Exploring the association between diabetes and breast cancer morbidity: considerations for quality care improvements among Latinas

Abstract

Objective Cancer and diabetes are two severe chronic illnesses that often co-occur. In cancer patients, diabetes increases the risk for treatment complexities and mortality. Yet patient-reported outcomes with co-occurring chronic illness are understudied. Design This preliminary study investigated the association of diabetes with breast cancer-related morbidity among underserved Latina breast cancer survivors (BCS). Participants 137 Latina BCS were recruited from the California Cancer Registry and hospitals. Setting and Main Outcome Measure(s): BCS completed a self-administered mailed questionnaire assessing demographic and medical characteristics e.g. Type2 diabetes mellitus (T2DM). Results 28% Latina BCS reported co-occurring T2DM at twice the general population rate. Diabetes was most prevalent among Latina BCS > 65 years (43%). Latina BCS with diabetes were more likely to report advanced cancer staging at diagnosis (P = 0.036) and more lymphedema symptoms (P = 0.036). Results suggest non-significant but lower general health and greater physical functioning limitations among BCS with T2DM. Conclusions This study has relevance for precision population medicine by (i) consideration of routine diabetes screening in Latina BCS, (ii) underscoring attention to disease co-occurrence in treatment planning and care delivery and (iii) informing follow-up care and survivorship care planning e.g. patient self-management, oncology and primarily care surveillance and specialty care. Our findings can inform providers, survivors and caregivers about the impact of disease co-occurrence that influence clinically and patient responsive care for both initial treatment and long-term follow-up care to address disparities.

Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors

“…Studies on the long-term survivorship of breast cancer found a positive association of diabetes mellitus with arm morbidities [53,54]. Our study revealed that diabetic patients had a nine-fold increased likelihood of developing early-onset lymphedema as compared to those who were not.…”

“…Therefore, we hypothesized that the occurrence of BCRL in diabetic patients was increased due to the delayed wound healing caused by breast surgery and the increased arm morbidity associated with these individuals. Moreover, a study on the Latino breast cancer population found post-operative participants with diabetes mellitus were likely to report more lymphedema symptoms such as swelling [54].…”

Racial disparities in diabetes prevalence among cancer patients

“…Meanwhile, the rates of diagnosed diabetes among American Indians/Alaskan Natives (14.5%), non-Hispanic Blacks (12.1%), and Hispanics (12.1%) are higher than other racial/ethnic groups (10). Previous research has indicated Latina breast cancer survivors had a higher risk of developing Type 2 Diabetes than the general population and diabetes was most prevalent among Latina survivors aged over 65 years old (11,12).…”

Tumor targetable and pH-sensitive polymer nanoparticles for simultaneously improve the Type 2 Diabetes Mellitus and malignant breast cancer

“…According to the data published by the Centers for Disease Control and Prevention, malignant breast cancer and diabetes are the leading causes of death among women with an estimated 268,600 new cases in a year [ 1 ]. Accumulating evidences demonstrated that a greater risk of developing breast cancer was found in those patients with type 2 diabetes [ 2–4 ]. It was demonstrated that women with diabetes have a 23% higher risk for developing breast cancer than those without diabetes [ 5 ].…”