Jul 2026· Indian Journal of Medical Specialities· 0 citations· 18 references
TL;DR
Insulin resistance, particularly insulin resistance as reflected by elevated HOMA-IR, is strongly associated with breast cancer in premenopausal women and underscores the importance of early identification and management of metabolic abnormalities as potential strategies for breast cancer risk reduction and prognostication in premenopausal females.
Abstract
Metabolic syndrome (MS) (defined as at least three among abdominal obesity, high blood triglycerides, low high-density lipoprotein cholesterol, high blood glucose, and high blood pressure) is emerging as a risk factor for breast cancer; however, few studies – most confined to postmenopausal women – have investigated associations between breast cancer risk and MS. The present research was done to study the association between MS and breast cancer among premenopausal females and also to establish the relationship of MS and other risk factors in this category.
The prospective observational study was done at the General Medicine Department, KSSSCI, for a period of 2 years among patients visiting KSSSCI in the Department of Oncosurgery and Medicine Department diagnosed to have clinically/histologically/cytologically confirmed breast cancer. Through convenience sampling, a total of 240 patients of premenopausal (<50 years age); 80 cases (with breast cancer), 160 controls (malignancies other than breast cancer); included on the basis of inclusion and exclusion criteria. Demographic data, lifestyle factors, anthropometric measurements, and metabolic parameters were recorded. MS was defined using the harmonized criteria. Fasting glucose, lipid profile, serum insulin, and Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were assessed. Statistical analysis was performed using SPSS version 20, with
P
≤ 0.05 considered statistically significant.
MS was significantly more prevalent among breast cancer cases compared to controls (56.3% vs. 21.3%; odds ratio 4.7, 95% confidence interval: 2.6–8.4;
P
< 0.001). Breast cancer patients exhibited significantly higher fasting glucose, fasting insulin, and HOMA-IR values than controls (mean HOMA-IR: 3.1 ± 1.4 vs. 1.9 ± 0.9;
P
< 0.001). A higher proportion of cases had HOMA-IR >2.5 (51.3% vs. 18.1%;
P
< 0.001). In addition, insulin resistance and other metabolic parameters showed a significant positive association with increasing histopathological tumor grade.
MS, particularly insulin resistance as reflected by elevated HOMA-IR, is strongly associated with breast cancer in premenopausal women. The severity of insulin resistance appears greater in breast cancer patients compared to premenopausal non-breast cancer counterparts and correlates with tumor aggressiveness. These findings underscore the importance of early identification and management of metabolic abnormalities as potential strategies for breast cancer risk reduction and prognostication in premenopausal females.
Abstract Background Adiposity is associated with increased risk of breast cancer in post-menopausal women, while the association appears to be the inverse among premenopausal women in Western populations, but is unclear for Chinese women. Methods Using data on 284 538 women with no history of cancer, hysterectomy, oophorectomy, or breast surgery at baseline in 2004–8 from the China Kadoorie Biobank (a prospective cohort study), Cox regression was used to estimate adjusted hazard ratios (HRs) for breast cancer and its subtypes by measured body mass index (BMI) and other adiposity measures (waist circumference, fat percentage, waist–hip ratio, fat mass) and by self-reported BMI at age 25 years. Results Mean BMI was 23.8 (3.5 SD) kg/m2 at baseline (mean age 51.4 years) and 21.9 (2.7 SD) kg/m2 at age 25 years. During 10 years of follow-up, there were 2379 incident breast cancer cases. Higher BMI was associated with a higher risk of breast cancer in women who were post-menopausal [HR = 1.35, 95% confidence interval (CI) 1.24–1.47] and premenopausal (HR = 1.13, 95% CI 1.03–1.24) at baseline, but not when censoring at age 50 years to capture mainly premenopausal cancers. Among post-menopausal women, BMI was associated with oestrogen-receptor positive (ER ) (HR = 1.47, 95% CI 1.24–1.74), but not with oestrogen-receptor negative (ER−) breast cancer (HR = 1.02, 95% CI 0.75–1.37). Waist circumference and fat percentage were associated with a higher risk of breast cancer. Conclusion In this cohort of Chinese women, higher levels of general and central adiposity were associated with a higher risk of breast cancer, in both women who were premenopausal and women who were post-menopausal at baseline. Among post-menopausal women, adiposity was associated with ER but not ER − breast cancer.
C. Kartsonaki, N. Wright, I. Millwood et al.· International Journal of Epi...· 0 citations
Early menarche and low parity were more frequently associated with aggressive non-Luminal A molecular subtypes, highlighting the importance of reproductive history in breast cancer risk assessment and individualized management.
Resti Arania, Amirah Zhafira Rizqiyanda, Zaleha Ulfa et al.· THE JOURNAL OF Mother and Ch...· 0 citations
Background The aim of this study was to compare clinical data between women with invasive breast cancer (IBC) and those with benign breast tumors, identify risk factors influencing IBC development, and provide evidence for early clinical identification and intervention. Methods Clinical records of 1, 049 female patients with breast masses who underwent surgical treatment at Hebei Provincial People’s Hospital between October 1, 2018, and October 1, 2020, were retrospectively collected. The cohort comprised 738 cases in the benign breast mass group and 311 cases in the invasive breast cancer group. Chi-square (χ²), Z-tests, and T-tests were used to compare the two groups regarding age, menopausal status, marital status, parity, family history of breast cancer, history of benign breast surgery, presence of metabolic syndrome (MS), and related inflammatory and nutritional indicators [prognostic nutritional index (PNI), albumin/globulin ratio (AGR), systemic inflammatory response index (SIRI), platelet/lymphocyte ratio (PLR), neutrophil/monocyte ratio (NMR). Independent risk factors for female IBC development were identified through univariate and multivariate logistic regression analyses. Results Logistic Regression Analysis: Univariate analysis revealed that age, postmenopausal status, marital history, parity, coexisting multiple sclerosis, PNI, AGR, SIRI, and history of benign breast surgery were associated with inflammatory breast cancer in women. Multivariate analysis indicated that age, postmenopausal status, coexisting multiple sclerosis, decreased PNI, elevated SIRI, and history of benign breast surgery were independent risk factors for inflammatory breast cancer in women. Conclusions Advanced age, postmenopausal status, concomitant metabolic syndrome, decreased PNI, and elevated SIRI are independent risk factors for invasive breast cancer in women. A history of benign breast surgery may serve as a protective factor. Clinicians should enhance screening and intervention for high-risk populations based on these factors.
Pei-Lin Chen, Xi Lv, Hang Su et al.· Frontiers in Oncology· 0 citations
Several reproductive factors are significantly associated with breast cancer risk among women in Central India and promotion of breastfeeding and identification of women with adverse reproductive profiles may facilitate early screening and risk reduction strategies.
Sriyansh Jain, R. Arjariya, Sunil Kumar Saxena et al.· Indian Journal of Pharmaceut...· 0 citations
Background: Hyperglycemia, a hallmark of type 2 diabetes mellitus (T2DM), is increasingly implicated in breast cancer pathogenesis through the Warburg effect, hyperinsulinemia, and chronic inflammation. Understanding its prevalence and relationship with breast cancer stage in Sub-Saharan African populations remains critical for informing context-specific screening strategies.
Objectives: (1) To determine the prevalence of hyperglycemia (HbA1c ≥6.5%) among breast cancer patients compared to controls; and (2) to identify glycated hemoglobin (HbA1c) as a biomarker associated with different breast cancer stages.
Methods: A hospital-based case-control study enrolled 285 women (142 histologically confirmed breast cancer cases, 143 controls with non-cancerous breast masses) at Meru Teaching and Referral Hospital, Kenya. HbA1c was measured using a validated immunoturbidimetric analyser. Chi-square tests, independent samples t-tests, one-way ANOVA with Tukey’s HSD post-hoc analysis, and ROC curve analysis were applied.
Results: Hyperglycemia was documented in 84.5% of cases versus 34.3% of controls (p < 0.001). Mean HbA1c was 6.89±0.75% in cases versus 5.82±0.71% in controls (t(283) = 12.445, p < 0.001). ROC analysis identified HbA1c ≥6.5% as the optimal threshold (AUC = 0.751, sensitivity 84.5%, specificity 65.7%). Stage IV cases had the highest HbA1c (7.56±0.87%), with a significant post hoc difference between Stage II and Stage IV (mean difference = 0.782%, p = 0.031), although the overall ANOVA was borderline (F(3,139) = 2.599, p = 0.055).
Conclusion: HbA1c ≥6.5% is a prevalent and clinically meaningful biomarker in this Kenyan breast cancer population, with elevated values clustering at advanced disease stages. Integration of HbA1c into routine breast cancer screening and staging protocols is warranted.
H. Kibebe, E. Muchiri, Maryjoy Kaimuri· Journal of medicine, nursing...· 0 citations
The most reported malignancy in women of Pakistan is breast cancer. About one in nine females suffers from this disease, that contributes largely to mortality. The burden of the disease here is much more than in any other country of South Asia, with such salient features as earlier age of onset and late-stage presentation. This paper aimed to synthesize evidence from recent studies conducted in Pakistan on risk factors for breast cancer. Lifestyle determinants such as obesity, physically inactive or sedentary behavior, and unhealthy dietary patterns prove to be common and strongly associated with high risk. Genetic predisposition, particularly BRCA1 and BRCA2 mutations, plays a key role in increasing susceptibility among high-risk women. Additionally, reproductive factors such as early menarche, late menopause, nulliparity, and limited breastfeeding have been recognized as important contributors. In addition to urban pollution and dietary contaminants, environmental exposure also increases the risk; vitamin D deficiency could compound the disease further. Diagnosis gets late͏ and results get worse due to socioeconomic͏ and cultural barriers, low awareness, stigma, and low access to screening facilities. When compared with the regional population and even the global population, it can be seen that Pakistani women face some unique sociocultural challenges that make them more vulnerable. This review article demonstrates the immediate need for specific public health interventions, better genetic counseling infrastructure, and culturally appropriate mass awareness campaigns to lessen the breast cancer burden at a national level. Identifying key risk factors and leveraging artificial intelligence (AI)-driven technologies can improve prevention strategies and facilitate early detection.
Rehana Kouser, Madiha Sadia, S. Abbasi· Journal of Human Centered Te...· 0 citations
