Diabetes, obesity, and survival in a large cohort of early-stage breast cancer patients.

Giordano, S.; Jiralerspong, Sao; Lopez, Aristeo; Feng, Lili; KIM, EUN SOOK; González-Angulo, Ana M.; Hortobágyi, Gabriel N.

doi:10.1200/jco.2010.28.15_suppl.1503

Cited by 3 publications

(2 citation statements)

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“…This finding enhances the growing literature in this field and corresponds with what has been published with non-Indigenous populations. [17][18][19][20] Canadian literature draws attention to the increasing rates of obesity in First Nations people, especially among women. 3 Furthermore, obesity in this population is predominately centrally distributed, characterized by a high waist-to-hip ratio, which is associated with an increased risk of diabetes 3 and increased risk of breast cancer mortality, independent of the effect of diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…17 Consistently elsewhere, the association remained significant after adjustment for age, race, smoking status, and/or BMI. [18][19][20] Only two studies have examined the influence of diabetes on cancer survival among an Indigenous population. 21,22 Poorer survival was found among an Australian Indigenous cohort that included all cancer sites, with only a small sample of patients with breast cancer (n = 81), of which 20% had preexisting diabetes, resulting in low statistical power.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Preexisting Diabetes on Survival After a Breast Cancer Diagnosis in First Nations Women in Ontario, Canada

Sheppard

Chiarelli

Hanley

et al. 2020

JCO Global Oncology

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PURPOSE Survival after a breast cancer diagnosis is poorer in First Nations women with a preexisting comorbidity compared with comorbidity-free First Nations women in Ontario, Canada. Given the high prevalence of diabetes in this population, it is important to determine whether preexisting diabetes is related to poorer survival after a breast cancer diagnosis. METHODS All First Nations women were identified from a cohort of First Nations people diagnosed with breast cancer in diagnostic periods—1995 to 1999 and 2000 to 2004—and seen at a regional cancer program (RCP) in Ontario. Preexisting diabetes status and other factors, such as age at diagnosis, body mass index, and stage at diagnosis, were collected from medical charts at the regional cancer programs. The association between preexisting diabetes and First Nations status was examined by each of the demographic, personal, tumor, and treatment factors using logistic regression models. Survival was compared between First Nations women with (n = 67) and without (n = 215) preexisting diabetes, adjusted by significant study factors using a Cox proportional hazards regression model. RESULTS The 5-year survival rate among First Nations women with diabetes was 59.8% versus 78.7% among those without diabetes ( P < .01). Preexisting diabetes significantly increased the risk of death among First Nations women with breast cancer (hazard ratio, 1.87; 95% CI, 1.12 to 3.13) after adjustment for age group, period of diagnosis, body mass index, other comorbidities at diagnosis, and stage. CONCLUSION This study recommends awareness of this survival discrepancy among the treatment team for First Nations patients with breast cancer with preexisting diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of Preexisting Diabetes on Survival After a Breast Cancer Diagnosis in First Nations Women in Ontario, Canada

Sheppard

Chiarelli

Hanley

et al. 2020

JCO Global Oncology

View full text Add to dashboard Cite

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Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients

Arce-Salinas

Aguilar-Ponce

Villarreal‐Garza

et al. 2014

Breast Cancer Res Treat

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Obesity and overweight are established risk factors for the development of breast cancer. They are also associated with poor prognosis for higher risk of disease recurrence and lower overall survival (OS). The aim of this study was to evaluate the influence of overweight and obesity in OS in patients with locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy. This is a retrospective analysis that included 819 patients diagnosed with LABC between January 2004 and December 2008. The patients were treated with neoadjuvant chemotherapy (NAT) based on anthracyclines, taxanes, or both, followed by surgery. For comparison, patients were divided into the normal weight (NW) group or the overweight/obesity (OW/OB) group. The prevalence of overweight/obesity was 74 %. General characteristics of the patients, including age, tumor size, clinical stage, nuclear grade, hormone receptors, and HER2 expression, were similar between both groups. At a median follow-up of 28 months, we found a statistically significant difference in OS between the two groups, achieving a 91.5 % in NW patients versus 85.9 % in the OW/OB group (P = 0.050). Cox multivariate analysis demonstrated that obesity was an independent factor for poor prognosis, with a hazard ratio of 1.79 (95 % CI (Confidence Interval) 1.09-2.96; P = 0.022). This is the first Mexican study that confirms the role of OW/OB as a risk factor for poor outcome among patients with LABC. Obesity in our country is a public health problem and requires strong preventive intervention strategies for its control, especially among patients diagnosed with breast cancer.

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Clinically Defined Type 2 Diabetes Mellitus and Prognosis in Early-Stage Breast Cancer

Erickson

Patterson

Flatt

et al. 2011

JCO

153

136

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A B S T R A C T PurposeSelf-reported diabetes has been associated with poor breast cancer outcomes. Research is needed to investigate the relationship between biologically determined glycemic control and breast cancer prognosis. MethodsArchived baseline blood samples from the Women's Healthy Eating and Living Study were used to measure hemoglobin A1C (HbA1C) among 3,003 survivors of early-stage breast cancer (age of diagnosis, 28 to 70 years) observed for a median of 7.3 years for additional breast cancer events and 10.3 years for all-cause mortality. HbA1C levels provide an accurate, precise measure of chronic glycemic levels. Cox regression analysis was performed to assess whether baseline HbA1C levels predicted disease-free and overall survival. ResultsOnly 5.8% of women had chronic hyperglycemia (defined as HbA1C levels Ն 6.5%). Those with HbA1C Ն 6.5% were older and more likely to be less educated, have nonwhite ethnicity, be obese, and have more advanced breast cancer at diagnosis. HbA1C was significantly associated with overall survival (P trend Ͻ .001). After adjusting for confounders, risk of all-cause mortality was twice as high in women with HbA1C Ն 7.0% compared with women with HbA1C less than 6.5% (hazard ratio [HR], 2.35; 95% CI, 1.56 to 3.54). For disease-free survival, there was a nonsignificant 30% increase in risk for HbA1C levels Ն 7.0% (HR, 1.26; 95% CI, 0.78 to 2.02). During study follow-up, previously diagnosed rather than undiagnosed diabetes seemed to account for the increased risk. ConclusionChronic hyperglycemia is statistically significantly associated with reduced overall survival in survivors of early-stage breast cancer. Further study of diabetes and its relationship to breast cancer outcomes is warranted.

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Diabetes, obesity, and survival in a large cohort of early-stage breast cancer patients.

Cited by 3 publications

References 0 publications

Influence of Preexisting Diabetes on Survival After a Breast Cancer Diagnosis in First Nations Women in Ontario, Canada

Influence of Preexisting Diabetes on Survival After a Breast Cancer Diagnosis in First Nations Women in Ontario, Canada

Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients

Clinically Defined Type 2 Diabetes Mellitus and Prognosis in Early-Stage Breast Cancer

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