الفهرس 
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Abstract
This study included 53 Egyptian females who attended to Minia oncology center, with median age 50 (ranged from 35 to 70) years old with biopsy confirmed breast cancer, they sub- grouped into two groups:
• Group-I: included 28 non-diabetic Egyptian females with breast cancer.
• Group-II: 25 Egyptian females with breast cancer and type II diabetes mellitus.
The aim of this study was to evaluate the level of CD44 and ILGF 1 in cancer breast with & without type II diabetes mellitus and to correlate the level of them with the clinicopathological features with cancer breast with and without diabetes mellitus
All participants included in our study were subjected to careful history taking, Anthropometric measurements (Height ,Weight, BMI and waist circumference ) and full clinical examination, laboratory studies included (fasting blood sugar, renal function tests, Complete blood counts and liver function tests),
The immunohistochemical staining of CD44, IGF-1, ER and PR expression was carried out in Multiple breast tissue biopsies obtained from malignant breast tissues and adjacent normal tissues .
Diabetic patients presented with significantly older age (P = 0.009), higher BMI (P = 0.003), higher fasting blood sugar (P = 0.001), larger tumor size (P = 0.009), and greater number of L.N metastasizes (P = 0.006) higher probability for distant Metastasizes (p= 0.003) compared with non-diabetic counterparts.
Diabetic patients significantly produce lesser ER & PR Expression in malignant tissues (p-value= 0.045 & 0.001 respectively) with significantly higher histological grading (p-value= 0.02) compared with non-diabetic patients.
IGF-1R expression in malignant breast tissues compared with normal breast tissues (p = 0.001).
IGF-1R Expression in malignant tissues were significantly higher in diabetic versus non-diabetic patients (p= 0.03).
CD44 Expression in malignant tissues were significantly higher versus normal tissue (p= 0.006).
CD44 Expression in malignant tissues were significantly higher in diabetic versus non-diabetic patients (p= 0.028), also CD44 Expression in normal adipose tissues were significantly higher in diabetic versus non-diabetic groups (p=0.041).
Positive Correlations between CD44 & IGF-1R in both malignant and normal breast tissues (p = <0.001, 0.008, <0.001 & 0.004 respectively) among both diabetic and non-diabetic patients.
IGF-1R expression in malignant breast tissues was negatively correlated with ER & PR expression in malignant breast tissues (p = 0.02 & r = -0.337) & (p = 0.01 & r = - 0.268) respectively, while it was positively correlated with tumor size (p = 0.015 & r = 0.332) and probability of distant cancer metastasis (p = 0.01 & r = 0.272). However, IGF-1R expression was not correlated with breast cancer grading (p=0.81, r=0.03) and L.N Metastasis (p=0.799, r=0.036).
CD44 expression in malignant breast tissues was negatively correlated with ER & PR expression in malignant breast tissues (p = 0.004 & r = - 0.387) & (p = 0.016 & r = - 0.331) respectively, while it was positively correlated with breast cancer grading (p = 0.004 & r = - 0.391) , tumor size (p = 0.031 & r = 0.297) L.N Metastasis (p=0.017, r=0.326)., and probability of distant cancer metastasis (p = 0.01 & r = 0.349).