Insulin and breast cancer: Implications for preventive counseling

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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.