ArticleBreast cancer research : BCR2020
Insulin resistance contributes to racial disparities in breast cancer prognosis in US women.
Article in Breast cancer research : BCR, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 63 citations in OpenAlex.
- A pilot study of a gratitude journaling intervention to enhance spiritual well-being and exercise self-efficacy in Black breast cancer survivors.BMC psychiatry · 2024Trial
- Insulin receptor expression and its association with hyperinsulinemia in triple negative breast cancer.Journal of the Endocrine Society · 2026Article
- Insulin resistance as a modifiable contributor to breast cancer: mechanisms, biomarkers, and therapeutic implications.Discover oncology · 2026Review
- Inverse Association Between METS-IR and Lung Cancer Risk: The Role of BMI in a Nationwide Korean Cohort.Cancers · 2025Article
- Comparing patient-reported outcomes and lifestyle factors before and after the COVID-19 pandemic among Black and Hispanic breast cancer survivors in New Jersey.Journal of cancer survivorship : research and practice · 2025Article
- Association between triglyceride-glucose related indicators, genetic risk, and incident breast cancer among postmenopausal women in UK Biobank.BMC cancer · 2025Article
- Gerotherapeutics: aging mechanism-based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities.Journal of the National Cancer Institute · 2025Review
- Role and therapeutic potential of the NEDD4 family in breast cancer.Frontiers in pharmacology · 2025Review
- Effect of adipocytes on the function and activity of T cells in tumor microenvironment.Frontiers in immunology · 2025Review
- Inherent Bias in Electronic Health Records: A Scoping Review of Sources of Bias.medRxiv : the preprint server for health sciences · 2024Article
- Racial differences in weight perception among Black and White women diagnosed with breast cancer.Journal of cancer survivorship : research and practice · 2024Article
- Obesity, Dietary Fats, and Gastrointestinal Cancer Risk-Potential Mechanisms Relating to Lipid Metabolism and Inflammation.Metabolites · 2024Review
- Prognostic value of insulin resistance in patients with female reproductive system malignancies: A multicenter cohort study.Immunity, inflammation and disease · 2023Article
- Structural Racism, Lifestyle Behaviors, and Obesity-related Cancers among Black and Hispanic/Latino Adults in the United States: A Narrative Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Review
- Article
- Racial Disparity in Anthracycline-induced Cardiotoxicity in Breast Cancer Patients.Biomedicines · 2023Review
- Association between insulin resistance and cardiac remodeling in HER2-positive breast cancer patients: a real-world study.BMC cancer · 2023Article
- Subjective social status, race, and metabolic syndrome in women with breast cancer.Breast cancer research and treatment · 2023Article
- Link between Blood Cell-Associated Inflammatory Indices and Chemotherapy-Induced Hyperglycemia in Women Affected with Breast Cancer: Clinical Studies.South Asian journal of cancer · 2023Article
- Primary diffuse large B-cell lymphoma of the breast: A retrospective study of outcomes and insulin resistance.Saudi medical journal · 2023Article
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundRacial disparities in breast cancer survival between Black and White women persist across all stages of breast cancer. The metabolic syndrome (MetS) of insulin resistance disproportionately affects more Black than White women. It has not been discerned if insulin resistance mediates the link between race and poor prognosis in breast cancer. We aimed to determine whether insulin resistance mediates in part the association between race and breast cancer prognosis, and if insulin receptor (IR) and insulin-like growth factor receptor (IGF-1R) expression differs between tumors from Black and White women.
methodsWe conducted a cross-sectional, multi-center study across ten hospitals. Self-identified Black women and White women with newly diagnosed invasive breast cancer were recruited. The primary outcome was to determine if insulin resistance, which was calculated using the homeostatic model assessment of insulin resistance (HOMA-IR), mediated the effect of race on prognosis using the multivariate linear mediation model. Demographic data, anthropometric measurements, and fasting blood were collected. Poor prognosis was defined as a Nottingham Prognostic Index (NPI) > 4.4. Breast cancer pathology specimens were evaluated for IR and IGF-1R expression by immunohistochemistry (IHC).
resultsFive hundred fifteen women were recruited (83% White, 17% Black). The MetS was more prevalent in Black women than in White women (40% vs 20%, p < 0.0001). HOMA-IR was higher in Black women than in White women (1.9 ± 1.2 vs 1.3 ± 1.4, p = 0.0005). Poor breast cancer prognosis was more prevalent in Black women than in White women (28% vs 15%. p = 0.004). HOMA-IR was positively associated with NPI score (r = 0.1, p = 0.02). The mediation model, adjusted for age, revealed that HOMA-IR significantly mediated the association between Black race and poor prognosis (β = 0.04, 95% CI 0.005-0.009, p = 0.002). IR expression was higher in tumors from Black women than in those from White women (79% vs 52%, p = 0.004), and greater IR/IGF-1R ratio was also associated with higher NPI score (IR/IGF-1R > 1: 4.2 ± 0.8 vs IR/IGF-1R = 1: 3.9 ± 0.8 vs IR/IGF-1R < 1: 3.5 ± 1.0, p < 0.0001).
conclusionsIn this multi-center, cross-sectional study of US women with newly diagnosed invasive breast cancer, insulin resistance is one factor mediating part of the association between race and poor prognosis in breast cancer.
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