title: Demographic and clinico-pathological characteristics in patients with invasive breast cancer receiving metformin.
abstract: There was a contradictory data with metformin use on breast cancer risk, but there is growing evidence that the use of metformin in diabetic patients was associated with lower risks of breast cancer mortality and incidence. The effect of metformin on clinical and pathological properties of breast cancer was not known exactly, and we aimed to investigate the demographic and clinico-pathological characteristics of patients with metformin users at the time of breast cancer diagnosis. Patients with breast cancer diagnosed from 2000 to 2012 in our clinic were retrospectively analyzed. Patient's demographics, including survival data and tumor characteristics were obtained from medical charts. Breast cancer patients who were taking metformin at the time of breast cancer diagnosis were enrolled as metformin users (n = 148), where the patients matched with the same age who were not taking metformin were included as a control group (n = 636). A total of 784 patients were included in this study. Median age of both metformin users and nonusers was 57 (23-87). There were no significant differences in baseline tumor size (P = 0.60), tumor stage (P = 0.76), and node positivity (P = 0.13) between the two groups. Metformin user patients compared to nonusers had significantly lower incidence of histological grade III tumor (P = 0.03). A similar significant trend for lower incidence of triple negative (P = 0.01) and higher incidence ER positivity (P = 0.008) and PR positivity (P = 0.01) was also seen in metformin users. In survival analysis, the estimated median disease-free survival was 118 months in metformin users, whereas 69 months in nonusers (P = 0.09). Median overall survival (OS) could not be obtained due to low events. In patients with metformin users, OS rate was 98.4, 97.1, and 93.8 %, and in nonusers was 99.6, 94.4, and 90.5 %, the first, third, and fifth years, respectively. The use of metformin at the time of breast cancer diagnosis was associated with better clinico-pathological properties and nonsignificantly improved disease-free survival in breast cancer patients.
authors: Department of Medical Oncology, Hacettepe University Cancer, Ankara, Turkey.
authors: Sercan
authors: S
authors: Aksoy
authors: Mehmet Ali Nahit
authors: MA
authors: Sendur
authors: Kadri
authors: K
authors: Altundag
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin
references: Int J Cancer. 2007 Aug 15;121(4):856-62
references: 17397032
references: J Clin Invest. 2001 Oct;108(8):1167-74
references: 11602624
references: Expert Opin Pharmacother. 2012 Aug;13(12):1797-805
references: 22775758
references: J Clin Oncol. 2012 Aug 10;30(23):2844-52
references: 22689798
references: Diabetes Care. 2006 Feb;29(2):254-8
references: 16443869
references: BMJ. 2007 Dec 1;335(7630):1134
references: 17986716
references: Crit Rev Oncol Hematol. 2008 Jul;67(1):1-7
references: 18343152
references: Best Pract Res Clin Endocrinol Metab. 2008 Aug;22(4):625-38
references: 18971123
references: Cancer Prev Res (Phila). 2010 Nov;3(11):1451-61
references: 20947488
references: Diabetologia. 2009 Jan;52(1):17-30
references: 18941734
references: Clin Gastroenterol Hepatol. 2006 Mar;4(3):369-80
references: 16527702
references: Breast Cancer Res Treat. 2012 Oct;135(3):639-46
references: 22847511
references: Br J Cancer. 2004 Aug 16;91(4):644-50
references: 15238982
references: J Clin Oncol. 2012 Jul 20;30(21):2593-600
references: 22564993
references: Clin Cancer Res. 2005 Feb 15;11(4):1563-71
references: 15746061
references: JAMA. 1995 May 24-31;273(20):1605-9
references: 7745774
references: Lancet Oncol. 2005 Feb;6(2):103-11
references: 15683819
references: BMC Med. 2011 Apr 06;9:33
references: 21470407
references: Endocr Pract. 2011 Jul-Aug;17(4):616-28
references: 21454235
references: Cancer Res. 2011 May 1;71(9):3196-201
references: 21415163
references: J Clin Oncol. 2011 Jan 1;29(1):54-60
references: 21115861
references: Am J Clin Nutr. 2007 Sep;86(3):s867-71
references: 18265480
references: Diabetes Care. 2010 Jun;33(6):1304-8
references: 20299480
references: Diabetes Care. 2009 Sep;32(9):1620-5
references: 19564453
references: J Clin Oncol. 2009 Jul 10;27(20):3297-302
references: 19487376
references: Cell Cycle. 2009 Jul 1;8(13):2031-40
references: 19440038
references: Breast Cancer Res Treat. 2011 Feb;126(1):215-20
references: 20976543
references: Med Oncol. 2011 Dec;28(4):1260-3
references: 20490716
references: Exp Clin Endocrinol Diabetes. 2009 Nov;117(10):563-6
references: 19924603
references: Int J Cancer. 2007 May 15;120(10):2202-7
references: 17278089
references: Diabetologia. 2007 Jul;50(7):1365-74
references: 17476474
references: Breast Cancer Res Treat. 2010 Aug;122(3):859-65
references: 20077000
references: Diabetologia. 2006 Dec;49(12):2819-23
references: 17021919
references: Breast Cancer Res Treat. 2012 Oct;135(3):821-30
references: 22933030
references: Cancer Res. 2009 Oct 1;69(19):7507-11
references: 19752085
references: Diabetologia. 2009 Sep;52(9):1766-77
references: 19572116
references: Cell Metab. 2005 Jan;1(1):15-25
references: 16054041
references: Breast Cancer Res Treat. 2011 Aug;128(3):783-94
references: 21655990
references: J Clin Oncol. 2011 Jan 1;29(1):40-6
references: 21115865
references: Cancer Causes Control. 2012 Nov;23(11):1785-95
references: 22971998
references: J Natl Cancer Inst. 2005 Nov 16;97(22):1679-87
references: 16288121