title: Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer.
abstract: BACKGROUND
  Many studies have reported an increased risk of developing a second primary malignancy (SPM) of the breast in women treated for thyroid cancer. In this study, we investigated several potential risk factors for this association. The aim of this retrospective cohort study was to identify a subgroup of women surgically treated for papillary thyroid cancer that may benefit from more careful breast cancer screening.
  
  
  METHODS
  A total of 101 women surgically treated for papillary thyroid cancer from 1996 to 2009 with subsequent follow-up were interviewed by phone regarding personal risk factors and lifestyle habits. Only 75 questionnaires could be evaluated due to a 25.7% rate of patients not retrieved or refusing the interview. Data analysis was performed using a multivariate logistic model.
  
  
  RESULTS
  The standardised incidence ratio (SIR) for breast cancer was 3.58 (95% IC 1.14 - 8.37). Our data suggest a protective effect of multiparity on the development of a SPM of the breast (O.R. 0.15; 95% IC 0.25 - 0.86). Significant associations were not found with other known risk factors including Body Mass Index (BMI), age at first tumour, concurrent metabolic diseases, smoking, physical activity and familiarity.
  
  
  CONCLUSIONS
  This study confirms that a higher incidence of SPM of the breast is observed in women treated for papillary thyroid cancer. Additionally, this risk is increased by nulliparity, thus a strict breast screening program for nulliparous women treated for thyroid cancer may be advisable.
authors.affiliation: Department of Cardiocirculatory Pathophysiology, Anesthesiology and General Surgery, Sapienza University of Rome, Rome, Italy. fabrizio.consorti@uniroma1.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Consorti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Tanna
authors.forename: Francesca
authors.initials: F
authors.lastname: Milazzo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Antonaci
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D013997:Time Factors