Document Type : Research Article
Authors
1
Clinical Assistant Professor. Howard University College of Pharmacy, Clinical and Administrative Pharmacy Sciences. Washington, DC.
2
Professor. Howard University College of Pharmacy, Clinical and Administrative Pharmacy Sciences. Washington, DC.
3
Ambulatory Clinical Pharmacist, Yale New Haven Health, 789 Howard Ave, New Haven, CT
4
Assistant Professor. Howard University College of Pharmacy, Clinical and Administrative Pharmacy Sciences. Washington, DC.
5
PGY1 Resident. Philadelphia VA Medical Center. Philadelphia, PA.
10.21608/aprh.2025.399413.1326
Abstract
Background: Metabolic Syndrome (MS) is a cluster of chronic conditions characterized by the co-occurrence of at least three out of five clinical risk factors: central obesity, hyperglycemia, hypertension, elevated circulating triglycerides, and low high-density lipoprotein (HDL) levels. MS is a well-established precursor to cardiovascular disease and type 2 diabetes mellitus (DM), but emerging evidence also links MS-related pathways, particularly those involving obesity and hyperglycemia, to increased breast cancer (BC) risk and tumor progression. Despite this growing body of literature, there remains a significant gap in understanding the interplay between MS components and BC progression among Black women, a population disproportionately affected by both MS and adverse breast cancer outcomes. Objective: This study aims to evaluate the relationship between DM and BC among Black women in an ambulatory care setting, with a specific focus on the timing of diabetes onset in relation to BC diagnosis and treatment. Methods: We conducted a retrospective, longitudinal cohort study using medical records from an outpatient oncology clinic in an urban university hospital. The study population included self-identified Black women who were diagnosed with BC between the ages of 18 and above and received care at our institution over a three-year period. Data extracted included age at BC diagnosis, diabetes status, body mass index (BMI), timing of diabetes onset, and treatment history, including chemotherapy and hormonal therapy. Results: Among the study cohort, the median age of BC diagnosis in Black women was 60 years, which is notably younger than the average age of BC diagnosis in the general global population. Only 24% of the Black women with BC had a prior diagnosis of diabetes at the time of cancer diagnosis, while the remaining 76% were non-diabetic. Interestingly, 71% of the women who had both BC and DM developed diabetes only after the diagnosis of BC and initiation of hormonal therapy, suggesting a potential iatrogenic or disease-related metabolic shift. Additionally, 71% of the total BC patients in the cohort were overweight (BMI ≥ 25 kg/m²), and 34% of them were categorized as obese (BMI ≥ 30 kg/m²), further supporting the hypothesis that excess weight plays a pivotal role in the development of both BC and DM. Conclusions: Our findings suggest that while a minority of Black women with BC had pre-existing diabetes, the majority developed DM after their diagnosis of BC and initiation of hormonal therapy, indicating a possible treatment-related or disease-associated onset. Furthermore, the high prevalence of overweight and obesity in the cohort underscores the role of excess adiposity as a central driver in the development of breast cancer and subsequent metabolic disturbances. These results emphasize the need for proactive metabolic screening and weight management interventions in Black women diagnosed with BC, particularly during and after cancer treatment, to mitigate the risk of DM and improve long-term health outcomes.
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