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Clinical Studies Examining the Impact of Obesity on Breast Cancer Risk and Prognosis

  • Rishi Jain
  • Howard D. Strickler
  • Eugene Fine
  • Joseph A. Sparano
Article

Abstract

Obesity is associated with an increased risk of breast cancer, and increased risk of recurrence in women who develop breast cancer. Evidence suggests that the risk of estrogen-receptor (ER)-positive breast cancer is increased in obese postmenopausal women, whereas in premenopausal women the risk of triple negative breast cancer is increased. Nonetheless, the presence of obesity at diagnosis, and possibly weight gain after diagnosis, may independently contribute to an individual’s risk of recurrence of both pre- and postmenopausal breast cancer. Factors associated with adiposity that are likely contributing factors include hyperinsulinemia, inflammation, and relative hyperestrogenemia. Some studies suggest that some aromatase inhibitors may be less effective in obese women than lean women. Clinical trials have evaluated pharmacologic (eg, metformin) and dietary/lifestyle interventions to reduce breast cancer recurrence, although these interventions have not been tested in obese women who may be most likely to benefit from them. Further research is required in order to identify adiposity-associated factors driving recurrence, and design clinical trials to specifically test interventions in obese women at highest risk of recurrence.

Keywords

Obesity Breast cancer Body mass index Prognosis Recurrence 

Abbreviations

BCSS

breast cancer specific survival

BMI

body mass index

CI

confidence interval

DFS

disease free survival

ER

estrogen receptor

FDG-PET

fluorodeoxyglucose positron emission

HER2

human epidermal growth factor receptor 2

HOMA

homeostasis model assessment

HR

hazard ratio

IGF

insulin-like growth factor

LC

low carbohydrate

mTOR

mammalian target of rapamycin

OR

odds ratio

OS

overall survival

PI3K

phosphoinositide 3-kinase

RFS

relapse free survival

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Rishi Jain
    • 1
  • Howard D. Strickler
    • 2
  • Eugene Fine
    • 3
  • Joseph A. Sparano
    • 4
    • 5
  1. 1.Department of MedicineMontefiore Medical Center, Albert Einstein College of MedicineBronxUSA
  2. 2.Department of Epidemiology and Population HealthMontefiore Medical Center, Albert Einstein College of MedicineBronxUSA
  3. 3.Department of Radiology, Division of Nuclear MedicineMontefiore Medical Center, Albert Einstein College of MedicineBronxUSA
  4. 4.Department of Medicine/OncologyMontefiore Medical Center, Albert Einstein College of MedicineBronxUSA
  5. 5.Weiler DivisionMontefiore Medical CenterBronxUSA

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