Impact of distinct insulin index on neoadjuvant treatment of breast cancer: A clinical retrospective study.

A combination of glucose and lipid metabolism, insulin resistance (IR) is correlated with the outcome of neoadjuvant treatment (NAT) for breast cancer. The purpose of this research sought to explore how IR affects breast cancer patients' reactions after NAT. We gathered 132 individuals with breast cancer who had surgery after NAT. Continuous values were analyzed using the Wilcoxon (Mann-Whitney) test and independent samples t test; pathological complete response (PCR)-related independent influencing factors were investigated using the binary logistic regression model; and the predictive value of each index on the effectiveness of NAT was assessed using subject work characteristics (receiver operating characteristic) curves. Compared with the non-PCR group, the PCR group's IR levels were lower. Baseline IR levels and NAT effectiveness did not significantly correlate, according to multifactorial logistic analysis (P > .05). Nevertheless, there was a negative correlation (P < .05) between PCR and total cholesterol (TC)/high-density lipoprotein (HDL) and MetS-IR levels following NAT. According to the receiver operating characteristic curve prediction model, TC/HDL had a greater predictive value than MetS-IR. Dynamic IR indicators (ΔTC/HDL and ΔMetS-IR) demonstrate predictive value for NAT response in breast cancer, mechanistically linked to lipid metabolism reprogramming and immunosuppressive tumor microenvironment. Future multicenter studies should validate optimal thresholds and investigate combined metabolic-immune targeted therapeutic strategies.