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Diabetes Drug Metformin May Cut Breast Cancer Risk in Older Women

June 13, 2012
By

MONDAY, June 11 (HealthDay News) — A widely prescribed drug,
metformin, may lower the risk of invasive breast cancer in postmenopausal
women with diabetes, a new study indicates.

The research, published online June 11 in the Journal of Clinical
Oncology
, echoes other recent studies that have suggested the diabetes
drug may help cut the chances of prostate, pancreatic, liver and oral
cancer, as well as certain forms of melanoma.

The researchers found that the incidence of invasive breast cancer was
25 percent lower in women with diabetes who were taking metformin than it
was in women who weren’t taking the drug.

Approximately 25.8 million people in the United States have diabetes,
according to the U.S. Centers for Disease Control and Prevention. Between
90 percent and 95 percent of these cases are type 2 diabetes, in which the
body’s ability to make and use insulin deteriorates.

“Type 2 diabetes is a disease of insulin resistance,” said study
co-author Dr. Rowan Chlebowski, a medical oncologist with the Los Angeles
Biomedical Research Institute at Harbor-UCLA Medical Center, in Torrance,
Calif.

Insulin is a hormone that helps regulate the level of glucose (sugar)
in the body. With type 2 diabetes, the body manufactures larger quantities
of insulin to maintain normal levels of glucose in the blood.

Metformin, commonly used to treat type 2 diabetes, increases insulin
sensitivity and improves the control of blood sugar. “It makes the insulin
you have more effective,” Chlebowski explained. The drug, approved in the
United Kingdom in 1958 and in Canada in 1972, was introduced in the United
States in 1994.

The new research looked at relationships among diabetes, metformin use
and breast cancer among over 68,000 women between 50 and 79 years old in
the national Women’s Health Initiative project. In this group, 3,401 had
diabetes and 3,273 invasive breast cancers were diagnosed during the
study.

Because of the design of the Women’s Health Initiative trials, detailed
information was available for this large and diverse population in many
areas, including breast cancer risk factors, baseline mammograms, clinical
breast exams and verification of breast cancers when they occurred.
Researchers were also able to know which participants had diabetes —
along with their use of diabetes medication.

The trials excluded women who had already had breast cancer. Women who
had developed diabetes before adulthood (suggesting they were type 1
diabetics) were also excluded from the study.

How can a drug that treats people with high blood sugar play a role in
reducing breast cancer risk? Chlebowski suggested that metformin “may
inhibit the master regulator of the cell, ‘mTOR,’ changing critical
pathways involved in cancer.”

The mTOR pathway is affected by a wide range of cellular signals,
including growth factors, hormones such as insulin, nutrients including
glucose and amino acids, cellular energy levels and stress. A key cell
pathway associated with mTOR is critically involved in cell reproduction
and survival.

Chlebowski and other experts cautioned against looking to metformin as
a cancer prevention drug just yet.

“It’s too soon to change clinical practice,” said Jennifer Ligibel, a
medical oncologist in the Women’s Cancer Program at the Dana-Farber Cancer
Institute in Boston. “While a number of other studies have suggested
metformin has a role in preventing breast cancer and its recurrence, I
would not recommend women take metformin for breast cancer prevention
based on the data we have now.”

As to the question of whether metformin could ever be used more broadly
beyond diabetic patients to reduce the risk of breast cancer, Chlebowski
said the answer is unclear and more studies are necessary to further
analyze the linkage.

While the study uncovered an association between metformin use and
lower breast cancer risk in diabetic postmenopausal women, it did not
prove a cause-and-effect relationship.

The U.S. Food and Drug Administration has issued warnings about
metformin in recent years. It requires product inserts for physicians and
patients to say that the drug has been associated with increased
cardiovascular risks, including heart attack and stroke, and lactic
acidosis, which causes fatigue, muscle pain, difficulty breathing and
other symptoms. The FDA also stipulates that the drug literature include a
warning that the drug should only be used by patients with type 2 diabetes
who cannot control their blood sugar with lifestyle or other
medications.

Article source: http://news.yahoo.com/diabetes-drug-metformin-may-cut-breast-cancer-risk-200607056.html

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  2. Metformin Preferred Drug for Type 2 Diabetes, Experts Say
  3. Diabetes, Obesity After 60 May Drive Up Breast Cancer Risk
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  5. Diabetes drug shows promise in reducing risk of cancer, study suggests
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  7. 6 Things Women Can Do to Lower Breast Cancer Risk
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  9. Drinking Risky for Women With Family History of Breast Cancer: Study
  10. Breast cancer women ‘stop drugs’

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