349P - Impact of diabetes and hyperglycemia on survival in advanced breast cancer patients

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Breast Cancer, Metastatic
Cancer Aetiology, Epidemiology, Prevention
Presenter Robin Shaw Dulin
Authors R.J. Shaw Dulin1, C. Villarreal-Garza2, F. Lara1, L. Bacon3, D. Rivera3, A.D. Rivera Salceda3, L. Urzua3, L. Herrera4, C. Aguila3, J.E.R. Bargallo5
  • 1Breast Tumor Department, Instituto Nacional de Cancerología Mexico, 14080 - Mexico City/MX
  • 2Depto. De Tumores Mamarios, Instituto Nacional de Cancerología Mexico, 14080 - Mexico City/MX
  • 3Medical Oncology, Instituto Nacional de Cancerología Mexico, 14080 - Mexico City/MX
  • 4Department Of Biomedical Research In Cancer, Instituto Nacional de Cancerologia, Mexico City/MX
  • 5Instituto Nacional de Cancerología Mexico, 14080 - Mexico City/MX

Abstract

Background

Clinical experience and previous studies suggest that women with diabetes and breast cancer have worse outcomes than their non-diabetic counterparts. The purpose of this study was to examine the impact of diabetes and hyperglycemia on cancer-specific survival of patients with metastatic or recurrent breast cancer.

Methods

We performed a retrospective analysis of patients with advanced breast cancer receiving palliative chemotherapy from 2006 to 2011 at the National Cancer Institute in Mexico, and compared breast cancer-specific mortality in diabetic and non-diabetic patients, as well as in patients that presented hyperglycemia during palliative treatment.

Results

A total of 265 patients receiving palliative therapy were eligible for inclusion. Previous diagnosis or detection of diabetes at recurrence was recorded in 40 patients (15%). No difference was observed between diabetic and non-diabetic patients in terms of OS. A statistically significant difference in OS was observed between patients without diabetes and diabetic patients who had hyperglycemia (p = 0.003). OS in diabetic patients with proper metabolic control was shown to be superior compared to diabetics with hyperglycemia (p = 0.01) Hyperglycemia was identified in 14% of non-diabetics at some point while receiving palliative treatment. For patients that experienced hyperglycemia during treatment or who had a mean glucose level above 130, either in the diabetic or non-diabetic subgroups, a worse outcome was noted compared to normoglycemic patients, with a HR of 1.5 (p = 0.029) and HR of 2.04 (p = 0.006) for death, respectively.

Conclusions

Elevated glucose levels confer a poor outcome in diabetic and non-diabetic patients in contrast with patients with normoglycemic levels, conferring an elevated risk of death. According to these results, clinicians must monitor glucose levels during treatment for advanced breast cancer disease, and should take action in order to maintain normal glucose levels.

Disclosure

All authors have declared no conflicts of interest.