Grant Number:	1R01CA171558-01 Interpret this number
Primary Investigator:	Bickell, Nina
Organization:	Icahn School Of Medicine At Mount Sinai
Project Title:	Insulin Resistance and Breast Cancer Prognosis in Black & White Women
Fiscal Year:	2012

DESCRIPTION (provided by applicant): Despite improvements in breast cancer diagnosis and treatment, Black women with breast cancer continue to have a worse prognosis than White women. The purpose of this study is to determine whether differences in insulin resistance can explain in part the disparities in breast cancer survival between Black and White women. Insulin resistance is an important component of obesity, the metabolic syndrome and early stage type 2 diabetes, conditions associated with more aggressive breast cancer subtypes and increased mortality. Higher insulin levels in White women have also been associated with increased breast cancer mortality, although this has not been studied in Black women. Given that obesity and diabetes epidemics disproportionately affect minority populations, it is important understand the relationship of hyperinsulinemia, a result of obesity, insulin resistance and increased IR signaling on the progression of breast cancer. Understanding these relationships could explain the different patterns of disease seen in different racial groups and help to identify patients who would benefit from targeted therapy. Our research attempts to address some of these gaps in the literature. We have 2 main aims: Aim 1: To examine whether the association between peripheral insulin resistance and breast cancer with a poor prognosis differs between black and white women. Aim 2: To demonstrate whether the tumor's insulin receptor and / or IGF-1 receptor signaling pathway is associated with poor prognostic features and whether activation of this pathway differs between black and white women. We will recruit 936 white women and 350 black women with a newly diagnosed breast cancer, to investigate the links between insulin resistance, breast cancer aggression, and race. Measures of insulin resistance, the metabolic syndrome and obesity will be collected to investigate whether insulin is a key mechanistic link in the association between obesity and breast cancer aggressivity, and how race affects this association. Blood samples for insulin resistance and anthropometric measures will be taken during the pre-operative evaluation of women with a new primary breast cancer. Samples of breast cancer tissue removed during primary surgical resection will be examined using immunohistochemistry to assess the role of insulin, insulin-like disparities in breast cancer prognosis between racial groups. PUBLIC HEALTH RELEVANCE: The purpose of this study is to determine whether differences in insulin resistance can explain in part the disparities in breast cancer survival between Black and White women. Insulin resistance is an important component of obesity, the metabolic syndrome and early stage type 2 diabetes, conditions associated with more aggressive breast cancer subtypes and increased mortality.




Subjective social status, race, and metabolic syndrome in women with breast cancer.
Authors: Greco G. , Bickell N.A. , Lin S. , Yagnik R. , LeRoith D. , Gallagher E.J. .
Source: Breast Cancer Research And Treatment, 2023-04-23 00:00:00.0; , .
EPub date: 2023-04-23 00:00:00.0.
PMID: 37087701
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Insulin resistance and racial disparities in breast cancer prognosis: a multi-center cohort study.
Authors: Gallagher E.J. , Greco G. , Lin S. , Yagnik R. , Feldman S.M. , Port E. , Friedman N.B. , Boolbol S.K. , Killelea B. , Pilewskie M. , et al. .
Source: Endocrine-related Cancer, 2022-12-01 00:00:00.0; 29(12), p. 693-701.
EPub date: 2022-11-02 00:00:00.0.
PMID: 36197762
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Racial differences in weight perception among Black and White women diagnosed with breast cancer.
Authors: Edmonds M.C. , Bickell N.A. , Gallagher E.J. , LeRoith D. , Lin J.J. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2022-09-28 00:00:00.0; , .
EPub date: 2022-09-28 00:00:00.0.
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Association of Insulin Resistance and Higher Oncotype DX™ Recurrence Score.
Authors: Gordon N.T. , Alberty-Oller J.J. , Fei K. , Greco G. , Gallagher E.J. , LeRoith D. , Feldman S.M. , Killilea B. , Boolbol S.K. , Choi L. , et al. .
Source: Annals Of Surgical Oncology, 2021-04-03 00:00:00.0; , .
EPub date: 2021-04-03 00:00:00.0.
PMID: 33813671
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Insulin resistance contributes to racial disparities in breast cancer prognosis in US women.
Authors: Gallagher E.J. , Fei K. , Feldman S.M. , Port E. , Friedman N.B. , Boolbol S.K. , Killelea B. , Pilewskie M. , Choi L. , King T. , et al. .
Source: Breast Cancer Research : Bcr, 2020-05-12 00:00:00.0; 22(1), p. 40.
EPub date: 2020-05-12 00:00:00.0.
PMID: 32393319
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The effect of modifiable risk factors on breast cancer aggressiveness among black and white women.
Authors: Killelea B.K. , Gallagher E.J. , Feldman S.M. , Port E. , King T. , Boolbol S.K. , Franco R. , Fei K. , Le Roith D. , Bickell N.A. .
Source: American Journal Of Surgery, 2019-07-18 00:00:00.0; , .
EPub date: 2019-07-18 00:00:00.0.
PMID: 31375248
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Statin Use and Breast Cancer Prognosis in Black and White Women.
Authors: Leiter A. , Bickell N.A. , LeRoith D. , Nayak A. , Feldman S.M. , Friedman N.B. , Estabrook A. , King T.A. , Fei K. , Franco R. , et al. .
Source: Hormones & Cancer, 2018 Feb; 9(1), p. 55-61.
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Silencing vimentin expression decreases pulmonary metastases in a pre-diabetic mouse model of mammary tumor progression.
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Type 2 Diabetes Mellitus And Cancer: The Role Of Pharmacotherapy
Authors: Shlomai G. , Neel B. , LeRoith D. , Gallagher E.J. .
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Metabolic syndrome and pre-diabetes contribute to racial disparities in breast cancer outcomes: hypothesis and proposed pathways.
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Source: Diabetes/metabolism Research And Reviews, 2016 Oct; 32(7), p. 745-753.
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Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality.
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