Breast Cancer Research and Treatment

, Volume 150, Issue 3, pp 613–620 | Cite as

The association between diabetes and breast cancer stage at diagnosis: a population-based study

  • Lorraine L. Lipscombe
  • Hadas D. Fischer
  • Peter C. Austin
  • Longdi Fu
  • R. Liisa Jaakkimainen
  • Ophira Ginsburg
  • Paula A. Rochon
  • Steven Narod
  • Lawrence Paszat
Epidemiology

Abstract

Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study examined stage at diagnosis (II, III, or IV vs I) among women aged 20–105 years who were newly diagnosed with invasive breast cancer between 2007 and 2012. We compared those with diabetes to those without diabetes. Diabetes was defined based on medical records using a validated algorithm. Among 38,407 women with breast cancer, 6115 (15.9 %) women had diabetes. Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality.

Keywords

Diabetes Breast cancer Stage at diagnosis Administrative databases 

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lorraine L. Lipscombe
    • 1
    • 2
    • 3
    • 4
  • Hadas D. Fischer
    • 3
  • Peter C. Austin
    • 3
    • 4
  • Longdi Fu
    • 3
  • R. Liisa Jaakkimainen
    • 3
    • 5
    • 6
  • Ophira Ginsburg
    • 1
    • 2
    • 4
  • Paula A. Rochon
    • 1
    • 2
    • 3
    • 4
  • Steven Narod
    • 1
    • 2
  • Lawrence Paszat
    • 3
    • 4
    • 6
  1. 1.Women’s College Research InstituteWomen’s College HospitalTorontoCanada
  2. 2.Department of MedicineUniversity of TorontoTorontoCanada
  3. 3.Institute for Clinical Evaluative SciencesTorontoCanada
  4. 4.Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  5. 5.Department of Family and Community MedicineUniversity of TorontoTorontoCanada
  6. 6.Sunnybrook Health Sciences CentreTorontoCanada

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