To Study the Association between Metabolic Syndrome and Breast Cancer among Premenopausal Females

Abstract

Metabolic syndrome (MS) (defined as at least three among abdominal obesity, high blood triglycerides, low high-density lipoprotein cholesterol, high blood glucose, and high blood pressure) is emerging as a risk factor for breast cancer; however, few studies – most confined to postmenopausal women – have investigated associations between breast cancer risk and MS. The present research was done to study the association between MS and breast cancer among premenopausal females and also to establish the relationship of MS and other risk factors in this category. The prospective observational study was done at the General Medicine Department, KSSSCI, for a period of 2 years among patients visiting KSSSCI in the Department of Oncosurgery and Medicine Department diagnosed to have clinically/histologically/cytologically confirmed breast cancer. Through convenience sampling, a total of 240 patients of premenopausal (<50 years age); 80 cases (with breast cancer), 160 controls (malignancies other than breast cancer); included on the basis of inclusion and exclusion criteria. Demographic data, lifestyle factors, anthropometric measurements, and metabolic parameters were recorded. MS was defined using the harmonized criteria. Fasting glucose, lipid profile, serum insulin, and Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were assessed. Statistical analysis was performed using SPSS version 20, with P ≤ 0.05 considered statistically significant. MS was significantly more prevalent among breast cancer cases compared to controls (56.3% vs. 21.3%; odds ratio 4.7, 95% confidence interval: 2.6–8.4; P < 0.001). Breast cancer patients exhibited significantly higher fasting glucose, fasting insulin, and HOMA-IR values than controls (mean HOMA-IR: 3.1 ± 1.4 vs. 1.9 ± 0.9; P < 0.001). A higher proportion of cases had HOMA-IR >2.5 (51.3% vs. 18.1%; P < 0.001). In addition, insulin resistance and other metabolic parameters showed a significant positive association with increasing histopathological tumor grade. MS, particularly insulin resistance as reflected by elevated HOMA-IR, is strongly associated with breast cancer in premenopausal women. The severity of insulin resistance appears greater in breast cancer patients compared to premenopausal non-breast cancer counterparts and correlates with tumor aggressiveness. These findings underscore the importance of early identification and management of metabolic abnormalities as potential strategies for breast cancer risk reduction and prognostication in premenopausal females.