The Effects of Diabetes and Fasting Plasma Glucose on Treatment of Breast Cancer With Neoadjuvant Chemotherapy

Abstract

Purpose: To determine the effects of diabetes and fasting plasma glucose (FPG) level on the pathologic response in patients with breast cancer who received neoadjuvant chemotherapy. Methods: One hundred and thirty-five patients files who received neoadjuvant chemotherapy between 2013 and 2017 years, were scanned. Pathologic responses, diabetes, and FPG dates of patients were reached from archive files. Patients were grouped as diabetic and nondiabetic. Results: Patients with higher than 90% pathologically response according to Miller-Payne grading system, constituted 11 (44%) and 61 (55.5%) of patients: patients with equally or lower than 90% pathologically response were 14 (56%) and 49 (44.5%) and the number of patients with nonpathologic response 5 (20%) and 2 (1.8%) in diabetic and nondiabetic group, respectively. This difference between diabetic and nondiabetic groups was statistically significant (P=0.005). In Miller-Payne groups, the median FPG levels were 135 mg/dl (165.6 +/- 86.5), 96 mg/dl (110.0 +/- 30.6), 97 mg/dl (101.9 +/- 23.9). 91.5 mg/dl (102.5 +/- 44.3) and 93.5 mg/dl (112.0 +/- 61.2) respectively 0%, 1%-30%, 31%-90%, 91%-99%, and 100%. Patients with lower 91% pathologic response had statistically significant higher FPG levels compared with patients with higher patholocig response (P= 0.008). The cut-of FPG value to determine nonpathologic response was calculated 105 mg/dl (sensitivity 85.7% specificity 74.2%). The FPG, diabetes, lymph node positivity, and disease stage were statistically significant in the multivariate analysis for affecting non-pathologic response (P= 0.013, P=0.016, P= 0.036, and P=0.035 respectively). Conclusion: Diabetes and high FPG level may be predictive to the non-response of neoadjuvant chemotherapy in patients with breast cancer. (C) 2019 Elsevier Inc. All rights reserved.