Characteristics And Prognosis Of Breast Cancer Patients With Type-2Diabetes Mellitus

Objective: DM is one of the high risk factors for breast cancer，Despite many correlativity studies about diabetes mellitus and breast cancerhave been reported, it is still lacking of studies about clinicopathologicalcharacteristics and prognosis of breast cancer with type-2diabetesmellitus(T2DM), a better understanding of biological characteristics andprognosis, can provide the bases of individualized treatment for this kind ofpatients. This study compared the clinicopathological characteristics andprognosis of breast cancer with T2DM with the non-diabetic breast cancer,to investigate the influence on the biological behavior of breast cancer byT2DM, in order to provide the bases for the individualized treatment andprognostic judgement. Methods: A retrospective analysis, which includes58breast cancer patients with comorbidity of T2DM in the AffiliatedHospital of Luzhou Medical College between April2010and April2012(experimental group), according to the proportion1:2,116non-diabetic breast cancer patients in the same term were randomlyselected by the means of random number table(control group), thematching principle: the date of visit±1month, the general physicalcondition. All cases were confirmed as breast cancer by pathology,breast cancer patients with comorbidity of type Ⅰ diabetesor secondarydiabetes, male breast cancer, bilateral breast cancer, carcinoma in sitr, Ⅳ stage breast cancer，the breast cancer patients who had been treatedby neoadjuvant chemotherapy, the patients who used estrogenpreviously, patients with incomplete medical records andnon-standardized cancer treatment were discounted. Collect andarrange all the clinical and pathologic examination data, includinghosptial number, name, age, height, weight, menopausal status, historyof the diabetes, a family history of breast cancer, past history, tumorsize, pathological type, axillary lymph nodes metastasis, tumor stage,histologic grade, immunohistochemical indicators(ER, PR, Her-2, P-gp,Topo Ⅱ,Gst-π), surgical method and date, chemotherapy and courses,telephone numbers and home addresses, all the cases were followed uppostoperatively according to the principles of follow-up of breastcancer. SPSS17.0statistical software was used to compare thedifference of clinical patological parameters and prognosis betweenthe two groups, t-test was used to compare the mean, Chi-square testwas used to compare the rate, Kaplan-Meier method was used toestimate the survival rate. Results:1. Compared with the non-diabeticbreast cancer group, the age was larger(P=0.001), the post-menopausalproportion was larger(P=0.001) and the body mass index waslarger(P=0.008) in the breast cancer with T2DM group, there was asignificant difference. No significant differences were found in afamily history of breast cancer and the underlying diseases.2.Compared with the non-diabetic breast cancer group, the primary tumor diameter was larger(P=0.021), the tumor stage waslater(P=0.018), the axillary lymph node-positive rate washigher(P=0.029) and the ER negative rate was higher(P=0.003) in thebreast cancer with T2DM group, there was a significant difference.3.Compared with the non-diabetic breast cancer group, no significantdifferences were found in pathological type, histological grade, PR,Her-2, P-gp, Topo Ⅱ and Gst-π in the breast cancer with T2DM group.4.Compared with the non-diabetic breast cancer group, the recurrencerate is higher in the breast cancer with T2DM group, and the differencewas statistically significant (P=0.022). The Kaplan-Meier curveanalysis: compared with the non-diabetic breast cancer group, therecurrence-free survival was lower in the breast cancer with T2DMgroup, and the difference was statistically significant (long-rank testderived P=0.014). Conclusion:1. The post-menopausal proportion andthe body mass index were both larger in the breast cancer patients withT2DM comparing with the non-diabetic breast cancer patients.2.Compared with the non-diabetic breast cancer patients, the breastcancer patients with T2DM had the larger primary tumor diameter, thelater tumor stage, the higher axillary lymph node metastasis rate andthe higher ER-negative rate.3. Compared with the non-diabetic breastcancer patients, the breast cancer with T2DM had the higherrecurrence rate, the lower recurrence-free survival and the worseprognosis. T2DM is adverse prognostic factors for breast cancer, the breast cancer patients with T2DM should pay more attention to thepostoperative follow-up.