Abstract
Diabetes is one of the most important chronic conditions worldwide, and breast cancer is the most prevalent cancer in women worldwide. Several types of research have been conducted to ascertain the link between diabetes and its potential for increasing the risk of breast cancer. This research aims to determine the relationship between diabetes and breast cancer; patients with diabetes have a higher risk than the general population of developing cancer, and diabetes patients have a higher incidence and mortality of breast cancer. This research also reviewed the relationship between cytokines, the mitogenic effect of insulin-like growth factors, and breast cells. The review includes searching the PubMed database using the keywords “diabetes,” “breast cancer,” “risk factor,” and “premenopausal.” The search returned 53 articles used for review of this article.
Highlights
BackgroundDiabetes is a medical disease that causes an increase in blood glucose levels
Type 2 diabetes is a medical disease that affects more than 7% of adults in developed countries, and up to 10% to 20% of patients with breast cancer have diabetes; the significant risk factors for type 2 diabetes are old age and obesity, which are risk factors for breast cancer [6]
There is a slight increase in the risk of developing breast cancer among women with type 2 diabetes
Summary
Diabetes is a medical disease that causes an increase in blood glucose levels. A fasting blood glucose of 126 mg/dL or higher or an oral glucose tolerance test of 200 mg/dL or higher confirms diabetes. According to Wolf et al, “three mechanisms have been postulated to associate diabetes with breast cancer: activation of the insulin pathway, activation of the insulin-like growth factor pathway, and regulation of endogenous sex hormones” [6] Another mechanism postulated is chronic hyperglycemia that could increase the risk of breast cancer known as the Warburg effect [9]. Hyperglycemia is associated with increased level Insulin-like growth factor 1 (IGF-1) and inflammatory cytokines, directly and indirectly influencing cancer cell proliferation, apoptosis, and metastasis [10]. Diabetes can lead to end-organ damage and indirectly affects breast cancer by influencing screening and treatment choices, affecting treatment toxicities, and potentially leading to a worse outcome in breast cancer patients Lifestyle modifications such as weight loss increased physical activity, and dietary changes are attainable in breast cancer populations. The mortality increased further when type 2 diabetes mellitus was diagnosed at or after the breast cancer diagnosis (hazard ratio 1.39) [27]
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