second-highest prevalence of cancer in Indonesia. The aetiology of breast cancer involves endogenous sex hormone activity, estrogen. Besides, thyroid hormones have estrogen-like effects on breast tissue which are thought to play a role in the development of breast cancer. This case report aims to evaluate the physiological aspect of thyroid-induced breast cancer.Case Report: A 49-year-old Balinese woman came to the Primary Health Care with a history of uncontrolled hyperthyroidism for 5 years (2014-2019), complaining of a lump in her left breast. Open biopsy and immunohistochemistry were done (Grade III Invasive Carcinoma ER + 50%, Her + 2-3). Patients were diagnosed with stage 3B breast cancer and conservative treatment has been taken. The examination of TSH thyroid hormone was 0.204 µIU/mL (normal = 0.5 - 6 µIU/mL) and FT4 3.1 ng/dL (normal = 0.7-1.9 ng/dL).The primary management of patients was chemotherapy following by Modified Radical Mastectomy (MRM), hormone suppressant injection, as well as Herceptin. Those medications were effective in reducing the development of breast cancer through thyroid hormone pathway.Conclusion: Some studies showed hyperthyroidism increase the risk of breast cancer and that high thyroid levels can cause estrogen-like effects, trigger proliferation and angiogenesis by activating the same pathway as estrogen those are mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase ½ (ERK ½).
Highlights
INTRODUCTIONOne of them is breast cancer having the second highest prevalence in Indonesia.[1] In 2019, the incidence of breast cancer was 42.1 per 100,000 people with an average mortality rate of 17 per 100,000 population.[2,3] The causes of breast cancer are multifactorial, including genetic factors, hormonal factors, and lifestyle.[3] In addition, several hematological markers have been evaluated to the determine the risk and subtype-related breast cancer.[4,5] The hormonal factor that is known to play a significant role in the pathophysiology of breast cancer is the hormone estrogen
Cancer is recently known has a higher prevalence in Indonesia since decades
The hormonal factor that is known to play a significant role in the pathophysiology of breast cancer is the hormone estrogen
Summary
One of them is breast cancer having the second highest prevalence in Indonesia.[1] In 2019, the incidence of breast cancer was 42.1 per 100,000 people with an average mortality rate of 17 per 100,000 population.[2,3] The causes of breast cancer are multifactorial, including genetic factors, hormonal factors, and lifestyle.[3] In addition, several hematological markers have been evaluated to the determine the risk and subtype-related breast cancer.[4,5] The hormonal factor that is known to play a significant role in the pathophysiology of breast cancer is the hormone estrogen. Consists of the proliferation of neoplastic epithelial cells forming a solid infiltrative structure between the tissue stroma. Giving Herceptin therapy for Her 3+ is still considered in this case
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