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Breast cancer in relation to overnutrition

Brustkrebs in Beziehung zu Überernährung

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Zusammenfassung

Übermäßige Nahrungsaufnahme (hauptsächlich tierisches Fett) und Adipositas koinzidieren mit einem erhöhten Brustkrebsrisiko. Die mammäre Karzinogenese in adipösen Frauen ist mit folgenden Parametern in Beziehung gesetzt worden: 1. Nahrungsfett als Überträger von fettlöslichen karzinogenen Substanzen der Umwelt; 2. vom Fett entstammende co-karzinogene Fettsäuren und Sterole; 3. Hypercholesterämie mit erhöhter ovarieller und adrenokortikaler Steroidsynthese (Östrogene, Androgene, Kortisol); 4. reduzierte Umwandlung von Östron in das „Antiöstrogen“ 2-Hydroxy-Östron; 5. erhöhte Umwandlung von Androstendion in das „karzinogene“ Östron (Östradiol) und 6. Schwächung der Immunität. Jedoch ist für keinen dieser karzinogenen Faktoren und Mechanismen, deduziert von epidemiologischen, endokrinologischen und immunologischen Untersuchungen an Mensch und Tier, der kausale Zusammenhang mit der Brustkrebsgenese bewiesen. Demzufolge ist die Beziehung von Ursache und Wirkung hinsichtlich Adipositas und Mammakarzinom nicht geklärt; noch ist das Wechselspiel zwischen ernährungsbedingten, hormonalen und umweltsbedingten Risikofaktoren bekannt. Fortschritt auf dem Gebiet Adipositas und Brustkrebsrisiko erscheint nur möglich, wenn gezielte prospektive Untersuchungen mit bewährten Methoden durchgeführt werden.

Summary

Overnutrition and obesity, mainly due to intake of excess animal fat, have been associated with an increased risk of breast cancer by virtue of: (1) fat serving as a vehicle for fat-soluble environmental carcinogens, (2) fat-derived “cocarcinogenic” fatty acids and sterols, (3) hypercholesterolemia and increased ovarian and adrenocortical steroid synthesis (estrogens, androgens, cortisol), (4) decreased conversion of estrone to the “antiestrogenic” 2-hydroxyestrone, (5) increased conversion of androstenedione to the “carcinogenic” estrone (estradiol), and (6) depression of the immune response. However, the relevance of each of these mechanisms on the risk of breast cancer, remains unclear, despite many epidemiological, endocrinological, and immunological studies in humans and laboratory animals. Thus at present, the cause-effect relationship between overnutrition and breast cancer is not clear, nor is the interplay between nutritional, hormonal, and environmental risk factors of breast cancer understood. It seems that progress regarding overnutrition and risk of breast cancer can be achieved only when the various interrelated factors are evaluated in prospective studies with improved methods.

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  1. Departments of Obstetrics-Gynecology and Pharmacology, The University of New Mexico, School of Medicine, Albuquerque, New Mexico, USA

    H. Vorherr

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Vorherr, H. Breast cancer in relation to overnutrition. Klin Wochenschr 58, 167–171 (1980). https://doi.org/10.1007/BF01476775

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