The primary purpose of this proposed pilot study is to investigate the association between insulin resistance and breast cancer risk. We hypothesize that 1) insulin resistance, defined as high levels of insulin and glucose or type 2 diabetes, will be positively associated with breast cancer, and 2) the insulin resistance breast cancer association will be more pronounced among women with abdominal obesity and high levels of estradiol (E2).
The specific aims of the proposed case-control study are: 1) to obtain information on type 2 diabetes, waist and hip circumference, body mass index, body fat content, birth weight, age at which adult height was achieved, diet, physical activity, and weight gain, and to collect pre-diagnostic blood, 2) to assay blood for E2, sex hormone-binding globulin, insulin, glucose, and triglycerides, and 3) to perform statistical analyses to assess the association between insulin resistance and breast cancer risk, while accounting for confounding and interaction. This proposed study will be conducted in three mammographic centers. We plan to recruit 390 incident breast cancer cases and 390 control women. Breast cancer cases will be those women identified as having breast cancer through diagnostic mammography prior to undergoing treatment. Control women will be those women who are cancer free through screening mammography. In addition, control women will be at low risk of breast cancer defined as having no previous lesions that place her at higher than minimal risk, and no first-degree relative with a history of breast cancer or other hormone-related cancer. Insulin resistance may be associated with breast cancer, and may help explain the elevated risk of breast cancer among certain ethnic groups. Despite being at greater risk of insulin resistance, Hispanic women have a relatively low incidence of breast cancer. This proposed study may be useful in identifying factors associated with decreased breast cancer risk among Hispanic women.
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