Screening and Management Recommendations for Type 2 Diabetes in Women With Breast Cancer

Area of Science:

• Oncology
• Endocrinology
• Public Health

Background:

• Breast cancer diagnosis is associated with a 1.07- to 4.27-fold increased risk of type 2 diabetes.
• This elevated risk is influenced by factors like postmenopausal status, hormone therapy, and adjuvant chemotherapy.
• The increased risk of diabetes appears to commence around the time of breast cancer diagnosis and persists for 10-15 years.

Purpose of the Study:

• To evaluate existing evidence on the link between breast cancer and type 2 diabetes.
• To consider the implications for type 2 diabetes screening in breast cancer patients.
• To identify patient subsets at higher risk for developing type 2 diabetes.

Main Methods:

• A narrative review of studies published in English between 2000 and 2022.
• Searches were conducted using Embase and MEDLINE databases.
• Keywords included "diabetes" and "breast cancer".

Main Results:

• The risk of type 2 diabetes is elevated for at least 10 to 15 years post-breast cancer diagnosis, with the highest risk in the first two years.
• Patients treated with adjuvant chemotherapy or hormone therapy exhibit a particularly high risk.
• Simultaneous measurement of hemoglobin is recommended if glycated hemoglobin testing is performed due to potential anemia associated with breast cancer therapies.

Conclusions:

• Breast cancer patients have a substantially increased risk of developing type 2 diabetes.
• Further research is necessary to establish specific diabetes screening guidelines for this population.
• Treatment decisions for diabetes should not be unduly influenced by a breast cancer diagnosis.