Skip to main content

Advertisement

SpringerLink
Log in

Diabetes and differences in detection of incident invasive breast cancer

  • Brief report
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Many women diagnosed with breast cancer have chronic conditions such as diabetes that may impact other health behaviors. Our purpose was to determine if breast cancer screening and detection differs among women with and without diabetes. We conducted a cross-sectional analysis of a retrospective cohort of women aged 52–74 years diagnosed with incident stages I–III breast cancer enrolled in an integrated health plan between 1999 and 2014 with linkage to the Surveillance, Epidemiology and End Results registry (n = 2040). Screening data were taken from electronic health records. We used multivariable modified Poisson regression models with robust standard errors to estimate relative risks (RR) and 95% confidence intervals (CI) for outcomes of (i) receipt of screening in the 2 years prior to diagnosis; (ii) symptom-detected breast cancer; and (iii) diagnosis of locally advanced stage III breast cancer. Compared to women without diabetes, women with diabetes were similar with respect to receipt of screening mammography (78% and 77%), symptom-detected breast cancer (46% and 49%), and stage III diagnosis (7% and 7%). In multivariable models adjusting for age and year of diagnosis, race, BMI, Charlson comorbidity score and depression diagnosis no differences were observed in the outcomes by presence of diabetes. Further investigation is warranted to determine how diabetes acts as a mediating factor in adverse breast cancer outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. American Cancer Society (2015) Breast Cancer Facts & Figures 2015-2016. American Cancer Society, Atlanta

    Google Scholar 

  2. Menke A, Casagrande S, Geiss L, Cowie CC (2015) Prevalence of and trends in diabetes among adults in the United States, 1988-2012. JAMA 314(10):1021–1029. https://doi.org/10.1001/jama.2015.10029

    Article  CAS  PubMed  Google Scholar 

  3. Ritchie CS, Kvale E, Fisch MJ (2011) Multimorbidity: an issue of growing importance for oncologists. J Oncol Pract 7(6):371–374. https://doi.org/10.1200/JOP.2011.000460

    Article  PubMed  PubMed Central  Google Scholar 

  4. Peairs KS, Barone BB, Snyder CF, Yeh HC, Stein KB, Derr RL, Brancati FL, Wolff AC (2011) Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol 29(1):40–46. https://doi.org/10.1200/JCO.2009.27.3011

    Article  PubMed  Google Scholar 

  5. Gold HT, Makarem N, Nicholson JM, Parekh N (2014) Treatment and outcomes in diabetic breast cancer patients. Breast Cancer Res Treat 143(3):551–570. https://doi.org/10.1007/s10549-014-2833-x

    Article  CAS  PubMed  Google Scholar 

  6. Institute of Medicine (U.S.), Committee on Quality of Health Care in America (2013) In: Levit L, Balogh E, Nass S, Ganz PA (eds) Delivering high-quality cancer care: charting a new course for a system in crisis. Institute of Medicine, Washington (DC)

    Google Scholar 

  7. Beckman TJ, Cuddihy RM, Scheitel SM, Naessens JM, Killian JM, Pankratz VS (2001) Screening mammogram utilization in women with diabetes. Diabetes Care 24(12):2049–2053

    Article  CAS  PubMed  Google Scholar 

  8. Lipscombe LL, Hux JE, Booth GL (2005) Reduced screening mammography among women with diabetes. Arch Intern Med 165(18):2090–2095. https://doi.org/10.1001/archinte.165.18.2090

    Article  PubMed  Google Scholar 

  9. Tabaei BP, Herman WH, Jabarin AF, Kim C (2005) Does diabetes care compete with the provision of women’s preventive care services? Diabetes Care 28(11):2644–2649

    Article  PubMed  Google Scholar 

  10. Chlebowski RT, McTiernan A, Wactawski-Wende J, Manson JE, Aragaki AK, Rohan T, Ipp E, Kaklamani VG, Vitolins M, Wallace R, Gunter M, Phillips LS, Strickler H, Margolis K, Euhus DM (2012) Diabetes, metformin, and breast cancer in postmenopausal women. J Clin Oncol 30(23):2844–2852. https://doi.org/10.1200/JCO.2011.39.7505

    Article  PubMed  PubMed Central  Google Scholar 

  11. Alimova IN, Liu B, Fan Z, Edgerton SM, Dillon T, Lind SE, Thor AD (2009) Metformin inhibits breast cancer cell growth, colony formation and induces cell cycle arrest in vitro. Cell Cycle 8(6):909–915

    Article  CAS  PubMed  Google Scholar 

  12. Col NF, Ochs L, Springmann V, Aragaki AK, Chlebowski RT (2012) Metformin and breast cancer risk: a meta-analysis and critical literature review. Breast Cancer Res Treat 135(3):639–646. https://doi.org/10.1007/s10549-012-2170-x

    Article  CAS  PubMed  Google Scholar 

  13. Bronsveld HK, ter Braak B, Karlstad O, Vestergaard P, Starup-Linde J, Bazelier MT, De Bruin ML, de Boer A, Siezen CL, van de Water B, Siezen CL, van de Laan JW, Schmidt MK (2015) Treatment with insulin (analogues) and breast cancer risk in diabetics; a systematic review and meta-analysis of in vitro, animal and human evidence. Breast Cancer Res 17:100. https://doi.org/10.1186/s13058-015-0611-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Wirtz HS, Buist DS, Gralow JR, Barlow WE, Gray S, Chubak J, Yu O, Bowles EJ, Fujii M, Boudreau DM (2013) Frequent antibiotic use and second breast cancer events. Cancer Epidemiol Biomark Prev 22(9):1588–1599. https://doi.org/10.1158/1055-9965.EPI-13-0454

    Article  Google Scholar 

  15. Boudreau DM, Yu O, Chubak J, Wirtz HS, Bowles EJ, Fujii M, Buist DS (2014) Comparative safety of cardiovascular medication use and breast cancer outcomes among women with early stage breast cancer. Breast Cancer Res Treat 144(2):405–416. https://doi.org/10.1007/s10549-014-2870-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Calip GS, Hubbard RA, Stergachis A, Malone KE, Gralow JR, Boudreau DM (2015) Adherence to oral diabetes medications and glycemic control during and following breast cancer treatment. Pharmacoepidemiol Drug Saf 24(1):75–85. https://doi.org/10.1002/pds.3660

    Article  CAS  PubMed  Google Scholar 

  17. Kaiser Permanente Washington Breast Cancer Screening. https://wa.kaiserpermanente.org/healthAndWellness?item=%2Fcommon%2FhealthAndWellness%2Ftests%2Fscreenings%2Fmammogram.html Accessed 4 Mar 2019

  18. Cancer Surveillance System (contract No. N01-CN-67009) Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute, Bethesda MD http://www.fhcrc.org/en/labs/phs/projects/cancer-surveillance-system.html

  19. Surveillance Epidemiology and End Results (SEER) Program Overview of the SEER Program http://seer.cancer.gov/about/overview.html

  20. Saunders KW, Davis RL, Stergachis A (2005) Group health cooperative. In: Strom BL (ed) Pharmacoepidemiology, 4th edn. Wiley, Hoboken, pp 223–239

    Google Scholar 

  21. Bowles EJ, Wellman R, Feigelson HS, Onitilo AA, Freedman AN, Delate T, Allen LA, Nekhlyudov L, Goddard KA, Davis RL, Habel LA, Yood MU, McCarty C, Magid DJ, Wagner EH, Pharmacovigilance Study T (2012) Risk of heart failure in breast cancer patients after anthracycline and trastuzumab treatment: a retrospective cohort study. J Natl Cancer Inst 104(17):1293–1305

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Phipps AI, Ichikawa L, Bowles EJ, Carney PA, Kerlikowske K, Miglioretti DL, Buist DS (2010) Defining menopausal status in epidemiologic studies: a comparison of multiple approaches and their effects on breast cancer rates. Maturitas 67(1):60–66. https://doi.org/10.1016/j.maturitas.2010.04.015

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kaiser Permanente Washington Breast Cancer Surveillance Registry. https://www.kpwashingtonresearch.org/our-research/research-areas/cancer/breast-cancer-surveillance/. Accessed 4 Mar 2019

  24. Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45(6):613–619

    Article  CAS  PubMed  Google Scholar 

  25. Singletary SE, Allred C, Ashley P, Bassett LW, Berry D, Bland KI, Borgen PI, Clark GM, Edge SB, Hayes DF, Hughes LL, Hutter RV, Morrow M, Page DL, Recht A, Theriault RL, Thor A, Weaver DL, Wieand HS, Greene FL (2003) Staging system for breast cancer: revisions for the 6th edition of the AJCC cancer staging manual. Surg Clin North Am 83(4):803–819

    Article  PubMed  Google Scholar 

  26. Zou G (2004) A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 159(7):702–706

    Article  PubMed  Google Scholar 

  27. Jensen LF, Pedersen AF, Andersen B, Vestergaard M, Vedsted P (2015) Non-participation in breast cancer screening for women with chronic diseases and multimorbidity: a population-based cohort study. BMC Cancer 15:798. https://doi.org/10.1186/s12885-015-1829-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Diaz A, Kang J, Moore SP, Baade P, Langbecker D, Condon JR, Valery PC (2017) Association between comorbidity and participation in breast and cervical cancer screening: a systematic review and meta-analysis. Cancer Epidemiol 47:7–19. https://doi.org/10.1016/j.canep.2016.12.010

    Article  PubMed  Google Scholar 

  29. Murto MO, Artama M, Pukkala E, Visvanathan K, Murtola TJ (2018) Breast cancer extent and survival among diabetic women in a Finnish nationwide cohort study. Int J Cancer 142(11):2227–2233. https://doi.org/10.1002/ijc.31250

    Article  CAS  PubMed  Google Scholar 

  30. Alenzi EO, Madhavan SS, Tan X (2018) Association of the severity of diabetes-related complications with stage of breast cancer at diagnosis among elderly women with pre-existing diabetes. Breast Cancer Res Treat 167(1):183–193. https://doi.org/10.1007/s10549-017-4477-0

    Article  PubMed  Google Scholar 

  31. Chang HY, Weiner JP, Richards TM, Bleich SN, Segal JB (2012) Validating the adapted Diabetes Complications Severity Index in claims data. Am J Manag Care 18(11):721–726

    PubMed  Google Scholar 

  32. Yasmeen S, Xing G, Morris C, Chlebowski RT, Romano PS (2011) Comorbidities and mammography use interact to explain racial/ethnic disparities in breast cancer stage at diagnosis. Cancer 117(14):3252–3261. https://doi.org/10.1002/cncr.25857

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Institutes of Health, National Cancer Institute, through Grant Numbers R01CA188353 (Gold) and R01CA120562 (Boudreau). Author GSC was supported by the National Institutes of Health, National Center for Advancing Translational Sciences through Grant Number KL2TR000048. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 South Wood Street MC 871, Chicago, IL, 60612, USA

    Gregory S. Calip

  2. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    Onchee Yu & Denise M. Boudreau

  3. Departments of Epidemiology and Pharmacy, University of Washington, Seattle, WA, USA

    Denise M. Boudreau

  4. Baptist Memorial Health Care, Germantown, TN, USA

    Huibo Shao

  5. Department of Medicine, New York University School of Medicine, New York, NY, USA

    Ruth Oratz & Stephen B. Richardson

  6. Department of Population Health, New York University School of Medicine, New York, NY, USA

    Heather T. Gold

Authors
  1. Gregory S. Calip
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Onchee Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denise M. Boudreau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Huibo Shao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruth Oratz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stephen B. Richardson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Heather T. Gold
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory S. Calip.

Ethics declarations

Conflict of interest

Author O.Y. has received funding for research unrelated to the contributions as co-author of this work. This funder had no role in the design, interpretation or conclusions of this study. The other authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board of the Kaiser Permanente Washington Health Research Institute.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Calip, G.S., Yu, O., Boudreau, D.M. et al. Diabetes and differences in detection of incident invasive breast cancer. Cancer Causes Control 30, 435–441 (2019). https://doi.org/10.1007/s10552-019-01166-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-019-01166-2

Keywords

Search

Navigation