Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Jan 1;29(1):40-6.
doi: 10.1200/JCO.2009.27.3011. Epub 2010 Nov 29.

Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis

Kimberly S Peairs  1 , Bethany B Barone, Claire F Snyder, Hsin-Chieh Yeh, Kelly B Stein, Rachel L Derr, Frederick L Brancati, Antonio C Wolff
Affiliations
Meta-Analysis

Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis

Kimberly S Peairs et al. J Clin Oncol. .

Abstract

Purpose: The goal of this study was to perform a systematic review and meta-analysis to examine the effect of pre-existing diabetes on breast cancer-related outcomes.

Methods: We searched EMBASE and MEDLINE databases from inception through July 1, 2009, using search terms related to diabetes mellitus, cancer, and prognostic outcome. Studies were included if they reported a prognostic outcome by diabetes status, evaluated a cancer population, and contained original data published in the English language. We performed a meta-analysis of pre-existing diabetes and its effect on all-cause mortality in patients with breast cancer and qualitatively summarized other prognostic outcomes.

Results: Of 8,828 titles identified, eight articles met inclusion/exclusion criteria and described outcomes in patients with breast cancer and diabetes. Pre-existing diabetes was significantly associated with all-cause mortality in six of seven studies. In a meta-analysis, patients with breast cancer and diabetes had a significantly higher all-cause mortality risk (pooled hazard ratio [HR], 1.49; 95% CI, 1.35 to 1.65) compared with their nondiabetic counterparts. Three of four studies found pre-existing diabetes to be associated with more advanced stage at presentation. Diabetes was also associated with altered regimens for breast cancer treatment and increased toxicity from chemotherapy.

Conclusion: Compared with their nondiabetic counterparts, patients with breast cancer and pre-existing diabetes have a greater risk of death and tend to present at later stages and receive altered treatment regimens. Studies are needed to investigate pathophysiologic interactions between diabetes and breast cancer and determine whether improvements in diabetes care can reduce mortality in patients with breast cancer.

PubMed Disclaimer

Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Flowchart of study selection.
Fig 2.
Fig 2.
Meta-analysis of the effect of pre-existing diabetes on all-cause mortality in patients with breast cancer. HR, hazard ratio.
See this image and copyright information in PMC

Comment in

References

    1. Anderson GF, Chu E. Expanding priorities: Confronting chronic disease in countries with low income. N Engl J Med. 2007;356:209–211. - PubMed
    1. National Institute of Diabetes and Digestive and Kidney Diseases. Bethesda, MD: US Dept of Health and Human Services, National Institutes of Health; 2007. National Diabetes Statistics Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007.
    1. American Cancer Society. Atlanta, GA: American Cancer Society; 2008. Breast Cancer Facts and Figures 2007-2008.
    1. Chapman JA, Meng D, Shepherd L, et al. Competing causes of death from a randomized trial of extended adjuvant endocrine therapy for breast cancer. J Natl Cancer Inst. 2008;100:252–260. - PMC - PubMed
    1. Beckman TJ, Cuddihy RM, Scheitel SM, et al. Screening mammogram utilization in women with diabetes. Diabetes Care. 2001;24:2049–2053. - PubMed

Publication types