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Does diabetes affect breast cancer survival?

Ross Lawrenson1,2, Chunhuan Lao1, James Stanley3

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Cancer Reports (Hoboken, N.J.)
|March 20, 2024
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Summary

Diabetes does not impact breast cancer survival rates in New Zealand women. Differences observed are linked to age and advanced disease at diagnosis, not diabetes itself or treatment variations.

Keywords:
breast cancercause of deathdiabetesmortalitysurvival

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Area of Science:

  • Oncology
  • Endocrinology
  • Epidemiology

Background:

  • Diabetes is a prevalent comorbidity in women diagnosed with breast cancer.
  • Understanding the impact of diabetes on breast cancer prognosis is crucial for personalized treatment strategies.
  • Previous research has yielded conflicting results regarding diabetes and breast cancer survival.

Purpose of the Study:

  • To investigate the association between diabetes and breast cancer-specific survival in Aotearoa/New Zealand.
  • To determine if diabetes influences mortality risk in women diagnosed with invasive breast cancer.
  • To identify factors contributing to any observed survival differences.

Main Methods:

  • A cohort study utilizing data from the Te Rēhita Mate Ūtaetae-Breast Cancer Foundation National Register (2005-2020).
  • Kaplan-Meier survival analysis to compare survival curves between women with and without diabetes.
  • Cox proportional hazards modeling to estimate the hazard ratio (HR) for breast cancer-specific mortality, adjusting for confounders.

Main Results:

  • No significant difference in 5-year (87% vs. 89%) or 10-year (79% vs. 84%) breast cancer-specific survival between women with and without diabetes.
  • Adjusted HR for breast cancer-specific mortality in women with diabetes was 0.99 (95% CI: 0.89-1.11).
  • Advanced cancer stage at diagnosis and patient age were the primary drivers of survival disparities; survival was similar across cancer stages when stratified.

Conclusions:

  • Diabetes itself does not appear to independently affect breast cancer-specific survival in this New Zealand cohort.
  • Observed survival differences are primarily attributed to a higher incidence of advanced-stage disease and older age at diagnosis among women with diabetes.
  • Treatment modalities did not show differential impact on survival between the two groups.