Dose-dependent relation between metformin and the risk of hormone receptor-positive, her2-negative breast cancer among postmenopausal women with type-2 diabetes
Purpose Metformin has demonstrated a chemoprotective effect in breast cancer but there is limited evidence on the effect of cumulative exposure to metformin and the risk of hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR + /HER2-) breast cancer. This study assessed this risk with dose and intensity of metformin in postmenopausal women with type-2 diabetes mellitus (T2DM). Methods This nested case–control study used the Surveillance, Epidemiology, and End Results-Medicare data (2008–2015). Cohort entry was the date of incident T2DM diagnosis. Cases were those diagnosed with HR + /HER2- breast cancer (event date) as their first/only cancer. Non-cancer T2DM controls were matched using variable-ratio-matching. Cumulative dose and average intensity of metformin were measured during the 1-year lookback period. Dose(mg) was categorized as: (1)0, (2)0–30,000, (3)30,001–136,000, (4)136,001–293,000, and (5) > 293,000, and intensity(mg/day) as: 0, 1–500, and > 500. Covariates were conceptualized using the Andersen Behavioral Model. Conditional logistic regression was used to assess the risk of HR + /HER2- breast cancer with metformin-use. Results There were 690 cases and 2747 controls. The median duration of T2DM was 1178 days in controls and 1180 days in cases. Higher cumulative dose categories: 4 (adjusted odds ratio(aOR) = 0.72, 95% CI 0.55–0.95,p = 0.02), and 5 (OR = 0.60, 95% CI 0.42–0.85,p < 0.01) had significantly lower odds of HR + /HER2- breast cancer compared to category 0. The highest intensity category of metformin had 39% lower odds of HR + /HER2- breast cancer (OR = 0.61, 95% CI 0.46–0.82,p < 0.01) compared to the 0 mg/day group. Conclusions Higher metformin exposure was associated with reduced risk of HR + /HER2- breast cancer, adding to the evidence supporting metformin’s chemoprotective effect..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:195 |
|---|---|
| Enthalten in: |
Breast cancer research and treatment - 195(2022), 3 vom: 15. Aug., Seite 421-430 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chikermane, Soumya G. [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| BKL: | |
|---|---|
| Themen: |
Breast cancer risk |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s10549-022-06706-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2079509799 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2079509799 | ||
| 003 | DE-627 | ||
| 005 | 20230514122453.0 | ||
| 007 | tu | ||
| 008 | 221220s2022 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10549-022-06706-0 |2 doi | |
| 035 | |a (DE-627)OLC2079509799 | ||
| 035 | |a (DE-He213)s10549-022-06706-0-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 084 | |a 44.00 |2 bkl | ||
| 100 | 1 | |a Chikermane, Soumya G. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Dose-dependent relation between metformin and the risk of hormone receptor-positive, her2-negative breast cancer among postmenopausal women with type-2 diabetes |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Purpose Metformin has demonstrated a chemoprotective effect in breast cancer but there is limited evidence on the effect of cumulative exposure to metformin and the risk of hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR + /HER2-) breast cancer. This study assessed this risk with dose and intensity of metformin in postmenopausal women with type-2 diabetes mellitus (T2DM). Methods This nested case–control study used the Surveillance, Epidemiology, and End Results-Medicare data (2008–2015). Cohort entry was the date of incident T2DM diagnosis. Cases were those diagnosed with HR + /HER2- breast cancer (event date) as their first/only cancer. Non-cancer T2DM controls were matched using variable-ratio-matching. Cumulative dose and average intensity of metformin were measured during the 1-year lookback period. Dose(mg) was categorized as: (1)0, (2)0–30,000, (3)30,001–136,000, (4)136,001–293,000, and (5) > 293,000, and intensity(mg/day) as: 0, 1–500, and > 500. Covariates were conceptualized using the Andersen Behavioral Model. Conditional logistic regression was used to assess the risk of HR + /HER2- breast cancer with metformin-use. Results There were 690 cases and 2747 controls. The median duration of T2DM was 1178 days in controls and 1180 days in cases. Higher cumulative dose categories: 4 (adjusted odds ratio(aOR) = 0.72, 95% CI 0.55–0.95,p = 0.02), and 5 (OR = 0.60, 95% CI 0.42–0.85,p < 0.01) had significantly lower odds of HR + /HER2- breast cancer compared to category 0. The highest intensity category of metformin had 39% lower odds of HR + /HER2- breast cancer (OR = 0.61, 95% CI 0.46–0.82,p < 0.01) compared to the 0 mg/day group. Conclusions Higher metformin exposure was associated with reduced risk of HR + /HER2- breast cancer, adding to the evidence supporting metformin’s chemoprotective effect. | ||
| 650 | 4 | |a Breast cancer risk | |
| 650 | 4 | |a Postmenopausal women | |
| 650 | 4 | |a Type-2 diabetes | |
| 650 | 4 | |a Metformin | |
| 650 | 4 | |a Chemoprevention | |
| 700 | 1 | |a Sharma, Manvi |0 (orcid)0000-0002-4221-7801 |4 aut | |
| 700 | 1 | |a Abughosh, Susan M. |4 aut | |
| 700 | 1 | |a Aparasu, Rajender R. |4 aut | |
| 700 | 1 | |a Trivedi, Meghana V. |4 aut | |
| 700 | 1 | |a Johnson, Michael L. |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Breast cancer research and treatment |d Springer US, 1981 |g 195(2022), 3 vom: 15. Aug., Seite 421-430 |w (DE-627)167913557 |w (DE-600)604563-7 |w (DE-576)01590217X |x 0167-6806 |7 nnns |
| 773 | 1 | 8 | |g volume:195 |g year:2022 |g number:3 |g day:15 |g month:08 |g pages:421-430 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s10549-022-06706-0 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a SSG-OLC-DE-84 | ||
| 936 | b | k | |a 44.00 |q VZ |
| 951 | |a AR | ||
| 952 | |d 195 |j 2022 |e 3 |b 15 |c 08 |h 421-430 | ||