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Acta Diabetol. 2016 Feb;53(1):99-107. doi: 10.1007/s00592-015-0756-6. Epub 2015 Apr 29.

Association of diabetes and diabetes treatment with incidence of breast cancer.

Author information

1
Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III-ISCIII), Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
2
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
3
IdiPAZ, Madrid, Spain.
4
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
5
Unit of Biomarkers and Susceptibility, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
6
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
7
IMIM (Hospital del Mar Medical Research Insititute), Barcelona, Spain.
8
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
9
Institute of Health Research "Puerta de Hierro", IDIPHIM, Madrid, Spain.
10
Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain.
11
Public Health Divission of Gipuzkoa, BioDonostia Research Institute, San Sebastián, Spain.
12
Dirección General de Salud Pública, Fundación para el fomento de la investigación sanitaria y biomédica de la Comunidad Valenciana, FISABIO-Salud Pública, Barcelona, Spain.
13
Grupo de Investigación en Interacción Gen-Ambiente-Salud, Department of Preventive Medicine and Public Health, University of Leon, Leon, Spain.
14
Public Health Institute of Navarra, Pamplona, Spain.
15
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain.
16
Instituto Universitario de Oncología, University of Oviedo, Asturias, Spain.
17
Hospital Infanta Elena de Huelva, Huelva, Spain.
18
Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain.
19
Epidemiology Unit and Girona Cancer Registry (UERCG), Oncology Coordination Plan (PDO), Department of Health, Autonomous Government of Catalonia, Barcelona, Spain.
20
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
21
School of Public Health, Athens, Greece.
22
University of Barcelona, Barcelona, Spain.
23
Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III-ISCIII), Avda. Monforte de Lemos, 5, 28029, Madrid, Spain. mpollan@isciii.es.
24
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. mpollan@isciii.es.
25
Institute of Health Research "Puerta de Hierro", IDIPHIM, Madrid, Spain. mpollan@isciii.es.

Abstract

AIMS:

The aim of this study was to evaluate the association of diabetes and diabetes treatment with risk of postmenopausal breast cancer.

METHODS:

Histologically confirmed incident cases of postmenopausal breast (N = 916) cancer were recruited from 23 Spanish public hospitals. Population-based controls (N = 1094) were randomly selected from primary care center lists within the catchment areas of the participant hospitals. ORs (95 % CI) were estimated using mixed-effects logistic regression models, using the recruitment center as a random effect term. Breast tumors were classified into hormone receptor positive (ER+ or PR+), HER2+ and triple negative (TN).

RESULTS:

Diabetes was not associated with the overall risk of breast cancer (OR 1.09; 95 % CI 0.82-1.45), and it was only linked to the risk of developing TN tumors: Among 91 women with TN tumors, 18.7 % were diabetic, while the corresponding figure among controls was 9.9 % (OR 2.25; 95 % CI 1.22-4.15). Regarding treatment, results showed that insulin use was more prevalent among diabetic cases (2.5 %) as compared to diabetic controls (0.7 %); OR 2.98; 95 % CI 1.26-7.01. They also showed that, among diabetics, the risk of developing HR+/HER2- tumors decreased with longer metformin use (ORper year 0.89; 95 % CI 0.81-0.99; based on 24 cases and 43 controls).

CONCLUSION:

This study reinforces the need to correctly classify breast cancers when studying their association with diabetes. Given the low survival rates in women diagnosed with TN breast tumors and the potential impact of diabetes control on breast cancer prevention, more studies are needed to better characterize this association.

KEYWORDS:

Breast cancer; Diabetes Mellitus; Insulin; Metformin; Triple-negative breast neoplasms

PMID:
25916213
PMCID:
PMC4749645
DOI:
10.1007/s00592-015-0756-6
[Indexed for MEDLINE]
Free PMC Article

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