Evidence map›Paper›PMID 34001921›Full record

ArticleScientific reports2021

Association of antidiabetic medication and statins with survival from ductal and lobular breast carcinoma in women with type 2 diabetes.

Mayu Hosio, Elina Urpilainen, Ari Hautakoski, Mikko Marttila, Martti Arffman, Reijo Sund, Anne Ahtikoski, Ulla Puistola, Esa Läärä, Peeter Karihtala and 1 more

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In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Sequencing of high-frequency mutated genes in breast cancer (BRCA) and associated-functions analysis.International journal of clinical and experimental pathology · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. RETRACTED: Metformin and Breast Cancer: Where Are We Now?International journal of molecular sciences · 2022
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mayu HosioDepartment of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 22, 90029, Oulu, Finland. hosiomayu@gmail.com.
Elina UrpilainenDepartment of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 23, 90029, Oulu, Finland.
Ari HautakoskiResearch Unit of Mathematical Sciences, University of Oulu, PO Box 3000, 90014, Oulu, Finland.
Mikko MarttilaOrion Corporation, Orionintie 1, PO Box 65, 02101, Espoo, Finland.
Martti ArffmanService System Research Unit, Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
Reijo SundInstitute of Clinical Medicine, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland.
Anne AhtikoskiCancer and Translational Medicine Research Unit, Department of Pathology, Oulu University Hospital and University of Oulu, PO Box 50, 90029, Oulu, Finland.
Ulla PuistolaDepartment of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 23, 90029, Oulu, Finland.
Esa LääräResearch Unit of Mathematical Sciences, University of Oulu, PO Box 3000, 90014, Oulu, Finland.
Peeter KarihtalaDepartment of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 22, 90029, Oulu, Finland.
Arja JukkolaDepartment of Oncology and Radiotherapy, Cancer Center Tampere, Tampere University Hospital, Tampere, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We investigated the survival of female patients with pre-existing type 2 diabetes (T2D) diagnosed with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast, in relation to the use of metformin, other antidiabetic medication (ADM) and statins. The study cohort consisted of 3,165 women (2,604 with IDC and 561 with ILC). The cumulative mortality from breast cancer (BC) and from other causes was calculated using the Aalen-Johansen estimator. The cause-specific mortality rates were analysed by Cox models, and adjusted hazard ratios (HRs) were estimated for the use of different medications. No evidence of an association of metformin use with BC mortality was observed in either IDC (HR 0.92, 95% confidence interval [CI] 0.64-1.31) or ILC (HR 0.68, 95% CI 0.32-1.46) patients, when compared to other oral ADMs. The mortality from other causes was found to be lower amongst the IDC patients using metformin (HR 0.64, 95% CI 0.45-0.89), but amongst ILC patients the evidence was inconclusive (HR 1.22, 95% CI 0.64-2.32). Statin use was consistently associated with reduced mortality from BC in IDC patients (HR 0.77, 95% CI 0.62-0.96) and ILC patients (HR 0.59, 95% CI 0.37-0.96), and also mortality from other causes in IDC patients (HR 0.81, 95% CI 0.67-0.96) and in ILC patients (HR 0.66, 95% CI 0.43-1.01). We found no sufficient evidence for the possible effects of metformin and statins on the prognosis of BC being different in the two histological subtypes.

Indexed as

AdultAgedAged, 80 and overBreast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypoglycemic AgentsMiddle AgedPrognosisRegistriesSurvival AnalysisHydroxymethylglutaryl-CoA Reductase InhibitorsHypoglycemic Agents

Identifiers

PMID34001921
PMCPMC8129135

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.