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Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women.

Abstract

White women with type II diabetes (T2D) have an estimated 20% increased risk of developing breast cancer. Little is known about associations by breast cancer subtype or among African American (AA) women, who are disproportionately affected by T2D and estrogen receptor negative (ER-) breast cancer. We assessed the relation of T2D to incidence of ER- and ER+ breast cancer in data from the Black Women's Health Study, a prospective cohort of AA women enrolled in 1995 and followed biennially. During 847,934 person-years of follow-up, there were 1,851 incident invasive breast cancers, including 914 ER+ and 468 ER- cases. Multivariable Cox proportional hazards models were used to compute HRs for breast cancer incidence associated with T2D relative to no T2D, controlling for body mass index (BMI) and other potential confounders. The HR for T2D relative to no T2D was 1.18 [95% confidence interval (CI) 1.00-1.40] for overall breast cancer incidence, with the increase accounted for by ER- cancer: HRs were 1.02 (95% CI, 0.80-1.31) for ER+ and 1.43 (95% CI, 1.03-2.00) for ER- cancer. The HR for T2D and ER- breast cancer was highest among nonobese women (1.92; 95% CI, 1.22-3.04). The findings suggest that AA women with T2D are at increased risk of developing ER- breast cancer and that poor metabolic health may be more important than obesity for this subtype. Given the high prevalence of T2D in AA women, the observed association could, in part, explain racial disparities in incidence of ER- breast cancer. Cancer Res; 77(22); 6462-9. ©2017 AACR.

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  • Authors+Show Affiliations

    ,

    Slone Epidemiology Center at Boston University, Boston, Massachusetts. jpalmer@bu.edu.

    ,

    Slone Epidemiology Center at Boston University, Boston, Massachusetts.

    ,

    Slone Epidemiology Center at Boston University, Boston, Massachusetts.

    ,

    Slone Epidemiology Center at Boston University, Boston, Massachusetts.

    Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.

    Source

    Cancer research 77:22 2017 11 15 pg 6462-6469

    MeSH

    Adult
    African Americans
    Aged
    Body Mass Index
    Breast Neoplasms
    Comorbidity
    Diabetes Mellitus, Type 2
    Female
    Humans
    Incidence
    Middle Aged
    Multivariate Analysis
    Proportional Hazards Models
    Prospective Studies
    Receptors, Estrogen
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    29141994

    Citation

    Palmer, Julie R., et al. "Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women." Cancer Research, vol. 77, no. 22, 2017, pp. 6462-6469.
    Palmer JR, Castro-Webb N, Bertrand K, et al. Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women. Cancer Res. 2017;77(22):6462-6469.
    Palmer, J. R., Castro-Webb, N., Bertrand, K., Bethea, T. N., & Denis, G. V. (2017). Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women. Cancer Research, 77(22), pp. 6462-6469. doi:10.1158/0008-5472.CAN-17-1903.
    Palmer JR, et al. Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women. Cancer Res. 2017 11 15;77(22):6462-6469. PubMed PMID: 29141994.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Type II Diabetes and Incidence of Estrogen Receptor Negative Breast Cancer in African American Women. AU - Palmer,Julie R, AU - Castro-Webb,Nelsy, AU - Bertrand,Kimberly, AU - Bethea,Traci N, AU - Denis,Gerald V, PY - 2017/06/26/received PY - 2017/08/28/revised PY - 2017/09/18/accepted PY - 2017/11/17/entrez PY - 2017/11/17/pubmed PY - 2017/12/13/medline SP - 6462 EP - 6469 JF - Cancer research JO - Cancer Res. VL - 77 IS - 22 N2 - White women with type II diabetes (T2D) have an estimated 20% increased risk of developing breast cancer. Little is known about associations by breast cancer subtype or among African American (AA) women, who are disproportionately affected by T2D and estrogen receptor negative (ER-) breast cancer. We assessed the relation of T2D to incidence of ER- and ER+ breast cancer in data from the Black Women's Health Study, a prospective cohort of AA women enrolled in 1995 and followed biennially. During 847,934 person-years of follow-up, there were 1,851 incident invasive breast cancers, including 914 ER+ and 468 ER- cases. Multivariable Cox proportional hazards models were used to compute HRs for breast cancer incidence associated with T2D relative to no T2D, controlling for body mass index (BMI) and other potential confounders. The HR for T2D relative to no T2D was 1.18 [95% confidence interval (CI) 1.00-1.40] for overall breast cancer incidence, with the increase accounted for by ER- cancer: HRs were 1.02 (95% CI, 0.80-1.31) for ER+ and 1.43 (95% CI, 1.03-2.00) for ER- cancer. The HR for T2D and ER- breast cancer was highest among nonobese women (1.92; 95% CI, 1.22-3.04). The findings suggest that AA women with T2D are at increased risk of developing ER- breast cancer and that poor metabolic health may be more important than obesity for this subtype. Given the high prevalence of T2D in AA women, the observed association could, in part, explain racial disparities in incidence of ER- breast cancer. Cancer Res; 77(22); 6462-9. ©2017 AACR. SN - 1538-7445 UR - https://www.unboundmedicine.com/medline/citation/29141994/Type_II_Diabetes_and_Incidence_of_Estrogen_Receptor_Negative_Breast_Cancer_in_African_American_Women_ L2 - http://cancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=29141994 DB - PRIME DP - Unbound Medicine ER -