1. Survival after breast cancer in women with type 2 diabetes using antidiabetic medication and statins: a retrospective cohort study
- Author
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Esa Läärä, Ulla Puistola, Peeter Karihtala, Anne Ahtikoski, Ari Hautakoski, Mikko Marttila, Arja Jukkola, Elina Urpilainen, Mayu Hosio, Reijo Sund, and Martti Arffman
- Subjects
Adult ,Oncology ,medicine.medical_specialty ,Administration, Oral ,Breast Neoplasms ,Type 2 diabetes ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,medicine ,Humans ,Hypoglycemic Agents ,Radiology, Nuclear Medicine and imaging ,Registries ,Finland ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Proportional hazards model ,Mortality rate ,Hazard ratio ,nutritional and metabolic diseases ,Retrospective cohort study ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Metformin ,3. Good health ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Cohort ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Follow-Up Studies ,medicine.drug - Abstract
Background: We assessed survival of breast cancer in women with type 2 diabetes (T2D) treated with metformin, other types of antidiabetic medication (ADM) and statins.Materials and Methods: The study cohort consisted of women with T2D and diagnosed with breast cancer in Finland in 1998─2011. Mortality rates from breast cancer and other causes were analysed by Cox models, and adjusted hazard ratios (HRs) with 95% confidence intervals (Cls) were estimated in relation to the use of different types of medication.Results: The final cohort consisted of 3,533 women. No clear evidence was found for breast cancer mortality being different in metformin users (HR 0.86, 95% Cl 0.63-1.17), but their other-cause mortality appeared to be lower (HR 0.73, 95% Cl 0.55-0.97) in comparison with women using other types of oral ADM. Other-cause mortality was higher among insulin users (HR 1.45, 95% Cl 1.16-1.80) compared with users of other oral ADMs, other than metformin. Prediagnostic statin use was observed to be associated with decreased mortality from both breast cancer (HR 0.76, 95% Cl 0.63-0.92) and other causes (HR 0.75, 95% Cl 0.64-0.87).Conclusions: We did not find any association between ADM use and disease-specific mortality among women with T2D diagnosed with breast cancer. However, interestingly, prediagnostic statin use was observed to predict reduced mortality from breast cancer and other causes. We hypothesise that treating treatment practices of T2D or hypercholesterolaemia of breast cancer patients might affect overall prognosis of women diagnosed with breast cancer and T2D.
- Published
- 2020