Review Article

Type 2 Diabetes and Breast Cancer: The Interplay between Impaired Glucose Metabolism and Oxidant Stress

Table 1

Metformin and thiazolidinediones use and breast cancer risk in type 2 diabetes.

ReferenceStudy designNumber of cases/controlsMean age (years)Treatment comparisonRisk estimates (95% CI)

Metformin use: clinical studies
Libby et al., 2009 [65]Population-based, historical cohort study771/817066Non-metformin users0.6 (0.32–1.10)
Currie et al., 2009 [66]General practices, retrospective cohort study373/789764Sulfonylureas monotherapy
Insulin-based treatments
1.02 (0.71–1.45)
0.93 (0.69–1.27)
Bodmer et al., 2010 [67]Nested case-control study17/12068Non-metformin users0.44 (0.24–0.82)
Bosco et al., 2011 [68]Nested case-control study393/3930>50 yearsNon-metformin users0.81 (0.63–0.96)
Ruiter et al., 2012 [69]Case-control study207/217NASulfonylureas0.95 (0.91–0.98)
Chlebowski et al., 2012 [70]Observational cohort104/12964Other antidiabetic drugs0.75 (0.57–0.99)
van Staa et al., 2012 [71]Observational cohort/inception cohorts160/86
268/86
184/86
63Metformin treatment <6 months0.73 (0.56–0.96)a
0.91 (0.70–1.17)b
0.82 (0.61–1.10)c
García-Esquinas et al., 2015 [72]Population-based multicase-control study24/43NADuration of metformin use0.89 (0.81–0.99) for ER+/PR+ Her2−

Metformin use: meta-analyses
DeCensi et al., 2010 [73]Meta-analysis of various cancers,
including [65, 74, 75]
NANA0.70 (0.28–1.77)
Soranna et al., 2012 [76]Meta-analysis of various cancers,
including [65, 67, 74, 75]
NANA0.87 (0.69–1.10)
Franciosi et al., 2013 [77]Meta-analysis of various cancers,
including [65, 6770, 74, 75]
NANA0.71 (0.58–0.88)
Col et al., 2012 [78]Meta-analysis of breast cancer studies,
including [65, 6770, 74, 75]
NANA0.83 (0.71–0.97)
Zhang et al., 2013 [75]Meta-analysis of various cancers,
including [65, 6769, 74, 75]
NANA0.94 (0.91–0.97)

Thiazolidinedione (TZD) use
Bodmer et al., 2010 [67]Nested case-control study12/3068TZD long-term users1.76 (0.84–3.68)
Colmers et al., 2012 [79]Meta-analysis of various cancersNANA0.89 (0.81–0.98)
van Staa et al., 2012 [71]Observational cohort/inception cohorts160/86
268/86
184/86
63TZD treatment <6 months1.04 (0.60–1.80)a
0.99 (0.56–1.75)b
1.09 (0.53–2.22)c
Lin et al., 2014 [80]Population-based retrospective cohort studyNA56Other antidiabetic drugs
No antidiabetic drugs
0.22 (0.09–0.55)
0.19 (0.07–0.54)
Sun et al., 2014 [81]Retrospective cohort studyNA66Sulphonylurea0.68 (0.48–0.97)d

6–24 months since start of metformin/TZD.
b25–60 months since start of metformin/TZD.
>60 months since start of metformin/TZD.
dAll women cancer types.