December 25, 2011
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Diabetes, obesity associated with development of breast cancer

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San Antonio Breast Cancer Symposium

SAN ANTONIO — Diabetes, obesity and low blood lipids are associated with the development of breast cancer, according to researchers from Lund University in Sweden.

“There is a link between diabetes and breast cancer, even after adjusting for obesity and abnormal lipids, especially seen within 4 years of the diagnosis,” said study researcher Håkan Olsson, MD, professor in the departments of oncology and cancer epidemiology at Lund University. “Obesity after age 60 is also associated with breast cancer. However, fewer breast cancer patients are diagnosed with high abnormal blood lipids compared with the general population.”

The researchers analyzed the incidence of diabetes, obesity and abnormal blood lipids 0 to 10 years before the diagnosis of breast cancer in 2,724 people with breast cancer. The study also included 20,542 controls matched for age, sex and domicile.

Outpatient and inpatient population-based registries were used to obtain data on diagnoses. The researchers also examined the use of glargine and metformin in relation to cancer risk in patients with diabetes. Information on the drugs’ use was obtained from the national pharmacy prescription registry.

Diabetes was significantly more common before diagnosis in patients with breast cancer when the diabetes diagnosis was made 0 to 4 years before the cancer diagnosis. This held true after adjustment for obesity and high blood lipids.

Obesity was more common in patients with breast cancer who were older than 60 years, when the obesity was diagnosed close to the cancer diagnosis. High blood lipids were significantly less common in patients with breast cancer close to diagnosis.

The use of glargine was associated with a doubled risk (RR=2.88) and the use of metformin was associated with a lower risk for cancer (RR=0.92) in patients with diabetes.

“Our study does have some shortcomings, such as the short time span,” Olsson said. “There is a low power to study individual cancer types in relations to different medications. We also looked at only obese people and not overweight people. We also have not studied the role of anti-lipid therapy.”

Disclosure: Dr. Olsson reports no relevant financial disclosures.

Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.

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PERSPECTIVE

This work is very important as we try to understand obesity, which is unfortunately a growing health problem around to world, and its link to cancer. The MA32 study is testing the impact of metformin on early-stage breast cancer. That study has enrolled more than 1,000 patients worldwide and will provide more information about the relationship between these metabolic disorders and breast cancer.

Jennifer A. Ligibel, MD
Medical Oncologist in Breast Oncology at the Dana-Farber Cancer Institute

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