Insulin and breast cancer: Implications for preventive counseling

方案#06-CH-0119旨在揭示胰岛素和胰岛素相关行为（如胰岛素抵抗，腹部脂肪）对乳腺癌风险的贡献。最终目标是对有风险的患者进行早期筛查，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控制胰岛素功能的因素是否可能参与特定患者群体乳腺癌风险的改变。(2)确定腹部脂肪和其他人体测量指标对有和无阳性家族史（按绝经状态分类）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)为未来研究胰岛素对乳腺癌的作用介质（IRS-1， IRA异构体）和该患者群体中涉及的基因多态性提供足够的数据。(4)针对对胰岛素促生长作用有反应的部分患者，制定合理的、具有成本效益的风险降低指南和筛查策略。目前我们已经评估了20多名患者。用于支付患者费用的资金减少阻碍了患者招募。我们正在分析我们的试验数据，并将随后确定需要进行哪些修改以继续执行该协议。

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.