肥胖与乳腺癌:到底是什么关系!

CA-A CANCER JOURNAL FOR CLINICIANS

2017-08-01Review

187.040

影响因子

原标题:肥胖与乳腺癌风险及预后:机制和干预方法

① 肥胖与乳腺癌(BC)发病风险增加相关,尤其是绝经后女性,所有患者预后均差;② 绝经前后女性、激素受体阳性和阴性患者中肥胖与BC发生的相关性不同;③ 肥胖增加局部和循环血促炎细胞因子、促进肿瘤血管新生、刺激多数恶性肿瘤干细胞以驱动肿瘤生长、浸润和转移的分子机制;④ 增加体育活动降低BC风险并改善预后,生活方式干预,减少肥胖BC患者不良预后相关的性激素、胰岛素/胰岛素样生长因子1通路的活化、炎症生物标志物。

乳腺癌 饮食与运动 激素受体 免疫 炎症性细胞因子 核因子κB(NF-κB) 肥胖 绝经前后 性激素 体重下降

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Title:
Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention

DOI:
10.3322/caac.21405

Abstract & Authors展开

Abstract:
Answer questions and earn CME/CNE Recent decades have seen an unprecedented rise in obesity, and the health impact thereof is increasingly evident. In 2014, worldwide, more than 1.9 billion adults were overweight (body mass index [BMI], 25-29.9 kg/m(2) ), and of these, over 600 million were obese (BMI ≥30 kg/m(2) ). Although the association between obesity and the risk of diabetes and coronary artery disease is widely known, the impact of obesity on cancer incidence, morbidity, and mortality is not fully appreciated. Obesity is associated both with a higher risk of developing breast cancer, particularly in postmenopausal women, and with worse disease outcome for women of all ages. The first part of this review summarizes the relationships between obesity and breast cancer development and outcomes in premenopausal and postmenopausal women and in those with hormone receptor-positive and -negative disease. The second part of this review addresses hypothesized molecular mechanistic insights that may underlie the effects of obesity to increase local and circulating proinflammatory cytokines, promote tumor angiogenesis and stimulate the most malignant cancer stem cell population to drive cancer growth, invasion, and metastasis. Finally, a review of observational studies demonstrates that increased physical activity is associated with lower breast cancer risk and better outcomes. The effects of recent lifestyle interventions to decrease sex steroids, insulin/insulin-like growth factor-1 pathway activation, and inflammatory biomarkers associated with worse breast cancer outcomes in obesity also are discussed. Although many observational studies indicate that exercise with weight loss is associated with improved breast cancer outcome, further prospective studies are needed to determine whether weight reduction will lead to improved patient outcomes. It is hoped that several ongoing lifestyle intervention trials, which are reviewed herein, will support the systematic incorporation of weight loss intervention strategies into care for patients with breast cancer. CA Cancer J Clin 2017;. © 2017 The Authors. CA A Cancer Journal for Clinicians published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

All Authors:
Manuel Picon-Ruiz,Cynthia Morata-Tarifa,Janeiro J Valle-Goffin,Eitan R Friedman,Joyce M Slingerland

First Authors:
Manuel Picon-Ruiz

Correspondence:
Joyce M Slingerland

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