Oncologie

, Volume 11, Issue 4, pp 236–242

Impact de l’alimentation sur le pronostic du cancer du sein

  • M. Gerber
Synthèse / Review Article
  • 79 Downloads

Résumé

Il est maintenant reconnu qu’une corpulence élevée, signe de surpoids ou d’obésité, est associée à un pronostic aggravé en cas de cancer du sein. Il est probable que cet effet défavorable s’exerce quel que soit l’âge au diagnostic, avec cependant une réserve pour les patientes âgées de 85 ans et plus, pour lesquelles un index de masse corporelle (IMC) inférieur à 25 peut être associéà une fragilité. Il n’est pas encore certain que les patientes qui prennent du poids après le diagnostic soient plus à risque, même si cet effet est suggéré par une large étude prospective. Il est largement admis que le tissu adipeux puisse être une source extragonadale d’estrogènes, via l’aromatisation des stéroïdes. Cependant, l’hyperinsulinémie, capable de stimuler la prolifération tumorale, apparaît comme une cible potentielle d’intervention. Dans l’état actuel des connaissances, une restriction calorique avec perte de poids apparaît comme la meilleure piste nutritionnelle pour améliorer le pronostic de cancer du sein chez les patientes en surpoids ou obèses, qui peut encore être amélioré par l’activité physique.

Mots clés

Cancer du sein Obésité Surpoids Lipides Fibres Récidive mortalité 

Impact of nutrition on breast cancer prognosis

Abstract

It is generally recognised that overweight and obesity at the time of diagnosis are risk factors for breast cancer recurrence and mortality. This effect is likely to be observed whatever the age at the time of diagnosis, except that for women aged 85 and over, a low BMI might cause frailty. A large prospective study indicated that an increase in weight after diagnosis is also a risk factor for recurrence and breast cancer mortality. Such an observation awaits confirmation. Adipose tissue is a source of estrogen synthesis through the activity of aromatase on steroids. However, high levels of insulin, as found in metabolic syndrome, can stimulate tumour cell proliferation and might therefore be a target for lifestyle intervention. Currently, calorific restriction with weight loss has been shown to be the most successful nutritional intervention in overweight or obese women and can be further improved by physical activity.

Keywords

Breast cancer Overweight Obesity Lipids Fibre Recurrences Mortality 

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Copyright information

© Springer Verlag France 2009

Authors and Affiliations

  • M. Gerber
    • 1
  1. 1.Centre de recherche en cancérologieCRLC Val-d’AurelleMontpellier cedex 05France

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