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Obesity and Breast Cancer: A Complex Relationship

  • Breast Cancer Surgery (J. Tchou, Section Editor)
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Abstract

As prevalence of obesity continues to rise in the United States, we are beginning to elucidate the complex role of obesity-associated chronic inflammation, endocrine dysfunction, and hormone production as a driver for increased breast cancer risk. Epidemiological data suggest that obesity (BMI > 30) is associated with increased breast cancer incidence, worse prognosis, and higher mortality rates. Mechanistically, obesity and excess fat mass represent a state of chronic inflammation, insulin resistance, adipokine imbalance, and increased estrogen signaling. This pro-tumorigenic environment stimulates cancer development through abnormal growth, proliferation, and survival of mammary tissue. Importantly, obesity is a modifiable risk factor; alterations in cell proliferation, apoptosis, circulating estrogen, and insulin sensitivity are observed in response to weight loss attainable through behavior modification including dietary and exercise changes.

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References

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

  1. Howlader N, Altekruse SF, Li CI, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;. doi:10.1093/jnci/dju055.

    PubMed  PubMed Central  Google Scholar 

  2. DeSantis CE, Fedewa SA, Goding Sauer A, et al. Breast cancer statistics, 2015: convergence of incidence rates between black and white women. CA Cancer J Clin. 2016;66:31–42. doi:10.3322/caac.21320.

    Article  PubMed  Google Scholar 

  3. McPherson K, Steel CM, Dixon JM. ABC of breast diseases. Breast cancer-epidemiology, risk factors, and genetics. BMJ. 2000;321:624–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ahn J, Schatzkin A, Lacey JV, et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 2007;167:2091–102. doi:10.1001/archinte.167.19.2091.

    Article  PubMed  Google Scholar 

  5. Maehle BO, Tretli S, Skjaerven R, Thorsen T. Premorbid body weight and its relations to primary tumour diameter in breast cancer patients; its dependence on estrogen and progesteron receptor status. Breast Cancer Res Treat. 2001;68:159–69.

    Article  CAS  PubMed  Google Scholar 

  6. Rose DP, Komninou D, Stephenson GD. Obesity, adipocytokines, and insulin resistance in breast cancer. Obes Rev. 2004;5:153–65. doi:10.1111/j.1467-789X.2004.00142.x.

    Article  CAS  PubMed  Google Scholar 

  7. Stewart ST, Cutler DM, Rosen AB. Forecasting the effects of obesity and smoking on U.S. life expectancy. N Engl J Med. 2009;361:2252–60. doi:10.1056/NEJMsa0900459.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lovegrove JA. Obesity, body fat distribution and breast cancer. Nutr Res Rev. 2002;15:389–412. doi:10.1079/NRR200245.

    Article  CAS  PubMed  Google Scholar 

  9. White AJ, Nichols HB, Bradshaw PT, Sandler DP. Overall and central adiposity and breast cancer risk in the Sister Study. Cancer. 2015;121:3700–8. doi:10.1002/cncr.29552.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.

  11. Ogden CL, Carroll MD, Flegal KM. Prevalence of obesity in the United States. JAMA. 2014;312(2):189–90.

    Article  CAS  PubMed  Google Scholar 

  12. Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311:1401–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. ••Goodwin PJ, Stambolic V. Impact of the obesity epidemic on cancer. Annu Rev Med. 2015;66:281–96. Thorough review of the relationship between the obesity epidemic and cancer incidence. Review covers biological plausibility of obesity as a driver and disease modifier of cancer.

  14. Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013;93(1):359–404. doi:10.1152/physrev.00033.2011.

    Article  CAS  PubMed  Google Scholar 

  15. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.

    Article  Google Scholar 

  16. Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist. 2010;15:556–65. doi:10.1634/theoncologist.2009-0285.

    Article  PubMed  PubMed Central  Google Scholar 

  17. ••Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008;371:569–78. doi: 10.1016/S0140-6736(08)60269-X This article provides an in-depth report of the epidemiological association between obesity and cancer. Explores biological mechanisms that link obesity with cancer.

  18. van Kruijsdijk RCM, van der Wall E, Visseren FLJ. Obesity and cancer: the role of dysfunctional adipose tissue. Cancer Epidemiol Biomark Prev. 2009;18:2569–78. doi:10.1158/1055-9965.EPI-09-0372.

    Article  CAS  Google Scholar 

  19. Huang Z, Hankinson SE, Colditz GA, et al. Dual effects of weight and weight gain on breast cancer risk. JAMA. 1997;278:1407–11.

    Article  CAS  PubMed  Google Scholar 

  20. Morimoto LM, White E, Chen Z, et al. Obesity, body size, and risk of postmenopausal breast cancer: the Women’s Health Initiative (United States). Cancer Causes Control. 2002;13(8):741–51.

    Article  PubMed  Google Scholar 

  21. Sellers TA, Kushi LH, Potter JD, et al. Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer. N Engl J Med. 1992;326:1323–9. doi:10.1056/NEJM199205143262004.

    Article  CAS  PubMed  Google Scholar 

  22. Stephenson GD, Rose DP. Breast cancer and obesity: an update. Nutr Cancer. 2003;45:1–16. doi:10.1207/S15327914NC4501_1.

    Article  CAS  PubMed  Google Scholar 

  23. Eliassen AH, Colditz GA, Rosner B, et al. Adult weight change and risk of postmenopausal breast cancer. JAMA. 2006;296(2):193–201. doi:10.1001/jama/296.2.193.

    Article  CAS  PubMed  Google Scholar 

  24. Santen RJ, Boyd NF, Chlebowski RT, et al. Critical assessment of new risk factors for breast cancer: considerations for development of an improved risk prediction model. Endocr Relat Cancer. 2007;14:169–87. doi:10.1677/ERC-06-0045.

    Article  PubMed  Google Scholar 

  25. Strong AL, Ohlstein JF, Biagas BA, et al. Leptin produced by obese adipose stromal/stem cells enhances proliferation and metastasis of estrogen receptor positive breast cancers. Breast Cancer Res. 2015;17:112. doi:10.1186/s13058-015-0622-z.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–38. doi:10.1056/NEJMoa021423.

    Article  PubMed  Google Scholar 

  27. Haakinson DJ, Leeds SG, Dueck AC, et al. The impact of obesity on breast cancer: a retrospective review. Ann Surg Oncol. 2012;19:3012–8. doi:10.1245/s10434-012-2320-8.

    Article  PubMed  Google Scholar 

  28. Cleveland RJ, Eng SM, Abrahamson PE, et al. Weight gain prior to diagnosis and survival from breast cancer. Cancer Epidemiol Biomark Prev. 2007;16:1803–11. doi:10.1158/1055-9965.EPI-06-0889.

    Article  Google Scholar 

  29. Feigelson HS, Patel AV, Teras LR, et al. Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women. Cancer. 2006;107:12–21. doi:10.1002/cncr.21965.

    Article  PubMed  Google Scholar 

  30. Dal Maso L, Zucchetto A, Talamini R, et al. Effect of obesity and other lifestyle factors on mortality in women with breast cancer. Int J Cancer. 2008;123:2188–94. doi:10.1002/ijc.23747.

    Article  CAS  PubMed  Google Scholar 

  31. Reeves KW, Faulkner K, Modugno F, et al. Body mass index and mortality among older breast cancer survivors in the study of osteoporotic fractures. Cancer Epidemiol Biomark Prev. 2007;16:1468–73. doi:10.1158/1055-9965.EPI-07-0051.

    Article  Google Scholar 

  32. Senie RT, Rosen PP, Rhodes P, et al. Obesity at diagnosis of breast carcinoma influences duration of disease-free survival. Ann Intern Med. 1992;116:26–32.

    Article  CAS  PubMed  Google Scholar 

  33. Majed B, Moreau T, Senouci K, et al. Is obesity an independent prognosis factor in woman breast cancer? Breast Cancer Res Treat. 2008;111:329–42. doi:10.1007/s10549-007-9785-3.

    Article  PubMed  Google Scholar 

  34. Chlebowski RT, Aiello E. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43.

    Article  PubMed  Google Scholar 

  35. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat. 2010;123:627–35. doi:10.1007/s10549-010-0990-0.

    Article  PubMed  Google Scholar 

  36. •Berger NA. Obesity and cancer pathogenesis. Ann N Y Acad Sci. 2014;1311:57–76. doi:10.1111/nyas.12416.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Del Fabbro E, Parsons H, Warneke CL, et al. The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer. Oncologist. 2012;17:1240–5. doi:10.1634/theoncologist.2012-0169.

    Article  PubMed  PubMed Central  Google Scholar 

  38. McTiernan A, Rajan KB, Tworoger SS, et al. Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol. 2003;21:1961–6. doi:10.1200/JCO.2003.07.057.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. •Iyengar NM, Hudis CA, Dannenberg AJ. Obesity and inflammation: new insights into breast cancer development and progression. Am Soc Clin Oncol Educ Book 2013. p. 46–51. doi: 10.1200/EdBook_AM.2013.33.46 Description of mechanistic relationship between obesity related inflammation and breast cancer progression.

  40. Lorincz AM, Sukumar S. Molecular links between obesity and breast cancer. Endocr Relat Cancer. 2006;13:279–92. doi:10.1677/erc.1.00729.

    Article  CAS  PubMed  Google Scholar 

  41. Vona-Davis L, Rose DP. Adipokines as endocrine, paracrine, and autocrine factors in breast cancer risk and progression. Endocr Relat Cancer. 2007;14:189–206. doi:10.1677/ERC-06-0068.

    Article  CAS  PubMed  Google Scholar 

  42. Schäffler A, Schölmerich J, Buechler C. Mechanisms of disease: adipokines and breast cancer - endocrine and paracrine mechanisms that connect adiposity and breast cancer. Nat Clin Pract Endocrinol Metab. 2007;3:345–54. doi:10.1038/ncpendmet0456.

    Article  PubMed  CAS  Google Scholar 

  43. Bulun SE, Chen D, Moy I, et al. Aromatase, breast cancer and obesity: a complex interaction. Trends Endocrinol Metab. 2012;23:83–9. doi:10.1016/j.tem.2011.10.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Braun S, Bitton-Worms K, LeRoith D. The link between the metabolic syndrome and cancer. Int J Biol Sci. 2011;7:1003–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840–6. doi:10.1038/nature05482.

    Article  CAS  PubMed  Google Scholar 

  46. Kaaks R. Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control. 1996;7:605–25.

    Article  CAS  PubMed  Google Scholar 

  47. Goodwin PJ, Ennis M, Pritchard KI, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002;20:42–51.

    Article  CAS  PubMed  Google Scholar 

  48. Pollak MN, Schernhammer ES. Insulin-like growth factors and neoplasia. Nat Rev Cancer. 2004;4:505–18. doi:10.1038/nrc1387.

    Article  CAS  PubMed  Google Scholar 

  49. Renehan AG, Roberts DL, Dive C. Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem. 2008;114:71–83. doi:10.1080/13813450801954303.

    Article  CAS  PubMed  Google Scholar 

  50. Moore T, Beltran L, Carbajal S, et al. Dietary energy balance modulates signaling through the Akt/mammalian target of rapamycin pathways in multiple epithelial tissues. Cancer Prev Res (Phila). 2008;1:65–76. doi:10.1158/1940-6207.CAPR-08-0022.

    Article  CAS  Google Scholar 

  51. Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8:915–28. doi:10.1038/nrc2536.

    Article  CAS  PubMed  Google Scholar 

  52. Hursting SD, Smith SM, Lashinger LM, et al. Calories and carcinogenesis: lessons learned from 30 years of calorie restriction research. Carcinogenesis. 2010;31:83–9. doi:10.1093/carcin/bgp280.

    Article  CAS  PubMed  Google Scholar 

  53. Hawsawi Y, El-Gendy R, Twelves C, et al. Insulin-like growth factor–oestradiol crosstalk and mammary gland tumourigenesis. Biochim Biophys Acta. 2013;1836:345–53. doi:10.1016/j.bbcan.2013.10.005.

    CAS  PubMed  Google Scholar 

  54. Su B, Wong C, Hong Y, Chen S. Growth factor signaling enhances aromatase activity of breast cancer cells via post-transcriptional mechanisms. J Steroid Biochem Mol Biol. 2011;123:101–8. doi:10.1016/j.jsbmb.2010.11.012.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Surmacz E. Function of the IGF-I receptor in breast cancer. J Mammary Gland Biol Neoplas. 2000;5(1):95–105.

    Article  CAS  Google Scholar 

  56. Le Roith D. Regulation of proliferation and apoptosis by the insulin-like growth factor I receptor. Growth Hormone IGF Res. 2000;10:S12–3.

    Article  Google Scholar 

  57. Seccareccia E, Brodt P. The role of the insulin-like growth factor-I receptor in malignancy: an update. Growth Hormone IGF Res. 2012;22(6):193–9.

    Article  CAS  Google Scholar 

  58. Stewart AJ, Johnson MD, May FE, Westley BR. Role of insulin-like growth factors and the type I insulin-like growth factor receptor in the estrogen-stimulated proliferation of human breast cancer cells. J Biol Chem. 1990;265:21172–8.

    CAS  PubMed  Google Scholar 

  59. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89:2548–56. doi:10.1210/jc.2004-0395.

    Article  CAS  PubMed  Google Scholar 

  60. Gautron L, Elmquist JK. Sixteen years and counting: an update on leptin in energy balance. J Clin Invest. 2011;121:2087–93. doi:10.1172/JCI45888.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Catalano S, Marsico S, Giordano C, et al. Leptin enhances, via AP-1, expression of aromatase in the MCF-7 cell line. J Biol Chem. 2003;278:28668–76. doi:10.1074/jbc.M301695200.

    Article  CAS  PubMed  Google Scholar 

  62. Galic S, Oakhill JS, Steinberg GR. Adipose tissue as an endocrine organ. Mol Cell Endocrinol. 2010;316:129–39. doi:10.1016/j.mce.2009.08.018.

    Article  CAS  PubMed  Google Scholar 

  63. Tian YF, Chu CH, Wu MH, Chang CL. Anthropometric measures, plasma adiponectin, and breast cancer risk. Endocr Relat Cancer. 2007;14:669–77.

    Article  CAS  PubMed  Google Scholar 

  64. Mantzoros C, Petridou E, Dessypris N. Adiponectin and breast cancer risk. J Clin Endocr Metab. 2004;89(3):1102–7.

    Article  CAS  PubMed  Google Scholar 

  65. Vaiopoulos AG, Marinou K, Christodoulides C. The role of adiponectin in human vascular physiology. Int J Cardiol. 2012;155(2):188–93.

    Article  PubMed  Google Scholar 

  66. Barb D, Williams CJ, Neuwirth AK, Mantzoros CS. Adiponectin in relation to malignancies: a review of existing basic research and clinical evidence. Am J Clin Nutr. 2007;86:s858–66.

    PubMed  Google Scholar 

  67. Stofkova A. Leptin and adiponectin: from energy and metabolic dysbalance to inflammation and autoimmunity. Endocr Regul. 2009;43:157–68.

    CAS  PubMed  Google Scholar 

  68. Dalamaga M, Diakopoulos KN, Mantzoros CS. The role of adiponectin in cancer: a review of current evidence. Endocr Rev. 2012;33:547–94. doi:10.1210/er.2011-1015.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Olefsky JM, Glass CK. Macrophages, inflammation, and insulin resistance. Annu Rev Physiol. 2010;72:219–46. doi:10.1146/annurev-physiol-021909-135846.

    Article  CAS  PubMed  Google Scholar 

  70. O’Rourke RW. Inflammation in obesity-related disease. Surgery. 2009;145(3):255–9.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Karin M. Nuclear factor-κB in cancer development and progression. Nature. 2006;441:431–6. doi:10.1038/nature04870.

    Article  CAS  PubMed  Google Scholar 

  72. Pierce BL, Ballard-Barbash R, Bernstein L, et al. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol. 2009;27:3437–44. doi:10.1200/JCO.2008.18.9068.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Osborn O, Olefsky JM. The cellular and signaling networks linking the immune system and metabolism in disease. Nat Med. 2012;18:363–74. doi:10.1038/nm.2627.

    Article  CAS  PubMed  Google Scholar 

  74. •Morris PG, Hudis CA, Giri D, Morrow M. Inflammation and increased aromatase expression occur in the breast tissue of obese women with breast cancer. Cancer Prev Res. 2011;4:1021–9. Description of in-breast inflammation underscoring how obesity-related inflammation promotes development of cancer, especially in mammary tissue.

  75. Charrière G, Cousin B, Arnaud E, André M. Preadipocyte conversion to macrophage Evidence of plasticity. J Biol Chem. 2003;278:9850–5.

    Article  PubMed  CAS  Google Scholar 

  76. Allavena P, Sica A, Garlanda C. The Yin-Yang of tumor-associated macrophages in neoplastic progression and immune surveillance. Immunol Rev. 2008;222:155–61.

    Article  CAS  PubMed  Google Scholar 

  77. Cinti S, Mitchell G, Barbatelli G, et al. Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res. 2005;46:2347–55. doi:10.1194/jlr.M500294-JLR200.

    Article  CAS  PubMed  Google Scholar 

  78. Subbaramaiah K, Howe LR, Bhardwaj P, et al. Obesity is associated with inflammation and elevated aromatase expression in the mouse mammary gland. Cancer Prev Res (Phila). 2011;4:329–46. doi:10.1158/1940-6207.CAPR-10-0381.

    Article  CAS  Google Scholar 

  79. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44. doi:10.1038/nature07205.

    Article  CAS  PubMed  Google Scholar 

  80. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420:860–7. doi:10.1038/nature01322.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Balkwill F, Charles KA, Mantovani A. Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005;7:211–7. doi:10.1016/j.ccr.2005.02.013.

    Article  CAS  PubMed  Google Scholar 

  82. Bachelot T, Ray-Coquard I, Menetrier-Caux C. Prognostic value of serum levels of interleukin 6 and of serum and plasma levels of vascular endothelial growth factor in hormone-refractory metastatic breast cancer patients. Br J Cancer. 2003;88:1721–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Dandona P, Weinstock R, Thusu K, et al. Tumor necrosis factor-alpha in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab. 1998;83:2907–10. doi:10.1210/jcem.83.8.5026.

    CAS  PubMed  Google Scholar 

  84. Korkaya H, Liu S, Wicha MS. Breast cancer stem cells, cytokine networks, and the tumor microenvironment. J Clin Invest. 2011;121:3804–9. doi:10.1172/JCI57099.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Andò S, Catalano S. The multifactorial role of leptin in driving the breast cancer microenvironment. Nat Rev Endocrinol. 2012;8:263–75. doi:10.1038/nrendo.2011.184.

    Article  CAS  Google Scholar 

  86. Madigan MP, Troisi R, Potischman N, et al. Serum hormone levels in relation to reproductive and lifestyle factors in postmenopausal women (United States). Cancer Causes Control. 1998;9:199–207.

    Article  CAS  PubMed  Google Scholar 

  87. Zhao Y, Agarwal VR, Mendelson CR, Simpson ER. Estrogen biosynthesis proximal to a breast tumor is stimulated by PGE2 via cyclic AMP, leading to activation of promoter II of the CYP19 (aromatase) gene. Endocrinology. 1996;137:5739–42. doi:10.1210/endo.137.12.8940410.

    CAS  PubMed  Google Scholar 

  88. Judd HL, Judd GE, Lucas WE. Endocrine function of the postmenopausal ovary: concentration of androgens and estrogens in ovarian and peripheral vein blood. J Clin Endocr Metab. 1974;39(6):1020–4.

    Article  CAS  PubMed  Google Scholar 

  89. Cleary MP, Grossmann ME. Obesity and breast cancer: the estrogen connection. Endocrinology. 2009;150(6):2537–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Purohit A, Newman SP, Reed MJ. The role of cytokines in regulating estrogen synthesis: implications for the etiology of breast cancer. Breast Cancer Res. 2002;4:65–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  92. Surmacz E. Leptin and adiponectin: emerging therapeutic targets in breast cancer. J Mammary Gland Biol Neoplas. 2013;18(3):321–32.

    Article  Google Scholar 

  93. Hursting SD, Berger NA. Energy balance, host-related factors, and cancer progression. J Clin Oncol. 2010;28:4058–65. doi:10.1200/JCO.2010.27.9935.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Carter JC, Church FC. Obesity and breast cancer: the roles of peroxisome proliferator-Activated receptor-and plasminogen activator inhibitor-1. PPAR Res. 2009;4:1–13.

    Google Scholar 

  95. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. Natl Health Stat Report; 2009. p. 1–7.

  96. •Hursting SD, Dunlap SM. Obesity, metabolic dysregulation, and cancer: a growing concern and an inflammatory (and microenvironmental) issue. Ann N Y Acad Sci. 2012;1271:82–7. doi: 10.1111/j.1749-6632.2012.06737.x Extensive review on metabolic and inflammatory change associated with increased adiposity and its role in cancer development.

  97. Poirier P, Giles TD, Bray GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26:968–76. doi:10.1161/01.ATV.0000216787.85457.f3.

    Article  CAS  PubMed  Google Scholar 

  98. Dunlap SM, Chiao LJ, Nogueira L, et al. Obesity enhances epithelial-to-mesenchymal transition and tumor progression in murine claudin-low and basal-like mammary tumor models. Cancer Prev Res. 2012;5:930–42.

    Article  CAS  Google Scholar 

  99. Thivat E, Thérondel S, Lapirot O, et al. Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. BMC Cancer. 2010;10:648. doi:10.1186/1471-2407-10-648.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Byers T, Sedjo RL. Does intentional weight loss reduce cancer risk? Diabetes Obes Metab. 2011;13(12):1063–72.

    Article  CAS  PubMed  Google Scholar 

  101. Friedenreich CM, Neilson HK, Lynch BM. State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer. 2010;46:2593–604. doi:10.1016/j.ejca.2010.07.028.

    Article  PubMed  Google Scholar 

  102. van Gemert WA, May AM, Schuit AJ, et al. Effect of weight loss with or without exercise on inflammatory markers and adipokines in postmenopausal women: the SHAPE-2 trial A Randomized Controlled Trial. Cancer Epidemiol Biomark Prev. 2016;. doi:10.1158/1055-9965.EPI-15-1065.

    Google Scholar 

  103. King B, Jiang Y, Su X, et al. Weight control, endocrine hormones and cancer prevention. Exp Biol Med (Maywood). 2013;238:502–8. doi:10.1177/1535370213480695.

    Article  CAS  Google Scholar 

  104. Lynch BM, Neilson HK, Friedenreich CM. Physical activity and breast cancer prevention. Physl Activity Cancer. 2010;186:13–42.

    Article  Google Scholar 

  105. Holmes MD, Chen WY, Feskanich D, Kroenke CH. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293(20):2479–86. doi:10.1001/jama.293.20.2479.

    Article  CAS  PubMed  Google Scholar 

  106. Irwin ML, McTiernan A, Manson J. Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res. 2011;4(4):522–9.

    Article  Google Scholar 

  107. Neilson HK, Friedenreich CM, Brockton NT, Millikan RC. Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomark Prev. 2009;18:11–27. doi:10.1158/1055-9965.EPI-08-0756.

    Article  CAS  Google Scholar 

  108. Rogers CJ, Colbert LH, Greiner JW, et al. Physical activity and cancer prevention: pathways and targets for intervention. Sports Med. 2008;38:271–96.

    Article  PubMed  Google Scholar 

  109. Christou NV, Lieberman M, Sampalis F, Sampalis JS. Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis. 2008;4:691–5. doi:10.1016/j.soard.2008.08.025.

    Article  PubMed  Google Scholar 

  110. Knoops KTB, de Groot LCPGM, Kromhout D, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004;292:1433–9. doi:10.1001/jama.292.12.1433.

    Article  PubMed  Google Scholar 

  111. Pierce JP, Stefanick ML, Flatt SW, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;25:2345–51. doi:10.1200/JCO.2006.08.6819.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA, 19104, USA

    Victoria M. Gershuni

  2. Department of Endocrinology, Diabetes and Metabolism Division, Hospital of the University of Pennsylvania, 3400 Civic Center Boulevard, Building 421, Philadelphia, PA, 19104, USA

    Rexford S. Ahima

  3. Department of Surgery Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, 34th & Civic Center Blvd, 3 South, Philadelphia, PA, 19104, USA

    Julia Tchou

Authors
  1. Victoria M. Gershuni
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  2. Rexford S. Ahima
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  3. Julia Tchou
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Corresponding author

Correspondence to Victoria M. Gershuni.

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

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Gershuni, V.M., Ahima, R.S. & Tchou, J. Obesity and Breast Cancer: A Complex Relationship. Curr Surg Rep 4, 14 (2016). https://doi.org/10.1007/s40137-016-0134-5

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  • DOI: https://doi.org/10.1007/s40137-016-0134-5

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