Type 2 diabetes mellitus and prognosis in early stage breast cancer women

Abstract

It has been suggested that type 2 diabetes mellitus may affect breast cancer prognosis, possibly due to increased diabetes-related comorbidity, or direct effects of insulin resistance and/or hyperinsulinemia. The aim of this study was to determine the impact of diabetes on disease-free survival (DFS) following mastectomy for breast cancer patients. The cases included in this retrospective study were selected from breast cancer women who had undergone mastectomy and completed adjuvant chemotherapy from 1998 to 2010. Patients were classified into two groups: diabetic and non-diabetic. Patients' age, sex, menopausal status, body mass index (BMI), histopathological features, tumor size, lymph node involvement, hormone receptor and HER2-neu status, and treatment types were recorded. There were 483 breast cancer patients included in the study. Postmenopausal patients' rate (53.7% vs. 36.8%, P = 0.016) and mean BMI levels were statistically higher (32.2 vs. 27.9, P = 0.007) in diabetic patients. There was no statistical difference for histological subgroup, grade, ER and PR positivity, HER2-neu overexpression rate, and tumor size between the diabetic and non-diabetic group. Lymph node involvements were statistically higher in diabetic patients compared with non-diabetic patients (P = 0.013). Median disease-free survival is 81 months (95% CI, 61.6-100.4) in non-diabetic patients and 36 months (95% CI, 13.6-58.4) in diabetic patients (P < 0.001). The odds ratio of recurrence was significantly increased in those with HER2-neu overexpression and lymph node involvement and decreased with PR-positive tumors. Our results suggest that diabetes is an independent prognostic factor for breast cancer.

Correlations of microRNA-124a and microRNA-30d with clinicopathological features of breast cancer patients with type 2 diabetes mellitus

“…The study performed by Dong et al (2015) has revealed that decreased expression of miR-124 may be associated with advanced TNM stage, lymph node metastasis and poorer pathological differentiation, implying that down-regulation of miR-124 may be an independent unfavorable prognostic factor for BC patients. Further, high levels of insulin are mitogenic for BC cells, and overexpressed insulin receptors are often found in BC patients (Kaplan et al 2012). Hyperexpression of miR-124a may be impaired glucose-stimulated insulin secretion, and the silencing of the miR-124a resulted in increased expression of target genes for beta-cell function, indicating that an altered miR-124a expression may lead to beta-cell dysfunction in T2DM (Sebastiani et al 2015).…”

Impact of Diabetes, Insulin, and Metformin Use on the Outcome of Patients With Human Epidermal Growth Factor Receptor 2–Positive Primary Breast Cancer: Analysis From the ALTTO Phase III Randomized Trial

“…[1][2][3][4] Insulin resistance and hyperinsulinemic state were suggested as potential mediators of this effect. [5][6][7] This led to evaluation of antidiabetic agents to improve breast cancer outcome.…”

Prognostic Significance of Diabetes Mellitus in Locally Advanced Non-small Cell Lung Cancer

“…Various studies have indicated that among patients with colorectal, pancreatic, breast, or liver cancer, existing diabetes mellitus (DM) was associated with a lower chance of long-term survival [16][17][18][19]. It has also been found that good performance status (PS), disease stage, age and weight loss are strong prognostic factors in this malignancy.…”