Diabetes, diabetes treatment and breast cancer prognosis.
Diabetes, diabetes treatment and breast cancer prognosis.
复制标题
糖尿病，糖尿病治疗和乳腺癌预后。
DOI：
10.1007/s10549-014-3146-9
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发表时间：
2014-11
影响因子：
3.8
通讯作者：
Margolis, Karen
中科院分区：
文献类型：
--
作者：
Luo, Juhua;Virnig, Beth;Hendryx, Michael;Wen, Sijin;Chelebowski, Rowan;Chen, Chu;Rohan, Tomas;Tinker, Lesley;Wactawski-Wende, Jean;Lessin, Lawrence;Margolis, Karen
本研究的目的是评估现有糖尿病和糖尿病治疗对乳腺癌预后的影响。妇女健康倡议对 1998 年至 2013 年间诊断出的 8,108 名集中确诊的浸润性乳腺癌女性进行了随访，直至死亡日期或 2013 年 9 月 20 日。有关糖尿病和糖尿病治疗的信息分别通过自我报告和当前药物容器的面对面审查获得。 Cox 比例风险回归用于估计调整后的总体死亡率相对风险比。比例次分布风险模型用于估计乳腺癌特异性死亡率的风险比。与未患糖尿病的女性相比，患有糖尿病的女性总体死亡风险显着增加（HR 1.26，95% CI 1.06-1.48），尤其是那些服用胰岛素或糖尿病病程较长的女性。然而，无论治疗类型和糖尿病持续时间如何，糖尿病与乳腺癌特异性死亡率增加无关，尽管糖尿病与不利的肿瘤特征显着相关。我们的大型前瞻性队列研究提供了额外的证据，表明既往患有糖尿病会增加乳腺癌女性的总死亡率风险。与糖尿病相关的总死亡率增加主要是由于死于乳腺癌以外的疾病的风险增加所致。因此，对患有糖尿病的乳腺癌患者的持续护理应包括仔细关注 CVD 危险因素和其他非癌症疾病。
The objectives of this study are to assess the impact of pre-existing diabetes and diabetes treatment on breast cancer prognosis. 8,108 women with centrally confirmed invasive breast cancer in the Women’s Health Initiative diagnosed between 1998 and 2013 were followed through the date of death or September 20, 2013. Information on diabetes and diabetes therapy were obtained via self-report and face-to-face review of current medication containers, respectively. Cox proportional hazard regression was used to estimate adjusted relative hazard ratios for overall mortality. The proportional subdistribution hazard model was used to estimate hazard ratios for breast cancer-specific mortality. Compared with women without diabetes, women with diabetes had significantly increased risk of overall mortality (HR 1.26 95 % CI 1.06–1.48), especially among those who took insulin or had longer duration of diabetes. However, diabetes was not associated with increased risk of breast cancer-specific mortality, regardless of type of treatment and duration of diabetes, despite the significant association of diabetes with unfavorable tumor characteristics. Our large prospective cohort study provides additional evidence that pre-existing diabetes increases risk of total mortality among women with breast cancer. The increased total mortality associated with diabetes was mainly driven by increased risk of dying from diseases other than breast cancer. Thus, the continuum of care for breast cancer patients with diabetes should include careful attention to CVD risk factors and other non-cancer conditions.
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影响因子：
3
作者：
Fleming, ST;Rastogi, A;Johnson, KD
通讯作者：
Johnson, KD
影响因子：
6.2
作者：
Liu, Xiangdong;Ji, Jianguang;Hemminki, Kari
通讯作者：
Hemminki, Kari
影响因子：
1.5
作者：
Peeters PJ;Bazelier MT;Vestergaard P;Leufkens HG;Schmidt MK;de Vries F;De Bruin ML
通讯作者：
De Bruin ML
影响因子：
16.2
作者：
McBean, A. Marshall;Yu, Xinhua
通讯作者：
Yu, Xinhua
影响因子：
2
作者：
Putter, H.;Fiocco, M.;Geskus, R. B.
通讯作者：
Geskus, R. B.