Issue: May 2015
March 26, 2015
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Advanced breast cancer more likely in women with diabetes

Issue: May 2015
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Diabetes was associated with more advanced breast cancer in a study of Canadian women, according to research published in Breast Cancer Research and Treatment.

The findings from a population-based study point to either more rapidly progressing cancers or barriers to timely detection among women with diabetes, even with adherence to screening recommendations, according to researchers.

“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,” Lorraine L. Lipscombe, MD, of the Women’s College Research Institute, Women’s College Hospital, Toronto, said in a press release.

Lorraine Lipscombe

Lorraine L. Lipscombe

Lipscombe and colleagues retrospectively analyzed breast cancer stage at diagnosis (stage II, III or IV vs. stage I) among 38,407 women aged 20 to 105 years, of whom 6,115 (15.9%) had diabetes as defined by medical records using a validated algorithm.

Those with breast cancer and diabetes were more likely to present with advanced stages of the disease than those without diabetes (stage II, III or IV, adjusted OR = 1.16; 95% CI, 1.09-1.23).

After adjusting for mammograms and other covariates, diabetes was associated with increased risk for stage II (adjusted OR = 1.14; 95% CI, 1.07-1.22), stage III (adjusted OR = 1.21; 95 % CI, 1.11-1.33) and stage IV (adjusted OR = 1.16; 95 % CI, 1.01-1.33) disease compared with stage I.

Women with diabetes also were at an elevated risk for lymph node metastases (adjusted OR = 1.16; 95% CI, 1.06-1.27) and tumors larger than 2 cm (adjusted OR = 1.16; 95% CI, 1.06-1.28).

“There is increasing evidence that type 2 diabetes not only increases the risk of certain cancers, but is also associated with higher mortality after cancer is diagnosed. Our study indicates that women with diabetes are at higher risk of more advanced stage breast cancer at diagnosis, which was not explained by differences in screening mammogram patterns. This suggests that diabetes may predispose to more aggressive breast cancers, and that enhanced screening of diabetes patients may be warranted,” Lipscombe told Endocrine Today. – by Allegra Tiver

Disclosure: The researchers report no relevant financial disclosures.