ASSOCIATION BETWEEN INSULIN TREATMENT AND BREAST CANCER CHARACTERISTICS
Author(s)
Overbeek JA1, Vissers PA2, van der Heijden AA1, Bronsveld HK3, van Herk-Sukel MP4, Herings RM4, Nijpels G1, Schmidt MK3
1EMGO Institute, VU Medical Centre, Amsterdam, The Netherlands, 2Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands, 3The Netherlands Cancer Institute, Amsterdam, The Netherlands, 4PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
OBJECTIVES: The objective of this study was to investigate whether treatment with insulin (analogues) before breast cancer (BC) diagnosis is associated with the development of specific BC characteristics. METHODS: For this case-control study, females with invasive BC (stage I-IV) diagnosed between 1998 and 2011 were selected from the Eindhoven area of the linked Netherlands Cancer Registry-PHARMO Database Network cohort. Females using insulin (analogues) were compared twice: once to females using oral antidiabetics (OAD) prior to their primary BC diagnosis (unmatched) and once to females with no antidiabetic (AD) treatment prior to diagnosis (matched (1:4)). Patient and tumour characteristics (TNM stage, morphology, grade, hormone receptor status and clinical subtype) were determined at the date of the first primary BC diagnosis. Multivariate (conditional) logistic regression analyses were used to investigate the association between AD treatment and different BC characteristics. RESULTS: A total of 149 females using insulin (analogues) were compared to 289 females using OAD and to 596 females with no AD treatment. Females using insulin (analogues) were more likely to have BC clinical subtype luminal B than BC clinical subtype luminal A compared to females using OAD (OR (95%CI): 3.0 (1.3-7.3)). This association was also observed compared to females with no AD treatment, but was statistically not significant (OR (95% CI): 2.2 (0.5-9.1)). Females using insulin (analogues) were more likely to have a poorly differentiated tumour (grade 3) than a well differentiated tumour (grade 1) compared to females using OAD (OR (95% CI): 2.2 (1.0-4.7)). This association was also observed when comparing to females with no use of AD treatment (OR (95%CI): 4.7 (1.5-15.2)). No statistical significant association was found for the other BC characteristics. CONCLUSIONS: The results of this study indicate that females using insulin (analogues) are at increased risk of developing more aggressive breast tumours than females using oral or no AD treatment.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PCN38
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Diabetes/Endocrine/Metabolic Disorders, Oncology