Abstract
Simple SummaryThis study describes the clinical, histological, and molecular features of breast cancer in French Guiana, and characterizes the expression of the tumor metabolic marker GLUT-1 in breast cancers cells in diabetic and obese patients compared to a control group. This study reveals an overall overexpression of GLUT-1 in 60% of invasive breast carcinomas and in all medullary pattern and carcinoma in situ lesions. Our results highlight the potential role of GLUT-1 as a tumor metabolic prognostic marker and also as an interesting target therapy, independently of patient metabolic disorder.The prevalence of obesity and type 2 diabetes is higher in French Guiana compared to mainland France. These metabolic disorders are associated with an increased risk of cancer. One of the factors involved is hyperinsulinemia that promotes the action of glucose transporter 1 (GLUT-1). The objective of this study is to characterize the expression of GLUT-1 in breast cancers cells in diabetic and obese patients compared to those who are not and to describe the clinical and histological prognostic factors of breast cancer in this population. We conducted a monocentric study including patients with breast cancer diagnosed between 2014 and 2020. Patients were classified into three groups: diabetes, obesity, and control group. The GLUT-1 expression was assessed by immunohistochemistry. In total, 199 patients were included in this study. The median age was 53.5 years, and the median tumor size was 2.8 cm. Luminal A was the most frequent molecular type (58.1%), followed by the triple-negative type (19.9%). The breast cancer in our population was characterized by a younger age at diagnosis, more aggressive molecular types, and larger tumor size. Thus, we suggest the advancement of the age of breast cancer screening in this territory. A total of 144 patients (31 diabetes, 22 obese, and 91 control group) were included for the study of GLUT-1 expression. Overexpression of GLUT-1 was observed in 60.4% of cases and in all carcinoma in situ lesions. GLUT-1 overexpression was associated with more aggressive cancers. This overexpression is correlated with high histological grade, high proliferation index, and aggressive molecular types. Our study found no difference in GLUT-1 expression between the diabetic or obese patients and the control group. These results highlight the potential role of GLUT-1 as a tumor metabolic prognostic marker and also as an interesting target therapy, independently of patient metabolic disorder.
Highlights
Obesity and type 2 diabetes are major public health problems in the world, with 600 and 415 million affected adults, respectively [1,2]
We found a trend for the presence of distant metastasis at diagnosis for diabetic patients (p = 0.067) and a trend for negative hormone receptor (HR) status for patients in the obese group (p = 0.061) compared to the control group (Table 5 summarizes the results of each analysis)
We have described for the first time the clinical, histological, and molecular features of breast cancer in French Guiana
Summary
Obesity and type 2 diabetes are major public health problems in the world, with 600 and 415 million affected adults, respectively [1,2] These two metabolic disorders are proven risk factors for many cancers, including breast cancer [3]. GLUT-1 is a transmembrane protein that catalyzes the entry of glucose into cells [11] and physiologically ensures the basal level of glucose necessary for their survival [12] It is overexpressed in many cancers, including lung, esophageal, and breast cancers, and in hepatocellular carcinoma [13]. The translocation of GLUT-1 transporter to the membrane, its site of action, induces an increase in intracellular glucose [15] This upregulation of GLUT-1 by insulin is dose-dependent [16]
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