Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Sep 20, 2025; 15(3): 108318
Published online Sep 20, 2025. doi: 10.5493/wjem.v15.i3.108318
Relationship of diabetes mellitus with prognostic factors in breast cancer
Songul Peltek Ozer, Fatih Keyif, Ferdi Bolat, Bahri Ozer, Gulali Aktas
Songul Peltek Ozer, Department of Pathology, Izzet Baysal Training and Research Hospital, Bolu 14030, Türkiye
Fatih Keyif, Ferdi Bolat, Bahri Ozer, Department of General Surgery, Abant Izzet Baysal University, Bolu 14030, Türkiye
Gulali Aktas, Department of Internal Medicine, Abant Izzet Baysal University, Bolu 14030, Türkiye
Author contributions: Ozer SP contributed to writing the original draft, reviewing, editing, investigation, formal analysis, data curation, and conceptualization; Keyif F contributed to writing the original draft, reviewing, editing, investigation, formal analysis, and data curation; Bolat F contributed to writing, reviewing, editing, methodology, investigation, and conceptualization; Ozer B contributed to conceptualization, methodology, reviewing, editing, and supervision; Aktas G contributed to writing, reviewing, editing, methodology, investigation, conceptualization, and supervision; All authors read and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the institutional ethics committee of the Abant Izzet Baysal University (approval date: 04.03.2025 and approval number: 110).
Informed consent statement: All participants have given informed consent to participate in the study.
Conflict-of-interest statement: All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: Research data related to this work is available by the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gulali Aktas, Professor, Department of Internal Medicine, Abant Izzet Baysal University, Golkoy, Bolu 14030, Türkiye. draliaktas@yahoo.com
Received: April 11, 2025
Revised: April 24, 2025
Accepted: June 13, 2025
Published online: September 20, 2025
Processing time: 123 Days and 23.6 Hours
Abstract
BACKGROUND

Hyperglycemia secondary to diabetes can lead to organ failure unless properly controlled, and it is associated with numerous health issues, particularly metabolic problems. Breast cancer is one of the most common malignancies in females worldwide and represents a major health concern due to its morbidity and mortality. The progression of the disease and the response to treatment depend on numerous variables, including both tumor biology and patient-related factors. Key prognostic indicators include age, tumor size, lymph node involvement, histological type, hormone receptor status, and expression of biomarkers such as HER2.

AIM

To investigate the relationship between preoperative blood glucose levels and cancer prognostic factors in patients diagnosed with breast cancer.

METHODS

In this study patients diagnosed with breast cancer were classified into two groups: Those with blood glucose levels < 125 mg/dL and those with levels > 125 mg/dL. Estrogen and progesterone receptor positivity, Ki-67 percentage, Cerb2 positivity, number of positive lymph nodes, and presence of lymphovascular invasion were examined histopathologically.

RESULTS

The study included 246 patients with breast cancer: 196 were in the normal glucose group and 50 were in the elevated glucose group. In the normal glucose group, 68% of the tumors were left-sided and 32% were right-sided, while all tumors in the elevated glucose group were left-sided. This difference was statistically significant (P < 0.001). Tumor size, Ki-67, and the number of positive lymph nodes were not associated with blood glucose in patients with breast cancer (P > 0.05 for all). However, blood glucose was correlated with age in this population. Correlation analyses revealed that blood glucose was positively correlated with age (r = 0.23, P < 0.001). Additionally, Ki-67 was correlated with tumor size (r = 0.14, P = 0.03) and age (r = -0.18, P = 0.005).

CONCLUSION

Our study highlighted the complex interplay between metabolic factors, such as fasting glucose levels, and breast cancer characteristics. Elevated glucose levels were associated with older age. The significant association between tumor laterality and glucose levels underscores the need for further investigation into the collective influence of metabolic and anatomical factors on breast cancer development and progression.

Keywords: Diabetes mellitus; Breast cancer; Hyperglycemia; Prognosis; Relationship

Core Tip: Hyperglycemia secondary to diabetes can lead to organ failure if not properly controlled and is associated with numerous health complications, particularly metabolic disorders. This study investigated the relationship between preoperative blood glucose levels and cancer prognostic factors in patients diagnosed with breast cancer. The results of the study indicated that tumors in patients with high blood glucose were left sided. The significant association between tumor laterality and glucose levels underscores the need for further investigation into the influence of metabolic and anatomical factors on breast cancer development and progression.