301 - Early breast cancer agressiveness does not differ between insulin-sensitive and insulin-resistant postmenopausal non-diabetic women

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Breast Cancer, Early Stage
Cancer in Special Situations
Presenter Hendrik K. van Halteren
Authors H.K. van Halteren1, S.B. Bins2, W. De Roos3, A. Bosch3, J. Klein Gunnewiek4, E. Ruijter5, J. Enserink3
  • 1Department Of Internal Medicine, Ziekenhuis Gelderse Vallei, 6710 HN - Ede/NL
  • 2Internal Medicine, Gelderse Vallei Hospital, 6716RP - Ede/NL
  • 3Surgery, Gelderse Vallei Hospital, 6716RP - Ede/NL
  • 4Clinical Chemistry, Gelderse Vallei Hospital, 6716RP - Ede/NL
  • 5Pathology, Alysis Hospital, Arnhem/NL

Abstract

Background

The metabolic syndrome is known to negatively influence breast cancer outcome. One of the syndromès components is hyperinsulinism, which can exert tumor-promoting effects directly or through increased hepatic IGF1-production. A fasting insulin concentration > 10 µIU/ml and/or a HOMA score > 2.6 are considered diagnostic for the metabolic syndrome. We performed a pilot study to evaluate the relation between insulin resistance and tumor characteristics.

Study design

Prior to surgery we collected blood samples of 33 consecutive non-diabetic postmenopausal women with early breast cancer to measure fasting insulin and glucose concentration. Correlation analyses were performed for both fasting insulin and HOMA-score (insulin resistance index) and parameters tested were body mass index, mitotic activity index (MAI), Bloom Richardson score (BNR) and tumor diameter. We also compared nodal status, ER-status and Her2-status of insulin-resistant and insulin-sensitive breast cancer patients.

Results

Median age was 66 (49- 86) years and median BMI was 25.8 (18.6- 45.4) kg/m2. Median MAI was 7 (1-52), median tumor diameter was 12 (3- 70) mm and 9 patients had node-positive disease ( 2 N0itc, 5 N1, 2 N2). Insulin resistance was found in 5 (15 %) patients. BMI showed a strong positive correlation with insulin concentration and HOMA score (2-sided Pearson test; P= 0.000). Insulin resistant and insulin sensitive patients however did not differ in terms of MAI, BNR, tumor diameter, nodal status, ER-status and Her2-status.

Conclusion

In postmenopausal non-diabetic women with early breast cancer insulin resistance is encountered quite often. It does however not appear to alter cancer biology.

Disclosure

All authors have declared no conflicts of interest.