Changes in thyroid stimulating hormone (TSH) and free thyroxine (fT4) in premenopausal women (a) and postmenopausal women (b) with breast cancer, treated or not with neoadjuvant chemotherapy (NCh), when compared to their corresponding control groups (IMAGE)
Caption
The effects of neoadjuvant chemotherapy in postmenopausal women on TSH and fT4, when compared with untreated postmenopausal women with breast cancer, are summarized in (c). Panel A highlights that both untreated breast cancer patients and those undergoing NCh exhibit an increase in TSH and fT4 levels compared to healthy premenopausal controls. Notably, premenopausal women receiving NCh display a more pronounced elevation in TSH, suggesting a potential impact of the tumor itself and the chemotherapy treatment on thyroid hormone regulation in this group. Panel B focuses on postmenopausal women, demonstrating that, similar to their premenopausal counterparts, both untreated and NCh-treated breast cancer patients show elevated TSH and fT4 levels compared to control postmenopausal women. However, in contrast to premenopausal women, postmenopausal women treated with NCh exhibit a smaller increase in fT4 compared to untreated postmenopausal breast cancer patients, indicating a difference in the effect of NCh on thyroid hormones based on menopausal status. Finally, the data in panel C underscore that postmenopausal women with breast cancer who received NCh showed a significantly reduced increase in fT4 compared to untreated postmenopausal women with breast cancer. These findings suggest that while breast cancer generally leads to elevated levels of TSH and fT4, neoadjuvant chemotherapy has a distinct modulating effect on fT4 levels, further demonstrating a complex interplay between menopausal status, breast cancer, and thyroid hormone levels. The importance of monitoring thyroid function in breast cancer patients, considering their menopausal status and chemotherapy treatment, in relation to the complex interplay between tumor progression and the effectiveness of oncologic treatment, is emphasized. fT3, free triiodothyronine; rT3, reverse triiodothyronine; T3, triiodothyronine; T4, thyroxine; TRH, thyrotropin-releasing hormone.
Credit
José Manuel Martínez-Martos
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