{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T16:24:09Z","timestamp":1784219049799,"version":"3.55.0"},"reference-count":38,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,10]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate whether hyperthyroidism or hypothyroidism increases the risk of subsequent breast cancer in an Asian population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Nationwide population-based case\u2013control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>All healthcare facilities in Taiwan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 103\u2009466 women (mean age 53.3 years) were enrolled.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>51\u2009733 adult women with newly diagnosed primary breast cancer without a previous cancer history between 2006 and 2011 were identified and included in our study. 51\u2009733 women with no cancer diagnosis prior to the index date were age matched as controls. Diagnosis of hyperthyroidism or hypothyroidism prior to the diagnosis of breast cancer or the same index date was identified, age, histories of thyroid disease treatment, oestrogen use and radioactive iodine treatment were adjusted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>To identify risk differences in developing breast cancer among patients with a medical history of hyperthyroidism or hypothyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was a significantly increased risk of breast cancer in women with hyperthyroidism under the age of 55 years (age &lt;45: OR 1.16, P=0.049; age 45\u201355: OR 1.15, P=0.019). Patients with hypothyroidism also showed an increased risk of breast cancer (OR 1.19, P=0.029) without statistical significance after stratification by age group (age &lt;45, 45\u201355, &gt;55 years). Treatment for thyroid disorders did not alter the association in subgroup analyses (P=0.857; 0.262, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Asian women under 55 years of age with history of hyperthyroidism have a significantly increased risk of breast cancer regardless of treatment. Women with history of hypothyroidism may also have an increased risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020194","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T09:25:55Z","timestamp":1522401955000},"page":"e020194","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Thyroid disorders and breast cancer risk in Asian population: a nationwide population-based case\u2013control study in Taiwan"],"prefix":"10.1136","volume":"8","author":[{"given":"Chien-Hsiang","family":"Weng","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA"},{"name":"NH Dartmouth Family Medicine Residency, Concord Hospital, Concord, New Hampshire, USA"},{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Huei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Heng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tseng-Hsi","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan"},{"name":"Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,30]]},"reference":[{"key":"2025101810424347000_8.3.e020194.1","unstructured":"U.S. breast cancer statistics. 2017. http:\/\/www.breastcancer.org\/symptoms\/understand_bc\/statistics"},{"key":"2025101810424347000_8.3.e020194.2","unstructured":"American Thyroid Association. 2017. http:\/\/www.thyroid.org\/media-main\/about-hypothyroidism\/"},{"key":"2025101810424347000_8.3.e020194.3","unstructured":"SEER Stat Fact Sheets: Female Breast Cancer, 2017."},{"key":"2025101810424347000_8.3.e020194.4","doi-asserted-by":"crossref","first-page":"5030","DOI":"10.1210\/jc.2016-2104","article-title":"Thyroid Function and Cancer Risk: The Rotterdam Study","volume":"101","author":"Khan","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2025101810424347000_8.3.e020194.5","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0989"},{"key":"2025101810424347000_8.3.e020194.6","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2005.15.1253"},{"key":"2025101810424347000_8.3.e020194.7","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-11-0838"},{"key":"2025101810424347000_8.3.e020194.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0122955","article-title":"Subclinical hypothyroidism is associated with increased risk for cancer mortality in adult Taiwanese-a 10 years population-based cohort","volume":"10","author":"Tseng","year":"2015","journal-title":"PLoS One"},{"key":"2025101810424347000_8.3.e020194.9","first-page":"2283","article-title":"Cancer mortality in women with thyroid disease","volume":"50","author":"Goldman","year":"1990","journal-title":"Cancer Res"},{"key":"2025101810424347000_8.3.e020194.10","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3109\/07853899708999335","article-title":"The thyroid and breast cancer: a significant association?","volume":"29","author":"Smyth","year":"1997","journal-title":"Ann Med"},{"key":"2025101810424347000_8.3.e020194.11","first-page":"389","article-title":"Thyroid hormones and duration of ovulatory activity in the etiology of breast cancer","volume":"1","author":"Morabia","year":"1992","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025101810424347000_8.3.e020194.12","doi-asserted-by":"publisher","DOI":"10.1186\/bcr2587"},{"key":"2025101810424347000_8.3.e020194.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsbmb.2007.12.008"},{"key":"2025101810424347000_8.3.e020194.14","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-12-0219"},{"key":"2025101810424347000_8.3.e020194.15","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23307"},{"key":"2025101810424347000_8.3.e020194.16","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.420"},{"key":"2025101810424347000_8.3.e020194.17","doi-asserted-by":"crossref","DOI":"10.1038\/248525a0","article-title":"Mammotropic effect of prolactin enhanced by thyroidectomy","volume":"248","author":"Mittra","year":"1974","journal-title":"Nature"},{"key":"2025101810424347000_8.3.e020194.18","doi-asserted-by":"publisher","DOI":"10.1007\/BF01476857"},{"key":"2025101810424347000_8.3.e020194.19","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s40618-017-0679-x","article-title":"Does thyroid dysfunction increase the risk of breast cancer? A systematic review and meta-analysis","volume":"40","author":"Fang","year":"2017","journal-title":"J Endocrinol Invest"},{"key":"2025101810424347000_8.3.e020194.20","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.surg.2015.10.009","article-title":"Breast cancer in thyroid cancer survivors: an analysis of the surveillance, epidemiology, and end results-9 database","volume":"159","author":"Kuo","year":"2016","journal-title":"Surgery"},{"key":"2025101810424347000_8.3.e020194.21","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S0140-6736(01)72384-7","article-title":"On the treatment of inoperable cases of carcinoma of the mamma: suggestions for a new method of treatment, with illustrative cases","volume":"148","author":"Beatson","year":"1896","journal-title":"The Lancet"},{"key":"2025101810424347000_8.3.e020194.22","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdj040"},{"key":"2025101810424347000_8.3.e020194.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3835(02)00614-6"},{"key":"2025101810424347000_8.3.e020194.24","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1205136"},{"key":"2025101810424347000_8.3.e020194.25","doi-asserted-by":"publisher","DOI":"10.1210\/jc.83.8.2711"},{"key":"2025101810424347000_8.3.e020194.26","doi-asserted-by":"publisher","DOI":"10.1038\/379458a0"},{"key":"2025101810424347000_8.3.e020194.27","first-page":"1188","article-title":"Sodium iodide symporter: its role in nuclear medicine","volume":"43","author":"Chung","year":"2002","journal-title":"J Nucl Med"},{"key":"2025101810424347000_8.3.e020194.28","doi-asserted-by":"publisher","DOI":"10.1186\/bcr609"},{"key":"2025101810424347000_8.3.e020194.29","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/BF03345548","article-title":"Association between breast cancer and autoimmune thyroid disorders: no increase of lymphocytic infiltrates in breast malignant tissues","volume":"29","author":"Fierabracci","year":"2006","journal-title":"J Endocrinol Invest"},{"key":"2025101810424347000_8.3.e020194.30","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-0760(96)00117-3"},{"key":"2025101810424347000_8.3.e020194.31","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1186\/1471-2407-14-536","article-title":"T3 levels in relation to prognostic factors in breast cancer: a population-based prospective cohort study","volume":"14","author":"Tosovic","year":"2014","journal-title":"BMC Cancer"},{"key":"2025101810424347000_8.3.e020194.32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/0014-2964(72)90082-5","article-title":"Effect of pituitary tumours and grafts on plasma prolactin levels","volume":"8","author":"Kwa","year":"1972","journal-title":"Eur J Cancer"},{"key":"2025101810424347000_8.3.e020194.33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3233\/BD-2006-24102","article-title":"Endogenous hormones and risk of breast cancer in postmenopausal women","volume":"24","author":"Hankinson","year":"2005","journal-title":"Breast Dis"},{"key":"2025101810424347000_8.3.e020194.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2006.01.032"},{"key":"2025101810424347000_8.3.e020194.35","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp025334"},{"key":"2025101810424347000_8.3.e020194.36","first-page":"1603","article-title":"Thyroid autoimmunity occurs more frequently in women with breast cancer compared to women with colorectal cancer and controls but it has no impact on relapse-free and overall survival","volume":"18","author":"Jiskra","year":"2007","journal-title":"Oncol Rep"},{"key":"2025101810424347000_8.3.e020194.37","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2886"},{"key":"2025101810424347000_8.3.e020194.38","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12783"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:42:51Z","timestamp":1760809371000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,3,30]]},"published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1136\/bmjopen-2017-020194"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020194","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}