Insulin and breast cancer: Implications for preventive counseling

方案#06-CH-0119旨在阐明胰岛素和胰岛素相关作用（例如胰岛素抵抗、腹部脂肪）对乳腺癌风险的影响。最终目标是早期筛查高危患者，并制定降低风险的新策略。研究计划中概述的具体目的是：（1）确定与胰岛素功能相关或支配胰岛素功能的因素是否可能参与特定患者人群中乳腺癌风险的改变。(2)确定腹部脂肪和其他人体测量指标对有和没有阳性家族史（按绝经状态分类）的患者乳腺癌风险的作用，以及与胰岛素和其他激素的相互作用。 (3)为将来研究胰岛素对乳腺癌作用的介质（IRS-1，伊拉亚型）和该患者人群中涉及的基因多态性提供足够的数据。(4)为对胰岛素促生长作用有反应的一部分患者制定合理的、具有成本效益的风险降低和筛查策略指南。 目前，我们已经对20多名患者进行了评估。 用于支付病人费用的资金减少阻碍了病人的招募。我们正在分析我们的试点数据，并将随后确定需要进行哪些修改以继续执行该方案。

Protocol #06-CH-0119 aims at unraveling the contributions of insulin and insulin-related actions (e.g. insulin resistance, abdominal fat) on breast cancer risk. The ultimate goal is early screening of patients at risk , and to develop new strategies for risk reduction. The specific aims outlined in the study plan are: (1) To determine whether factors associated or governing insulin function may be involved in modification of breast cancer risk in specific patient populations. (2) Determine the role of abdominal fat and other anthropometric measures on breast cancer risk in patients with and without a positive family history (classified by menopausal status) and the interaction with insulin, and other hormones. (3) Provide sufficient data for future studies looking at mediators of the actions of insulin on breast cancer (IRS-1, IRA isoform) and gene polymorphisms involved in this patient population. (4) Develop rational, cost-efficient guidelines for risk reducing and screening strategies for a subset of patients responsive to the growth promoting actions of insulin. At present we have evaluated more than 20 patients. The diminution of funds to cover patient costs has hindered patient recruitment. We are analyzing our pilot data and will subsequently determine what modifications are needed for continuation of the protocol.