The Role of Thyroid Disease and Other Biomarkers in Invasive Breast Cancer: A 3-year Retrospective Comparative Study

	Non-thyroidopathy group (Group A)	Thyroidopathy group (Group B)
Number of patients	49	48
Mean age (yrs)/median age (yrs)	64.26/65	64.31/64
LDH (U/L)	202.77	203.79
Calcium (mg/dL)	9.664	9.623
Mean Ki-67 (%)	35.96	36.92
Luminal A (number of patients) (n)	27	27
Luminal B (number of patients) (n)	7	12
HER2 overexpression (number of patients) (n)	1	2
Basal or triple negative (number of patients) (n)	13	5

[i] HER2 – human epidermal growth factor receptor 2, LDH – lactate dehydrogenase

Table 2:

Test for normality.

Group A
Variables	Kolmogorov–Smirnov			Shapiro–Wilk test
Variables	Statistic	df	Sig.	Statistic	df	Sig.
Age	.100	34	.200	.960	34	.239
Calcium	.184	42	.001	.700	42	<0.001
LDH	.102	44	.200	.916	44	.004
Ki-67	.216	25	.004	.855	25	.002
Postoperative TSH levels	.202	5	.200	.962	5	.819
Group B
Age	.061	35	.200	.986	35	.933
Calcium	.088	48	.200	.984	48	.770
LDH	.224	48	<.001	.805	48	<.001
Ki-67	.216	25	.004	.874	25	.005
fT3	.100	47	.200	.989	47	.936
fT4	.071	47	.200	.977	47	.462
Preoperative TSH levels	.235	48	<.001	.723	48	<.001
Postoperative TSH levels	.168	18	.194	.869	18	0.017

[i] df – degrees of freedom, fT3 – free T3, fT4 – free T4, LDH – lactate dehydrogenase, sig. – significance, TSH – thyroid-stimulating hormone

Table 3:

Wilcoxon signed-ranks test.

TSH preoperative – TSH postoperative	n	Mean rank	Sum of ranks
Negative ranks	8	8	64
Positive Ranks	10	10.7	107
Ties	0
Total	18

[i] Signed rank test was analysed for the following groups: a.TSH postop and TSH preop; b. TSH postop and TSH preop; c. TSH postop = TSH preop

Test statistics

	TSH postop - TSH preop
Z	.936
Asymp. sig. (2-tailed)	.349

a. Wilcoxon signed-ranks test;

b. based on negative ranks.

Table 4:

Correlation analysis.

Group A
			AGE	Calcium	TSH postop	LDH	Ki-67
Spearman's rho	AGE	Correlation coefficient	1,000	,096	−1,000	−,105	−,068
	p-Value	.	,626	.	,580	,781
	Calcium levels	Correlation coefficient	,096	1,000	,600	−,107	,449*
	p-Value	,626	.	,400	,499	,036
	TSH postop	Correlation coefficient	−1,000**	,600	1,000	,300	.
p-Value	.	,400	.	,624	.
LDH	Correlation coefficient	−,105	−,107	,300	1,000	,306
p-Value	,580	,499	,624	.	,167
Ki-67	Correlation coefficient	−,068	,449*	.	,306	1,000
p-Value	,781	,036	.	,167	.
Group B
	AGE	Correlation coefficient	1,000	−,002	−,055	,112	−,115
	p-Value	.	,989	,851	,520	,631
	Calcium	Correlation coefficient	−,002	1,000	−,279	−,118	,228
	p-Value	,989	.	,262	,426	,274
	TSH postop	Correlation coefficient	−,055	−,279	1,000	−,009	−,395
	p-Value	,851	,262	.	,971	,333
	LDH	Correlation coefficient	,112	−,118	−,009	1,000	−,330
	p-Value	,520	,426	,971	.	,107
Ki-67	Correlation coefficient	−,115	,228	−,395	−,330	1,000
p-Value	,631	,274	,333	,107	.
fT3	Correlation coefficient	−,303	−,030	,002	,021	,245
p-Value	,081	,841	,993	,891	,248
fT4	Correlation coefficient	,181	,049	−,120	,056	−,337
p-Value	,305	,743	,646	,711	,107
Preop TSH	Correlation coefficient	,033	,139	,216	,202	,168
p-Value	,853	,346	,390	,169	,421

* Correlation is significant at 0.05;

** correlation is significant at the 0.01 level (2-tailed).

fT3 – free T3, fT4 – free T4, LDH – lactate dehydrogenase, preop – preoperative; postop – postoperative; TSH – thyroid-stimulating hormone. Significant results are highlighted in bold

Group A – positive correlations with JASP statistical program

Variable		Age	ER	HER2	PR	Molecular subtype	Calcium	LDH
Age	Pearson's r	—
	p-Value	—
ER	Pearson's r	-0.249	—
	p-Value	0.915	—
HER2	Pearson's r	0.137	0.171	—
	p-Value	0.227	0.125	—
PR	Pearson's r	0.020	0.627	0.145	—
	p-Value	0.457	<0.001	0.168	—
Molecular subtype	Pearson's r	−0.164	0.857	−0.260	0.611	—
	p-Value	0.815	<0.001	0.961	<0.001	—
Calcium	Pearson's r	0.088	0.134	0.121	0.072	0.033	—
	p-Value	0.329	0.206	0.228	0.330	0.420	—
LDH	Pearson's r	0.021	0.043	−0.001	−0.089	3.345 × 10⁻⁴	−0.212	—
	p-Value	0.456	0.393	0.503	0.710	0.499	0.911	—
Ki-67	Pearson's r	−0.298	0.386	0.122	0.177	0.235	0.363	0.230
	p-Value	0.892	0.028	0.280	0.204	0.129	0.049	0.151

Note. All tests are one-tailed, for positive correlation.

* p < 0.05,

** p < 0.01,

*** p < 0.001, one-tailed Significant values are highlighted in bold

Molecular subtype luminal A- 1, Luminal B- 2, triple negative- 3, HER2 overexpression- 4

Negative correlations for Group A on JASP statistical program

Variable
		Age	ER	HER2	PR	Molecular subtype	Calcium	LDH
Age	Pearson's r	—
	p-Value	—
ER	Pearson's r	−0.249	—
	p-Value	0.085	—
HER2	Pearson's r	0.137	0.171	—
	p-Value	0.773	0.875	—
PR	Pearson's r	0.020	0.627	0.145	—
	p-Value	0.543	1.000	0.832	—
Molecular subtype	Pearson's r	−0.164	0.857	−0.260	0.611	—
	p-Value	0.185	1.000	0.039	1.000	—
Calcium	Pearson's r	0.088	0.134	0.121	0.072	0.033	—
	p-Value	0.671	0.794	0.772	0.670	0.580	—
LDH	Pearson's r	0.021	0.043	−0.001	−0.089	3.345 × 10⁻⁴	−0.212	—
	p-Value	0.544	0.607	0.497	0.290	0.501	0.089	—
Ki-67	Pearson's r	−0.298	0.386	0.122	0.177	0.235	0.363	0.230
	p-Value	0.108	0.972	0.720	0.796	0.871	0.951	0.849

Note. All tests are one-tailed, for negative correlation.

* p < 0.05,

** p < 0.01,

*** p < 0.001, one-tailed Significant results are highlighed in bold

Group B – positive correlations on JASP statistical program

Variable		fT4	PR	Molecular subtype	Calcium	TSH pre- operative	TSH post- operative	LDH	Ki-67	fT3	ER	HER2
fT4	Pearson's r	—
	p-Value	—
PR	Pearson's r	−0.035	—
	p-Value	0.592	—
Molecular subtype	Pearson's r	0.064	0.529	—
	p-Value	0.661	<0.001	—
Calcium	Pearson's r	0.010	0.146	0.056	—
	p-Value	0.472	0.166	0.356	—
TSH preoperaive	Pearson's r	0.407	0.234	0.070	0.172	—
	p-Value	0.998	0.059	0.322	0.121	—
TSH postoperative	Pearson's r	0.106	0.281	0.051	0.307	0.152	—
	p-Value	0.657	0.854	0.574	0.893	0.273	—
LDH	Pearson's r	0.060	0.204	−0.164	−0.074	0.023	−0.188	—
	p-Value	0.344	0.087	0.862	0.693	0.437	0.773	—
Ki-67	Pearson's r	−0.356	0.134	0.369	0.182	0.264	−0.441	−0.324	—
	p-Value	0.956	0.262	0.035	0.191	0.102	0.863	0.943	—
fT3	Pearson's r	0.021	−0.052	0.056	−0.009	−0.381	0.164	−0.003	0.247	—
	p-Value	0.445	0.632	0.357	0.524	0.996	0.264	0.507	0.122	—
ER	Pearson's r	−0.076	0.641	0.839	0.106	0.122	−0.156	−0.091	0.295	−0.041	—
	p-Value	0.689	< .001	< .001	0.241	0.210	0.718	0.726	0.076	0.605	—
HER2	Pearson's r	−0.001	0.027	−0.529	0.063	0.062	−0.162	0.160	−0.203	−0.167	0.017	—
	p-Value	0.504	0.430	1.000	0.338	0.341	0.726	0.144	0.835	0.863	0.455	—
Age	Pearson's r	0.200	−0.028	0.013	−0.043	0.142	−0.317	0.132	−0.327	−0.283	−0.142	−0.247
	p-Value	0.128	0.563	0.470	0.596	0.207	0.865	0.225	0.921	0.947	0.789	0.921

Negative correlations for Group B

Variable		fT4	PR	Molecular subtype	Calcium	TSH pre-operative	TSH post-operative	LDH	ki-67	fT3	ER	HER2
fT4	Pearson's r	—
	p-Value	—
PR	Pearson's r	−0.035	—
	p-Value	0.408	—
Molecular subtype	Pearson's r	0.064	0.529	—
	p-Value	0.339	1.000	—
Calcium	Pearson's r	0.010	0.146	0.056	—
	p-Value	0.528	0.834	0.644	—
TSH preoperative	Pearson's r	−0.407	0.234	0.070	0.172	—
	p-Value	0.002	0.941	0.678	0.879	—
TSH postoperative	Pearson's r	0.106	−0.281	−0.051	−0.307	0.152	—
	p-Value	0.343	0.146	0.426	0.107	0.727	—
LDH	Pearson's r	0.060	0.204	−0.164	−0.074	0.023	−0.188	—
	p-Value	0.656	0.913	0.138	0.307	0.563	0.227	—
Ki-67	Pearson's r	−0.356	0.134	0.369	0.182	0.264	−0.441	−0.324	—
	p-Value	0.044	0.738	0.965	0.809	0.898	0.137	0.057	—
fT3	Pearson's r	0.021	−0.052	0.056	−0.009	−0.381	0.164	−0.003	0.247	—
	p-Value	0.555	0.368	0.643	0.476	0.004	0.736	0.493	0.878	—
ER	Pearson's r	−0.076	0.641	0.839	0.106	0.122	−0.156	−0.091	0.295	−0.041	—
	p-Value	0.311	1.000	1.000	0.759	0.790	0.282	0.274	0.924	0.395	—
HER2	Pearson's r	−0.001	0.027	−0.529	0.063	0.062	−0.162	0.160	−0.203	−0.167	0.017	—
	p-Value	0.496	0.570	< .001	0.662	0.659	0.274	0.856	0.165	0.137	0.545	—
Age	Pearson's r	0.200	−0.028	0.013	−0.043	0.142	−0.317	0.132	−0.327	−0.283	−0.142	−0.247
	p-Value	0.872	0.437	0.530	0.404	0.793	0.135	0.775	0.079	0.053	0.211	0.079

Note. All tests are one-tailed, for negative correlation.

* p < 0.05,

** p < 0.01,

*** p < 0.001, one-tailed Significant results are highlighted in bold

Table 6:

Mann–Whitney test.

Test statistics

	Age	Calcium levels	TSH postoperative value	LDH	Ki-67
Mann–Whitney U	580,500	976,000	34,000	1040,500	260,500
Wilcoxon W	1210,500	1879,000	49,000	2216,500	585,500
Z	−,174	−,260	−,820	−,121	−1,013
Asymp. sig. (2-tailed)	,862	,795	,412	,904	,311
Exact sig. [2*(1-tailed)]			,446

References

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.2478/fco-2024-0026 | Journal eISSN: 1792-362X | Journal ISSN: 1792-345X

Journal RSS Feed

Language: English

Submitted on: Dec 25, 2024

Accepted on: Aug 27, 2025

Published on: Jul 8, 2026

Published by: Helenic Society of Medical Oncology

In partnership with: Paradigm Publishing Services

Keywords:

thyroid disease,

breast cancer,

thyroid hormones,

Tumor Nodes Metastasis,

Related subjects:

Haematology, oncology

© 2026 Alexandrina Nikova, Spyridon Plakas, Vasilios Tselepidis, Pinelopi Vlotinou, Helena Michalopoulou, Anna Tsiakiri, Loukas Karelis, Christos Valavanis, Eustathios Vlachakis, Maria Kyriazi, published by Helenic Society of Medical Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

AHEAD OF PRINT