The Association Between Adiposity and Breast Cancer Recurrence and Survival: A Review of the Recent Literature
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Breast cancer (BC) is the most common and second deadliest malignancy among American women. Many factors contribute to BC prognosis, but a key modifiable lifestyle factor is body weight. In this review, we update the reader on the association between adiposity and poor BC outcomes. We summarize the findings from studies that show obesity to be a risk factor for BC recurrence and reduced survival, including research that shows that treatment with aromatase inhibitors in hormone-receptor positive BC survivors who are obese may not be as effective as for normal-weight women. In addition, we summarize the findings from studies that show that obesity-induced changes in glucose metabolism, type-2 diabetes, and metabolic syndrome contribute to negative outcomes in BC survivors. Given the evidence, there is a critical need to determine whether weight loss can improve outcomes in BC survivors.
KeywordsBreast neoplasms Recurrence Survival Mortality Aromatase Aromatase inhibitor Adiposity Obesity Overweight Body fat Body mass index Body weight Insulin Estrogen-receptor positive Hormone-receptor positive Estrogen Glucose Glucose metabolism c-peptide HOMA Type 2 diabetes Metabolic syndrome Hormones
The authors are supported by the following grants from the National Institutes of Health (NIH): R01CA148791, R25CA047888, and P30CA13148.
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Conflict of Interest
Maria Azrad and Wendy Demark-Wahnefried declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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