Diabetics at Increased Risk of Advanced Breast Cancer

Publication
Article
OncologyOncology Vol 29 No 9
Volume 29
Issue 9

Women with diabetes are at a greater risk of being diagnosed with advanced-stage breast cancer, according to a retrospective study.

Image © 0833379753 / Shutterstock.com

Women with diabetes are at a greater risk of being diagnosed with advanced-stage breast cancer, according to a retrospective study published in Breast Cancer Research and Treatment.

Women with diabetes were 14% more likely to present with stage II breast cancer, 21% more likely to present with stage III breast cancer, and 16% more likely to present with stage IV breast cancer than they were with stage I breast cancer.

The results found that breast cancer patients with diabetes had a nearly 15% decrease in 5-year survival rate compared with those without diabetes.

The study, by the Institute for Clinical Evaluative Sciences and Women’s College Hospital, analyzed data on 38,407 women who were newly diagnosed with breast cancer between 2007 and 2012 in Ontario, Canada.

"Our findings suggest that women with diabetes may be predisposed to more advanced-stage breast cancer, which may be a contributor to their higher cancer mortality," said Lorraine Lipscombe, MD, an associate professor in the department of medicine at the University of Toronto and a researcher at the Institute for Clinical Evaluative Sciences and Women’s College Research Institute, in a statement.

Of the women included in the analysis, 15.9% (6,115 women) had diabetes.

Patients with diabetes tended to be older, have higher comorbidities, and had more primary care physician visits 2 years before their cancer diagnosis. These women were also more likely to live in lower income neighborhoods.

A total of 41.2% of the patients studied were diagnosed with stage I breast cancer; 39.2% with stage II; 14.5% with stage III; and 5.1% with stage IV.

Prior studies have suggested that diabetics may have both a higher risk of developing cancer and higher mortality from their cancer. While patients with diabetes may not be treated as aggressively due to comorbidities, contributing to a greater cancer mortality rate, the authors of the current study wanted to investigate whether cancer diagnosis at a more advanced stage could also play a part.

The study found that women with diabetes had lower rates of annual mammography in the 3 years before their cancer diagnosis. However, the association between diagnosis at a more advanced breast cancer stage and diabetes persisted even among women who did receive consistent mammography screening.

Women with diabetes had a 16% higher risk of lymph node metastases and were 16% more likely to have tumors greater than 2 cm.

“These findings suggest that diabetes may predispose women to more rapidly progressive breast cancers, leading to more advanced-stage disease at diagnosis even if they receive regular screening mammograms,” the study authors wrote. The authors suggested that diabetes may result in decreased sensitivity of mammography due to the association of type II diabetes with obesity.

“While further studies are needed to evaluate the impact of these findings, breast cancer screening and detection practices may need to be modified in patients with diabetes,” concluded the authors.

Recent Videos
Heather Zinkin, MD, states that reflexology improved pain from chemotherapy-induced neuropathy in patients undergoing radiotherapy for breast cancer.
Study findings reveal that patients with breast cancer reported overall improvement in their experience when receiving reflexology plus radiotherapy.
Patients undergoing radiotherapy for breast cancer were offered 15-minute nurse-led reflexology sessions to increase energy and reduce stress and pain.
Whole or accelerated partial breast ultra-hypofractionated radiation in older patients with early breast cancer may reduce recurrence with low toxicity.
Ultra-hypofractionated radiation in those 65 years or older with early breast cancer yielded no ipsilateral recurrence after a 10-month follow-up.
The unclear role of hypofractionated radiation in older patients with early breast cancer in prior trials incentivized research for this group.
Patients with HR-positive, HER2-positive breast cancer and high-risk features may derive benefit from ovarian function suppression plus endocrine therapy.
Paolo Tarantino, MD discusses updated breast cancer trial findings presented at ESMO 2024 supporting the use of agents such as T-DXd and ribociclib.
Paolo Tarantino, MD, discusses the potential utility of agents such as datopotamab deruxtecan and enfortumab vedotin in patients with breast cancer.
Paolo Tarantino, MD, highlights strategies related to screening and multidisciplinary collaboration for managing ILD in patients who receive T-DXd.
Related Content