title: The Association between Treatment for Metabolic Disorders and Breast Cancer Characteristics.
abstract: Purpose. To evaluate the associations between metformin, insulin, statins, and levothyroxine and breast cancer characteristics and outcome. Methods. Retrospective chart review of patients treated in our institute for early estrogen receptor (ER) positive, human epidermal growth factor receptor 2 negative breast cancer, whose tumors were sent to Oncotype DX (ODX) analysis. Patients were grouped according to medications usage during the time of breast cancer diagnosis. Each group was compared to the rest of the study population. Results. The study cohort included 671 patients. Sixty (9.1%) patients were treated with metformin, 9 (1.4%) with insulin, 208 (31.7%) with statins, and 62 (9.4%) with levothyroxine. Patients treated with metformin had more intense ER stain (p = 0.032) and a lower ODX recurrence score (RS) (p = 0.035). Diagnosis of diabetes mellitus was also associated with lower ODX RS (p = 0.014). Insulin usage was associated with a higher rate of angiolymphatic invasion (p = 0.041), but lower Ki67% (p = 0.017). Levothyroxine usage was associated with different histological subtype distribution (p = 0.02). Extended levothyroxine usage was associated with lower ODX RS (p = 0.005). Statin usage had no impact on tumor characteristics. Outcome was comparable in the studied subgroups. Conclusions. Common medications for metabolic disorders might be associated with breast cancer characteristics.
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
authors.forename: Hadar
authors.identifier: 0000-0002-9557-4634
authors.initials: H
authors.lastname: Goldvaser
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv, Israel.
authors.forename: Shulamith
authors.initials: S
authors.lastname: Rizel
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hendler
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
authors.forename: Victoria
authors.initials: V
authors.lastname: Neiman
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv, Israel; Department of Medicine A, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shepshelovich
authors.affiliation: Statistical Consulting Unit, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
authors.forename: Tzippy
authors.initials: T
authors.lastname: Shochat
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv, Israel.
authors.forename: Aaron
authors.initials: A
authors.lastname: Sulkes
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv, Israel.
authors.forename: Baruch
authors.initials: B
authors.lastname: Brenner
authors.affiliation: Institute of Oncology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv, Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Yerushalmi