STRUCTURAL AND FUNCTIONAL CHANGES IN THE THYROID GLAND BEFORE AND AFTER NEOADJUVANT POLYCHEMOTHERAPY IN BREAST CANCER PATIENTS AFFECTED BY THE CHORNOBYL DISASTER
DOI:
https://doi.org/10.15407/oncology.2026.02.074Keywords:
breast cancer, thyroid gland, structural changes in the thyroid gland, functional changes in the thyroid gland, the Chornobyl disasterAbstract
Summary. Aim: to study the nature of structural and functional changes in the thyroid gland, indicators of proliferative activity, molecular genetic phenotypes, the degree of prevalence and differentiation of tumors in breast cancer patients who suffered from the Chornobyl disaster. Object and methods: 96 patients with breast cancer who were exposed to ionizing radiation as a result of the Chornobyl accident were examined. Clinical, radiological, instrumental, morphological, and immunohistochemical, biochemical methods of investigation in establishing the diagnosis and evaluating the results of neoadjuvant chemotherapy were used. Results: the results of the conducted ultrasound examination of the thyroid gland and markers characterizing its functional state in 96 patients with breast cancer, who are considered victims of the Chornobyl accident, revealed structural changes in the thyroid gland in 81.2 % of patients. In the structure of the detected pathological changes in the thyroid gland, 53.1% were nodular lesions: 9.4% represented nodular goiter combined with autoimmune thyroiditis (AIT), 9.4% multinodular goiter, and 34.4% nodular goiter. Cystic thyroid changes were identified in 5.9% of cases, small hydrophilic and small fibrotic altered areas in 7.3%, chronic thyroiditis in 1.04%, autoimmune thyroiditis in 6.2%, parathyroid gland hyperplasia in 4.2%, diffuse goiter in 3.1%, and previous surgical interventions consisting of extended resection of the left thyroid lobe in 1.04% of patients. Changes in the parameters characterizing thyroid functional status in breast cancer patients affected by the Chornobyl disaster were detected in 27.1% of cases. Free thyroxine levels above the reference range were observed in 1.04% of patients, elevated thyroid-stimulating hormone (TSH) levels in 8.3%, and increased anti-thyroid peroxidase antibodies (anti-TPO) in 18.7% of patients. Ki-67 indices in patients with elevated thyroxine levels were 30%, in those with elevated TSH levels averaged 47.5%, and in patients with elevated anti-TPO antibodies – 30.8%. Following treatment, structural changes in the thyroid gland were observed in 7.3% of patients, while functional changes were diagnosed in 5.2% of patients. Conclusions. benign thyroid diseases and changes in thyroid status affect various levels of regulation regarding the functional and morphological state of the mammary glands, and thyroid hormones are classified as risk factors for breast cancer development. Studying the nature of structural and functional changes in the thyroid gland in breast cancer patients in general, and especially in patients affected by the Chornobyl disaster, remains a contemporary and highly relevant issue.
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