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<p>Breast carcinoma leads among the malignancies affecting women globally. Emerging evidence suggests a controversial association between raised thyroid peroxidase antibody (TPO-Ab) levels and carcinoma breast outcomes. While few studies indicate higher levels of TPO-Ab in patients with breast cancer, its role in tumorigenesis and prognostic value, especially concerning axillary lymph node metastasis (ALNM), remains underexplored. Previous research has indicated that TPO-Ab levels may predict a lower prevalence of ALNM in specific breast cancer molecular subtypes. A prospective observational study was conducted at a tertiary care center (2024–2025), enrolling 92 newly diagnosed breast cancer patients. After exclusion of patients with distant metastasis (Stage IV), 81 non-metastatic patients (Stage I–III) were included in the final analysis. Clinical, radiological, and histopathological parameters, including TPO-Ab levels, receptor status, and molecular subtypes, were analyzed for association with ALNM. Odds ratios (OR) were estimated using multivariate logistic regression with 95% confidence intervals (CI). Among the 81 non-metastatic breast cancer patients, 34.6% were diagnosed with stage I, 38.3% with stage II, and 27.1% with stage III disease. TPO-Ab positivity was detected in 26 patients (32.1%). ALNM was significantly less frequent in TPO-Ab–positive compared with TPO-Ab–negative patients (23.1% vs. 49.1%, <i>p</i> = 0.018; OR = 0.45, 95% CI: 0.16–0.98). TPO-Ab positivity correlated with higher estrogen receptor (ER) (OR = 3.98, 95% CI: 1.05–15.1, <i>p</i> = 0.036) and progesterone receptor (PR) (OR = 3.78, 95% CI: 1.14–12.5, <i>p</i> = 0.031) expression, and was closely linked to luminal A/B subtypes (OR = 10.6, 95% CI: 2.3–48.7, <i>p</i> = 0.001). On multivariate analysis, TPO-Ab positivity independently predicted reduced odds of axillary lymph node metastasis (adjusted OR = 0.44, 95% CI: 0.19–0.96, <i>p</i> = 0.021). TPO-Ab positivity correlates with fewer occurrences of axillary lymph node metastasis, hormone receptor positivity, and luminal subtypes in breast cancer patients. It may serve as a cost-effective adjunct biomarker for prognostication, particularly in luminal cancers common in India. Larger multicenter studies with survival analysis are needed for validation.</p>

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Role of Thyroid Peroxidase (TPO) Antibody Levels in Predicting Axillary Lymph Node Metastasis (ALMN) in Different Molecular Subtypes of Breast Cancer

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Nitesh Kumar,
  • Deepak Pankaj,
  • Vishwapal Vishwendu,
  • Vibhuti Bhushan,
  • Sweta Kumari,
  • Richa Madhawi,
  • Smita Pawar

摘要

Breast carcinoma leads among the malignancies affecting women globally. Emerging evidence suggests a controversial association between raised thyroid peroxidase antibody (TPO-Ab) levels and carcinoma breast outcomes. While few studies indicate higher levels of TPO-Ab in patients with breast cancer, its role in tumorigenesis and prognostic value, especially concerning axillary lymph node metastasis (ALNM), remains underexplored. Previous research has indicated that TPO-Ab levels may predict a lower prevalence of ALNM in specific breast cancer molecular subtypes. A prospective observational study was conducted at a tertiary care center (2024–2025), enrolling 92 newly diagnosed breast cancer patients. After exclusion of patients with distant metastasis (Stage IV), 81 non-metastatic patients (Stage I–III) were included in the final analysis. Clinical, radiological, and histopathological parameters, including TPO-Ab levels, receptor status, and molecular subtypes, were analyzed for association with ALNM. Odds ratios (OR) were estimated using multivariate logistic regression with 95% confidence intervals (CI). Among the 81 non-metastatic breast cancer patients, 34.6% were diagnosed with stage I, 38.3% with stage II, and 27.1% with stage III disease. TPO-Ab positivity was detected in 26 patients (32.1%). ALNM was significantly less frequent in TPO-Ab–positive compared with TPO-Ab–negative patients (23.1% vs. 49.1%, p = 0.018; OR = 0.45, 95% CI: 0.16–0.98). TPO-Ab positivity correlated with higher estrogen receptor (ER) (OR = 3.98, 95% CI: 1.05–15.1, p = 0.036) and progesterone receptor (PR) (OR = 3.78, 95% CI: 1.14–12.5, p = 0.031) expression, and was closely linked to luminal A/B subtypes (OR = 10.6, 95% CI: 2.3–48.7, p = 0.001). On multivariate analysis, TPO-Ab positivity independently predicted reduced odds of axillary lymph node metastasis (adjusted OR = 0.44, 95% CI: 0.19–0.96, p = 0.021). TPO-Ab positivity correlates with fewer occurrences of axillary lymph node metastasis, hormone receptor positivity, and luminal subtypes in breast cancer patients. It may serve as a cost-effective adjunct biomarker for prognostication, particularly in luminal cancers common in India. Larger multicenter studies with survival analysis are needed for validation.