Skip to main content

Advertisement

SpringerLink
Log in

Obesity, Metabolic Syndrome, and Breast Cancer: From Prevention to Intervention

  • Breast Cancer Surgery (J. Tchou, Section Editor)
  • Published:
Current Surgery Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Obesity contributes to an estimated forty-percent, or 630,000 cases, of malignant neoplasms diagnosed in the United States, and higher body mass index (BMI) has been associated with at least seventeen types of solid tumors, including 9% of all breast cancer cases. In this review, we discuss the impact of obesity and consequences of obesity, including the metabolic syndrome and type 2 diabetes mellitus, on breast cancer risk and recurrence.

Recent findings

Recent work has identified multiple molecular mechanisms that may underlie the association between obesity and breast cancer. In particular, insulin resistance, increased inflammatory cytokines, leptin signaling, and adipokine signaling have been shown to affect breast cancer risk and outcomes. While obesity is associated with higher breast cancer incidences and worse breast cancer outcomes, several risk reduction methods have been shown to attenuate these risks. Both metformin and statins have been shown to improve disease-free survival and overall survival compared to non-users. Metformin also has been associated with lower risk of breast cancer incidence. Furthermore, increased physical activity and weight loss have been shown to decrease the risk of breast cancer, especially in post-menopausal women.

Summary

These studies have emphasized the potential impact that lifestyle changes can have on breast cancer risk and outcomes, and demonstrate the need for randomized control trials to evaluate the roles of metformin and statins for the treatment and chemoprevention of breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. CDC. CDC Vital Signs [Internet]. 2017. Available from: https://www.cdc.gov/vitalsigns/.

  2. Breast Cancer Risk Factors: Genetics.

  3. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet (London, England). Elsevier. 2014 [cited 2017 Nov 3];384:755–65. http://www.ncbi.nlm.nih.gov/pubmed/25129328.

  4. Howell A, Anderson AS, Clarke RB, Duffy SW, Evans DG, Garcia-Closas M, et al. Risk determination and prevention of breast cancer. Breast Cancer Res. 2014;16(5):446.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Osaki Y, Taniguchi S, Tahara A, Okamoto M, Kishimoto T. Metabolic syndrome and incidence of liver and breast cancers in Japan. Cancer Epidemiol. 2012;36:141–7.

    Article  PubMed  Google Scholar 

  6. Bhandari R, Kelley GA, Hartley TA, Rockett IRH. Metabolic syndrome is associated with increased breast cancer risk: a systematic review with meta-analysis. Int J Breast Cancer. 2014;2014:1–13.

    Article  Google Scholar 

  7. Health United States Report 2016. 2016.

  8. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington DC, 2007.

  9. Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE. Adult Weight change and risk of postmenopausal breast cancer. JAMA. 2006;296:193–201.

    Article  CAS  PubMed  Google Scholar 

  10. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005–2014. JAMA. 2016 [cited 2017 Dec 2];315:2284. http://www.ncbi.nlm.nih.gov/pubmed/27272580.

  11. National Diabetes Statistics Report, 2017 estimates of diabetes and Its burden in the United States Background. 2017.

  12. Harlan DM, Giovannucci E, Archer MC, Bergenstal RM, Gapstur SM, Habel LA. Diabetes and cancer: a consensus report. CA. 2010;60:207–21.

    PubMed  Google Scholar 

  13. Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121:856–62.

    Article  CAS  PubMed  Google Scholar 

  14. Boyle P, Boniol M, Koechlin A, Robertson C, Valentini F, Coppens K, et al. Diabetes and breast cancer risk: a meta-analysis. Br J Cancer. 2012;107:1608–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Michels KB, Solomon CG, Hu FB, Rosner BA, Hankinson SE, Colditz GA, et al. Type 2 diabetes and subsequent incidence of breast cancer in the Nurses’ Health Study. Diabetes Care. 2003;26:1752–8.

    Article  PubMed  Google Scholar 

  16. Mauro L, Naimo GD, Ricchio E, Panno ML, Andò S. Cross-talk between adiponectin and IGF-IR in breast cancer. Front Oncol. 2015;5:157.

    Article  PubMed  PubMed Central  Google Scholar 

  17. • Huang J, Li L, Lian J, Schauer S, Vesely PW, Kratky D, et al. Tumor-induced hyperlipidemia contributes to tumor growth. Cell Rep. 2016 [cited 2017 Dec 3];15:336–48. http://www.ncbi.nlm.nih.gov/pubmed/27050512.

  18. Sun K, Kusminski CM, Scherer PE. Adipose tissue remodeling and obesity. J Clin Invest. 2011 [cited 2017 Dec 3];121:2094–101. http://www.ncbi.nlm.nih.gov/pubmed/21633177.

  19. Parsons DW, Jones S, Zhang X, Lin JC-H, Leary RJ, Angenendt P, et al. An integrated genomic analysis of human glioblastoma multiforme. Science. 2008 [cited 2017 Dec 18];321:1807–12. http://www.ncbi.nlm.nih.gov/pubmed/18772396.

  20. Chan LN, Chen Z, Braas D, Lee J-W, Xiao G, Geng H, et al. Metabolic gatekeeper function of B-lymphoid transcription factors. Nature. 2017 [cited 2017 Dec 18];542:479–83. http://www.nature.com/doifinder/10.1038/nature21076.

  21. Vander Heiden MG. Targeting cancer metabolism: a therapeutic window opens. Nat. Rev. Drug Discov. 2011 [cited 2017 Dec 18];10:671–84. http://www.ncbi.nlm.nih.gov/pubmed/21878982.

  22. Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Ins. 2009;101:48–60.

    Article  CAS  Google Scholar 

  23. Khandekar MJ, Cohen P, Spiegelman BM. Molecular mechanisms of cancer development in obesity. Nat Rev Cancer. 2011 [cited 2017 Nov 25];11:886–95. http://www.nature.com/doifinder/10.1038/nrc3174.

  24. • Freese KE, Kokai L, Edwards RP, Philips BJ, Sheikh MA, Kelley J, et al. Adipose-derived stems cells and their role in human cancer development, growth, progression, and metastasis: a systematic review. Cancer Res. 2015 [cited 2017 Dec 18];75:1161–8. http://www.ncbi.nlm.nih.gov/pubmed/25736688.

  25. VanSaun MN. Molecular pathways: adiponectin and leptin signaling in cancer. Clin Cancer Res. 2013 [cited 2017 Dec 18];19:1926–32. http://www.ncbi.nlm.nih.gov/pubmed/23355630.

  26. Saxena NK, Sharma D. Leptin-signaling pathways as therapeutic targets in cancer. Springer, Cham. 2017 [cited 2017 Nov 3]. p. 67–87. http://link.springer.com/10.1007/978-3-319-41677-9_4.

  27. Erkasap N, Ozkurt M, Erkasap S, Yasar F, Uzuner K, Ihtiyar E, et al. Leptin receptor (Ob-R) mRNA expression and serum leptin concentration in patients with colorectal and metastatic colorectal cancer. Braz J Med Biol Res. 2013 [cited 2017 Nov 3];46:306–10. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2013000300306&lng=en&tlng=en.

  28. Teraoka N, Mutoh M, Takasu S, Ueno T, Nakano K, Takahashi M, et al. High susceptibility to azoxymethane-induced colorectal carcinogenesis in obese KK-Ay mice. Int J Cancer. 2011 [cited 2017 Nov 30];129:528–35. http://doi.wiley.com/10.1002/ijc.25711.

  29. Arita S, Kinoshita Y, Ushida K, Enomoto A, Inagaki-Ohara K. High-fat diet feeding promotes stemness and precancerous changes in murine gastric mucosa mediated by leptin receptor signaling pathway. Arch Biochem Biophys. 2016 [cited 2017 Nov 30];610:16–24. http://www.ncbi.nlm.nih.gov/pubmed/27693038.

  30. Tamakoshi K, Toyoshima H, Wakai K, Kojima M, Suzuki K, Watanabe Y, et al. Leptin Is Associated with an increased female colorectal cancer risk: a nested case-control study in Japan. Oncology. 2005 [cited 2017 Nov 30];68:454–61. http://www.ncbi.nlm.nih.gov/pubmed/16020976.

  31. Park J, Kusminski CM, Chua SC, Scherer PE. Leptin receptor signaling supports cancer cell metabolism through suppression of mitochondrial respiration in Vivo. Am J Pathol. 2010 [cited 2017 Dec 1];177:3133–44. http://www.ncbi.nlm.nih.gov/pubmed/21056997.

  32. Amemori S, Ootani A, Aoki S, Fujise T, Shimoda R, Kakimoto T, et al. Adipocytes and preadipocytes promote the proliferation of colon cancer cells in vitro. AJP Gastrointest Liver Physiol. 2006 [cited 2017 Dec 1];292:G923–9. http://www.ncbi.nlm.nih.gov/pubmed/17170030.

  33. Deng T, Lyon CJ, Bergin S, Caligiuri MA, Hsueh WA. Obesity, inflammation, and cancer. Annu Rev Pathol Mech Dis. 2016 [cited 2017 Nov 3];11:421–49. http://www.annualreviews.org/doi/10.1146/annurev-pathol-012615-044359.

  34. Goldacre MJ, Wotton CJ, Yeates D, Seagroatt V, Jewell D. Cancer in patients with ulcerative colitis, Crohnʼs disease and coeliac disease: record linkage study. Eur J Gastroenterol Hepatol. 2008 [cited 2017 Dec 3];20:297–304. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00042737-200804000-00009.

  35. Frisch M, Biggar RJ, Engels EA, Goedert JJ, Group for the A-CMRS. Association of cancer with AIDS-related immunosuppression in adults. JAMA. American Medical Association. 2001 [cited 2017 Dec 3];285:1736. http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.285.13.1736.

  36. Durán HA, de Rey BM. Differential oxidative stress induced by two different types of skin tumor promoters, benzoyl peroxide and 12-O-tetradecanoylphorbol-13-acetate. Carcinogenesis. 1991 [cited 2017 Nov 3];12:2047–52. http://www.ncbi.nlm.nih.gov/pubmed/1934290.

  37. McCreery MQ, Halliwill KD, Chin D, Delrosario R, Hirst G, Vuong P, et al. Evolution of metastasis revealed by mutational landscapes of chemically induced skin cancers. Nat Med. 2015 [cited 2017 Nov 3];21:1514–20. http://www.ncbi.nlm.nih.gov/pubmed/26523969.

  38. Rehman I, Lowry DT, Adams C, Abdel-Fattah R, Holly A, Yuspa SH, et al. Frequent codon 12 Ki-ras mutations in mouse skin tumors initiated by N-methyl-N?-nitro-N-nitrosoguanidine and promoted by mezerein. Mol Carcinog. 2000 [cited 2017 Dec 1];27:298–307. http://doi.wiley.com/10.1002/%28SICI%291098-2744%28200004%2927%3A4%3C298%3A%3AAID-MC8%3E3.0.CO%3B2-4.

  39. Dong Y, Sun Q, Zhang X. PD-1 and its ligands are important immune checkpoints in cancer. Oncotarget. 2017 [cited 2017 Nov 3];8:2171–86. http://www.ncbi.nlm.nih.gov/pubmed/27974689.

  40. Yan H, Parsons DW, Jin G, McLendon R, Rasheed BA, Yuan W, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med. 2009 [cited 2017 Nov 3];360:765–73. http://www.ncbi.nlm.nih.gov/pubmed/19228619.

  41. McTiernan A, Rajan KB, Tworoger SS, Irwin M, Bernstein L, Baumgartner R, et al. Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol. 2003;21:1961–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst. 2003;95:1218–26.

    Article  CAS  PubMed  Google Scholar 

  43. Fuhrman BJ, Schairer C, Gail MH, Boyd-Morin J, Xu X, Sue LY, et al. Estrogen metabolism and risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 2012;104:326–39.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Gershuni V, Li YR, Williams AD, So A, Steel L, Carrigan E, et al. Breast cancer subtype distribution is different in normal weight, overweight, and obese women. Breast Cancer Res Treat. 2017 [cited 2017 Mar 21];163. http://link.springer.com/10.1007/s10549-017-4192-x.

  45. •• Ligibel JA, Cirrincione CT, Liu M, Citron M, Ingle JN, Gradishar W, et al. Body Mass Index, PAM50 subtype, and outcomes in node-positive breast cancer: CALGB 9741 (Alliance). J Natl Cancer Inst. Oxford University Press. 2015;107.

  46. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:2479–86.

    Article  CAS  PubMed  Google Scholar 

  47. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, et al. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 2008;26:3958–64.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol. 2014;25:1293–311.

    Article  CAS  PubMed  Google Scholar 

  49. •• Sonnenblick A, Agbor-Tarh D, Bradbury I, Di Cosimo S, Azim HA, Fumagalli D, et al. Impact of diabetes, insulin, and metformin use on the outcome of patients with human epidermal growth factor receptor 2-positive primary breast cancer: analysis from the ALTTO Phase III Randomized Trial. J Clin Oncol, American Society of Clinical Oncology. 2017;35:1421–9.

  50. Kaplan MA, Pekkolay Z, Kucukoner M, İnal A, Urakci Z, Ertugrul H, et al. Type 2 diabetes mellitus and prognosis in early stage breast cancer women. Med Oncol. 2012;29:1576–80.

    Article  PubMed  Google Scholar 

  51. Li CI, Daling JR, Tang MTC, Malone KE. Relationship between diabetes and risk of second primary contralateral breast cancer. Breast Cancer Res Treat. 2011;125:545–51.

    Article  PubMed  Google Scholar 

  52. Srokowski TP, Fang S, Hortobagyi GN, Giordano SH. Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. J Clin Oncol. 2009;27:2170–6.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Zhang Z-J, Li S. The prognostic value of metformin for cancer patients with concurrent diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. 2014;16:707–10.

    Article  CAS  PubMed  Google Scholar 

  54. Jiralerspong S, Palla SL, Giordano SH, Meric-Bernstam F, Liedtke C, Barnett CM, et al. Metformin and pathologic complete responses to neoadjuvant chemotherapy in diabetic patients with breast cancer. J Clin Oncol. 2009;27:3297–302.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Hadad S, Iwamoto T, Jordan L, Purdie C, Bray S, Baker L, et al. Evidence for biological effects of metformin in operable breast cancer: a pre-operative, window-of-opportunity, randomized trial. Breast Cancer Res Treat. 2011;128:783–94.

    Article  CAS  PubMed  Google Scholar 

  56. Ahern TP, Lash TL, Damkier P, Christiansen PM, Cronin-Fenton DP. Statins and breast cancer prognosis: evidence and opportunities. Lancet Oncol. 2014;15:461–8. https://doi.org/10.1016/S1470-2045(14)70119-6.

    Article  Google Scholar 

  57. Murtola TJ, Visvanathan K, Artama M, Vainio H, Pukkala E. Statin use and breast cancer survival: a nationwide cohort study from Finland. PLoS ONE. 2014;9:e110231. https://doi.org/10.1371/journal.pone.0110231.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Ahern TP, Pedersen L, Tarp M, Cronin-Fenton DP, Garne JP, Silliman RA, et al. Statin prescriptions and breast cancer recurrence risk: a Danish nationwide prospective cohort study. J Natl Cancer Inst. 2011;103:1461–8. https://doi.org/10.1093/jnci/djr291.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. •• Borgquist S, Giobbie-Hurder A, Ahern TP, Garber JE, Colleoni M, Láng I, et al. Cholesterol, cholesterol-lowering medication use, and breast cancer outcome in the BIG 1-98 Study. J Clin Oncol. 2017;35:1179–88.

  60. Wang A, Aragaki AK, Tang JY, Kurian AW, Manson JE, Chlebowski RT, et al. Statin use and all-cancer survival: prospective results from the women’s health initiative. Br J Cancer. 2016;115:129–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Keyomarsi K, Sandoval L, Band V, Pardee AB. Synchronization of tumor and normal cells from G1 to multiple cell cycles by lovastatin. Cancer Res. 1991;51:3602–9.

    CAS  PubMed  Google Scholar 

  62. Agarwal B, Bhendwal S, Halmos B, Moss SF, Ramey WG, Holt PR. Lovastatin augments apoptosis induced by chemotherapeutic agents in colon cancer cells. Clin Cancer Res. 1999;5:2223–9.

    CAS  PubMed  Google Scholar 

  63. Padayatty SJ, Marcelli M, Shao TC, Cunningham GR. Lovastatin-induced apoptosis in prostate stromal cells. J Clin Endocrinol Metab. 1997;82:1434–9.

    Article  CAS  PubMed  Google Scholar 

  64. Kusama T, Mukai M, Iwasaki T, Tatsuta M, Matsumoto Y, Akedo H, et al. Inhibition of epidermal growth factor-induced RhoA translocation and invasion of human pancreatic cancer cells by 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibitors. Cancer Res. 2001;61:4885–91.

    CAS  PubMed  Google Scholar 

  65. Seeger H, Wallwiener D, Mueck A. Statins can inhibit proliferation of human breast cancer cells in Vitro. Exp Clin Endocrinol. 2003;111:47–8.

  66. Matthews SB, Thompson HJ. The obesity-breast cancer conundrum: an analysis of the issues. Int J Mol Sci. 2016;17.

  67. • Hardefeldt PJ, Penninkilampi R, Edirimanne S, Eslick GD. Physical activity and weight loss reduce the risk of breast cancer: a meta-ANALYSIS of 139 prospective and retrospective studies. Clin. Breast Cancer. 2017

  68. •• Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ. British Medical Journal Publishing Group. 2016;354:i3857.

  69. Bardia A, Hartmann LC, Vachon CM, Vierkant RA, Wang AH, Olson JE, et al. Recreational physical activity and risk of postmenopausal breast cancer based on hormone receptor status. Arch Intern Med, American Medical Association. 2006;166:2478.

  70. • Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? a harmonised meta-analysis of data from more than 1 million men and women. Lancet. Elsevier. 2016;388:1302–10.

  71. • Moore SC, Lee I-M, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176:816.

  72. McTiernan A, Tworoger SS, Ulrich CM, Yasui Y, Irwin ML, Rajan KB, et al. Effect of exercise on serum estrogens in postmenopausal women: a 12-month randomized clinical trial. Cancer Res. 2004;64:2923–8.

    Article  CAS  PubMed  Google Scholar 

  73. Fisher B, Costantino JP, Wickerham DL, Cecchini RS, Cronin WM, Robidoux A, et al. Tamoxifen for the prevention of breast cancer: current status of the national surgical adjuvant breast and Bowel Project P-1 Study. JNCI J Natl Cancer Inst. 2005;97:1652–62.

    Article  CAS  PubMed  Google Scholar 

  74. Bodmer M, Meier C, Krahenbuhl S, Jick SS, Meier CR. Long-term metformin use is associated with decreased risk of breast cancer. Diabetes Care. 2010;33:1304–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Currie CJ, Poole CD, Gale EAM. The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia. 2009;52:1766–77.

    Article  CAS  PubMed  Google Scholar 

  76. Quinn BJ, Kitagawa H, Memmott RM, Gills JJ, Dennis PA. Repositioning metformin for cancer prevention and treatment. Trends Endocrinol Metab. 2013;24:469–80.

    Article  CAS  PubMed  Google Scholar 

  77. Chae YK, Arya A, Malecek M-K, Shin DS, Carneiro B, Chandra S, et al. Repurposing metformin for cancer treatment: current clinical studies. Oncotarget. 2016;7:40767–80.

    PubMed  PubMed Central  Google Scholar 

  78. Martinez JA, Chalasani P, Thomson CA, Roe D, Altbach M, Galons J-P, et al. Phase II study of metformin for reduction of obesity-associated breast cancer risk: a randomized controlled trial protocol. BMC Cancer. 2016;16:500.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Undela K, Srikanth V, Bansal D. Statin use and risk of breast cancer: a meta-analysis of observational studies. Breast Cancer Res Treat. 2012;135:261–9.

    Article  CAS  PubMed  Google Scholar 

  80. Bonovas S, Filioussi K, Tsavaris N, Sitaras NM. Use of statins and breast cancer: a meta-analysis of seven randomized clinical trials and nine observational studies. J Clin Oncol. 2005;23:8606–12.

    Article  PubMed  Google Scholar 

  81. Kuoppala J, Lamminpää A, Pukkala E. Statins and cancer: a systematic review and meta-analysis. Eur J Cancer. 2008;44:2122–32.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrine and Oncologic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 10th Floor South, Philadelphia, PA, 19104, USA

    Yun Rose Li, Vicky Ro & Julia C. Tchou

  2. Department of Radiation Oncology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, 94143, USA

    Yun Rose Li

Authors
  1. Yun Rose Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vicky Ro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julia C. Tchou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julia C. Tchou.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest relevant to this manuscript.

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.

Additional information

This article is part of the Topical collection on Breast Cancer Surgery.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Y.R., Ro, V. & Tchou, J.C. Obesity, Metabolic Syndrome, and Breast Cancer: From Prevention to Intervention. Curr Surg Rep 6, 7 (2018). https://doi.org/10.1007/s40137-018-0204-y

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s40137-018-0204-y

Keywords

Search

Navigation