Insulin Resistance and Breast Cancer Prognosis in Black & White Women

描述（由申请人提供）：尽管乳腺癌的诊断和治疗有所改善，但黑人女性乳腺癌的预后仍然比白人女性差。这项研究的目的是确定胰岛素抵抗的差异是否可以部分解释黑人和白人女性乳腺癌存活率的差异。胰岛素抵抗是肥胖、代谢综合征和早期2型糖尿病、与更具侵袭性的乳腺癌亚型和死亡率增加相关的疾病的重要组成部分。白人女性较高的胰岛素水平也与乳腺癌死亡率增加有关，尽管这一点尚未在黑人女性中进行过研究。鉴于肥胖和糖尿病流行对少数民族人群的影响不成比例，了解高胰岛素血症（肥胖、胰岛素抵抗和IR信号增加导致的结果）与乳腺癌进展的关系非常重要。了解这些关系可以解释在不同种族群体中看到的不同疾病模式，并有助于确定哪些患者

DESCRIPTION (provided by applicant): Despite improvements in breast cancer diagnosis and treatment, Black women with breast cancer continue to have a worse prognosis than White women. The purpose of this study is to determine whether differences in insulin resistance can explain in part the disparities in breast cancer survival between Black and White women. Insulin resistance is an important component of obesity, the metabolic syndrome and early stage type 2 diabetes, conditions associated with more aggressive breast cancer subtypes and increased mortality. Higher insulin levels in White women have also been associated with increased breast cancer mortality, although this has not been studied in Black women. Given that obesity and diabetes epidemics disproportionately affect minority populations, it is important understand the relationship of hyperinsulinemia, a result of obesity, insulin resistance and increased IR signaling on the progression of breast cancer. Understanding these relationships could explain the different patterns of disease seen in different racial groups and help to identify patients who would benefit from targeted therapy. Our research attempts to address some of these gaps in the literature. We have 2 main aims: Aim 1: To examine whether the association between peripheral insulin resistance and breast cancer with a poor prognosis differs between black and white women. Aim 2: To demonstrate whether the tumor's insulin receptor and / or IGF-1 receptor signaling pathway is associated with poor prognostic features and whether activation of this pathway differs between black and white women. We will recruit 936 white women and 350 black women with a newly diagnosed breast cancer, to investigate the links between insulin resistance, breast cancer aggression, and race. Measures of insulin resistance, the metabolic syndrome and obesity will be collected to investigate whether insulin is a key mechanistic link in the association between obesity and breast cancer aggressivity, and how race affects this association. Blood samples for insulin resistance and anthropometric measures will be taken during the pre-operative evaluation of women with a new primary breast cancer. Samples of breast cancer tissue removed during primary surgical resection will be examined using immunohistochemistry to assess the role of insulin, insulin-like disparities in breast cancer prognosis between racial groups.