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Meta-Analysis
. 2023 Nov;202(1):11-22.
doi: 10.1007/s10549-023-07043-6. Epub 2023 Sep 1.

Breast cancer and incidence of type 2 diabetes mellitus: a systematic review and meta-analysis

Nanna Jordt  1 , Kasper Aalbæk Kjærgaard  1 , Reimar W Thomsen  1 , Signe Borgquist  2 , Deirdre Cronin-Fenton  3
Affiliations
Meta-Analysis

Breast cancer and incidence of type 2 diabetes mellitus: a systematic review and meta-analysis

Nanna Jordt et al. Breast Cancer Res Treat. 2023 Nov.

Abstract

Purpose: Breast cancer and its treatments may increase the risk of type 2 diabetes (T2D). We conducted a systematic review and meta-analysis to investigate the association between breast cancer and the incidence of T2D overall, and according to breast cancer treatments.

Methods: We searched PubMed, Embase and references of relevant papers for studies on breast cancer, breast cancer treatment, and subsequent T2D risk. Using random-effects models, we calculated effect estimates and associated 95% confidence intervals of the association between breast cancer, adjuvant breast cancer treatments (i.e., endocrine therapy (tamoxifen, aromatase inhibitors, and combined) and chemotherapy), and subsequent T2D. We used funnel plots to assess publication bias.

Results: Among 15 eligible studies, 10 reported on T2D risk after breast cancer, chemotherapy, or endocrine therapy; five studies investigated more than one association. Compared with patients without breast cancer, those with breast cancer and those who received any endocrine therapy had elevated risk of incident T2D (EE = 1.23, 95% CI = 1.13-1.33 and EE = 1.23, 95% CI = 1.16-1.32, respectively). Among breast cancer patients only, the risk of T2D was higher for those who received tamoxifen compared with those who did not receive tamoxifen (EE = 1.28, 95% CI = 1.18-1.38). Due to few studies, analyses investigating T2D risk after treatment with aromatase inhibitors or chemotherapy were inconclusive.

Conclusion: Our findings suggest an elevated risk of T2D in breast cancer survivors, particularly after tamoxifen therapy. Further research is needed to determine the impact of aromatase inhibitors, and chemotherapy on the incidence of T2D after breast cancer.

Keywords: Aromatase inhibitors; Breast cancer; Endocrine therapy; Meta-analysis; Tamoxifen; Type 2 diabetes mellitus.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of literature search
Fig. 2
Fig. 2
Breast cancer and risk of type 2 diabetes mellitus
Fig. 3
Fig. 3
Funnel plot of studies pertaining breast cancer and risk of type 2 diabetes mellitus
Fig. 4
Fig. 4
Breast cancer therapy and type 2 diabetes mellitus compared with non-cancer referents
Fig. 5
Fig. 5
Breast cancer therapy and type 2 diabetes mellitus among breast cancer patients
See this image and copyright information in PMC

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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33. doi: 10.3322/caac.21708. - DOI - PubMed
    1. Lipscombe LL, Chan WW, Yun L, Austin PC, Anderson GM, Rochon PA. Incidence of diabetes among postmenopausal breast cancer survivors. Diabetologia. 2013;56(3):476–483. doi: 10.1007/s00125-012-2793-9. - DOI - PubMed
    1. Hwangbo Y, Kang D, Kang M, Kim S, Lee EK, Kim YA, Chang YJ, Choi KS, Jung SY, Woo SM, et al. Incidence of diabetes after cancer development: a Korean national cohort study. JAMA Oncol. 2018;4(8):1099–1105. doi: 10.1001/jamaoncol.2018.1684. - DOI - PMC - PubMed
    1. Wang CY, Shih SR, Huang KC. Increasing risk of diabetes mellitus in postmenopausal women with newly diagnosed primary breast cancer. J Diabetes Investig. 2020;11(2):490–498. doi: 10.1111/jdi.13112. - DOI - PMC - PubMed

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