Skip to main content
Erschienen in: Current Nutrition Reports 1/2014

01.03.2014 | Cancer (MF Leitzmann, Section Editor)

The Association Between Adiposity and Breast Cancer Recurrence and Survival: A Review of the Recent Literature

verfasst von: Maria Azrad, Wendy Demark-Wahnefried

Erschienen in: Current Nutrition Reports | Ausgabe 1/2014

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
1.
Zurück zum Zitat American Cancer Society. BC Facts & Figures 2013-2014. Atlanta: American Cancer Society, Inc; 2013. American Cancer Society. BC Facts & Figures 2013-2014. Atlanta: American Cancer Society, Inc; 2013.
2.
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
3.
Zurück zum Zitat Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief. 2012;82:1–8.PubMed Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief. 2012;82:1–8.PubMed
4.
Zurück zum Zitat Folkerd EJ, Dixon JM, Renshaw L, A'Hern RP, Dowsett M. Suppression of plasma estrogen levels by letrozole and anastrozole is related to body mass index in patients with breast cancer. J Clin Oncol. 2012;30:2977–80.PubMedCrossRef Folkerd EJ, Dixon JM, Renshaw L, A'Hern RP, Dowsett M. Suppression of plasma estrogen levels by letrozole and anastrozole is related to body mass index in patients with breast cancer. J Clin Oncol. 2012;30:2977–80.PubMedCrossRef
5.
Zurück zum Zitat Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin. 2010;60:207–21.PubMedCrossRef Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin. 2010;60:207–21.PubMedCrossRef
6.
Zurück zum Zitat Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35:2402–11.PubMedCrossRef Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35:2402–11.PubMedCrossRef
7.
Zurück zum Zitat Longcope C, Baker R, Johnston CC. Androgen and estrogen metabolism: relationship to obesity. Metabolism. 1986;35:235–7.PubMedCrossRef Longcope C, Baker R, Johnston CC. Androgen and estrogen metabolism: relationship to obesity. Metabolism. 1986;35:235–7.PubMedCrossRef
8.
Zurück zum Zitat Jiralerspong S, Kim ES, Dong W, et al. Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol. 2013;24:2506–14.PubMedCrossRef Jiralerspong S, Kim ES, Dong W, et al. Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol. 2013;24:2506–14.PubMedCrossRef
9.
Zurück zum Zitat Kamineni A, Weinmann S, Shy KK, et al. Efficacy of screening in preventing cervical cancer among older women. Cancer Causes Control. 2013;24:1653–60.PubMedCrossRef Kamineni A, Weinmann S, Shy KK, et al. Efficacy of screening in preventing cervical cancer among older women. Cancer Causes Control. 2013;24:1653–60.PubMedCrossRef
10.
Zurück zum Zitat Ademuyiwa FO, Groman A, O'Connor T, et al. Impact of body mass index on clinical outcomes in triple-negative BC. Cancer. 2011;117:4132–40.PubMedCrossRef Ademuyiwa FO, Groman A, O'Connor T, et al. Impact of body mass index on clinical outcomes in triple-negative BC. Cancer. 2011;117:4132–40.PubMedCrossRef
11.
Zurück zum Zitat Dawood S, Lei X, Litton JK, et al. Breast Impact of body mass index on survival outcome among women with early stage triple-negative breast cancer. Cancer. 2012;12:364–72. Dawood S, Lei X, Litton JK, et al. Breast Impact of body mass index on survival outcome among women with early stage triple-negative breast cancer. Cancer. 2012;12:364–72.
12.
Zurück zum Zitat Francis P, Crown J, Di Leo A, et al. Adjuvant chemotherapy with sequential or concurrent anthracycline and docetaxel: Breast International Group 02–98 randomized trial. J Natl Cancer Inst. 2008;100:121–33.PubMedCrossRef Francis P, Crown J, Di Leo A, et al. Adjuvant chemotherapy with sequential or concurrent anthracycline and docetaxel: Breast International Group 02–98 randomized trial. J Natl Cancer Inst. 2008;100:121–33.PubMedCrossRef
13.
Zurück zum Zitat de Azambuja E, McCaskill-Stevens W, Francis P, et al. The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02–98 trial. Breast Cancer Res Treat. 2010;119:145–53.PubMedCrossRef de Azambuja E, McCaskill-Stevens W, Francis P, et al. The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02–98 trial. Breast Cancer Res Treat. 2010;119:145–53.PubMedCrossRef
14.
Zurück zum Zitat Sparano JA, Wang M, Zhao F, et al. Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer. 2012;118:5937–46.PubMedCentralPubMedCrossRef Sparano JA, Wang M, Zhao F, et al. Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer. 2012;118:5937–46.PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Crozier JA, Moreno-Aspitia A, Ballman KV, et al. Effect of body mass index on tumor characteristics and disease-free survival in patients from the HER2-positive adjuvant trastuzumab trial N9831. Cancer. 2013;119:2447–54.PubMedCrossRef Crozier JA, Moreno-Aspitia A, Ballman KV, et al. Effect of body mass index on tumor characteristics and disease-free survival in patients from the HER2-positive adjuvant trastuzumab trial N9831. Cancer. 2013;119:2447–54.PubMedCrossRef
16.••
Zurück zum Zitat Ewertz M, Jensen MB, Gunnarsdóttir KÁ, et al. Effect of obesity on prognosis after early-stage BC. J Clin Oncol. 2011;29:25–31. The study was conducted in Denmark and included 18,967 breast cancer patients with up to 30-year follow-up. Results showed that obese women had increased risk for distant metastases and death and that chemotherapy and endocrine therapy may be less effective in this patient population.PubMedCrossRef Ewertz M, Jensen MB, Gunnarsdóttir KÁ, et al. Effect of obesity on prognosis after early-stage BC. J Clin Oncol. 2011;29:25–31. The study was conducted in Denmark and included 18,967 breast cancer patients with up to 30-year follow-up. Results showed that obese women had increased risk for distant metastases and death and that chemotherapy and endocrine therapy may be less effective in this patient population.PubMedCrossRef
17.
Zurück zum Zitat Kwan ML, Chen WY, Kroenke CH, et al. Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. Breast Cancer Res Treat. 2012;132:729–39.PubMedCentralPubMedCrossRef Kwan ML, Chen WY, Kroenke CH, et al. Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. Breast Cancer Res Treat. 2012;132:729–39.PubMedCentralPubMedCrossRef
18.•
Zurück zum Zitat Chen X, Lu W, Zheng W, et al. Obesity and weight change in relation to breast cancer survival. Breast. 2010;122:823–33. The study was conducted in a Chinese population that included more than 5,000 subjects with nearly 4-year follow-up. Results showed that obesity before and at diagnosis were poor prognostic factors. Importantly, this study also showed that weight gain after diagnosis was associated with inferior outcomes. Chen X, Lu W, Zheng W, et al. Obesity and weight change in relation to breast cancer survival. Breast. 2010;122:823–33. The study was conducted in a Chinese population that included more than 5,000 subjects with nearly 4-year follow-up. Results showed that obesity before and at diagnosis were poor prognostic factors. Importantly, this study also showed that weight gain after diagnosis was associated with inferior outcomes.
19.
Zurück zum Zitat Conroy SM, Maskarinec G, Wilkens LR, et al. Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat. 2011;129:565–74.PubMedCentralPubMedCrossRef Conroy SM, Maskarinec G, Wilkens LR, et al. Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat. 2011;129:565–74.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Burstein HJ, Prestrud AA, Seidenfeld J, et al. American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol. 2010;28:3784–96.PubMedCrossRef Burstein HJ, Prestrud AA, Seidenfeld J, et al. American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol. 2010;28:3784–96.PubMedCrossRef
21.
Zurück zum Zitat Howell A, Cuzick J, Baum M, et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for BC. Lancet. 2005;365:60–2.PubMedCrossRef Howell A, Cuzick J, Baum M, et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for BC. Lancet. 2005;365:60–2.PubMedCrossRef
22.••
Zurück zum Zitat Sestak I, Distler W, Forbes JF, et al. Effect of body mass index on recurrence in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28:3411–5. This was one of the earlier studies to investigate the efficacy of AIs in obese breast cancer patients. The results are from secondary analyses of large, double-blind, randomized clinical trial and showed that tamoxifen is equally effect across BMI categories, yet AIs may not confer the same protection for women with higher BMI.PubMedCrossRef Sestak I, Distler W, Forbes JF, et al. Effect of body mass index on recurrence in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28:3411–5. This was one of the earlier studies to investigate the efficacy of AIs in obese breast cancer patients. The results are from secondary analyses of large, double-blind, randomized clinical trial and showed that tamoxifen is equally effect across BMI categories, yet AIs may not confer the same protection for women with higher BMI.PubMedCrossRef
23.
Zurück zum Zitat Schmid M, Jakesz R, Samonigg H, et al. Randomized trial of tamoxifen versus tamoxifen plus aminoglutethimide as adjuvant treatment in postmenopausal breast cancer patients with hormone receptor-positive disease: Austrian breast and colorectal cancer study group trial 6. J Clin Oncol. 2003;21:984–90.PubMedCrossRef Schmid M, Jakesz R, Samonigg H, et al. Randomized trial of tamoxifen versus tamoxifen plus aminoglutethimide as adjuvant treatment in postmenopausal breast cancer patients with hormone receptor-positive disease: Austrian breast and colorectal cancer study group trial 6. J Clin Oncol. 2003;21:984–90.PubMedCrossRef
24.
Zurück zum Zitat Pfeiler G, Stöger H, Dubsky P, et al. Efficacy of tamoxifen ± aminoglutethimide in normal weight and overweight postmenopausal patients with hormone receptor-positive breast cancer: an analysis of 1509 patients of the ABCSG-06 trial. Br J Cancer. 2013;108:1408–14.PubMedCrossRef Pfeiler G, Stöger H, Dubsky P, et al. Efficacy of tamoxifen ± aminoglutethimide in normal weight and overweight postmenopausal patients with hormone receptor-positive breast cancer: an analysis of 1509 patients of the ABCSG-06 trial. Br J Cancer. 2013;108:1408–14.PubMedCrossRef
25.
Zurück zum Zitat Jakesz R, Greil R, Gnant M, et al. Extended adjuvant therapy with anastrozole among postmenopausal BC patients: results from the randomized Austrian Breast and Colorectal Cancer Study Group Trial 6a. J Natl Cancer Inst. 2007;99:1845–53.PubMedCrossRef Jakesz R, Greil R, Gnant M, et al. Extended adjuvant therapy with anastrozole among postmenopausal BC patients: results from the randomized Austrian Breast and Colorectal Cancer Study Group Trial 6a. J Natl Cancer Inst. 2007;99:1845–53.PubMedCrossRef
26.
Zurück zum Zitat Gnant M, Pfeiler G, Stöger H, et al. The predictive impact of body mass index on the efficacy of extended adjuvant endocrine treatment with anastrozole in postmenopausal patients with breast cancer: an analysis of the randomized ABCSG-6a trial. Br J Cancer. 2013;109:589–96.PubMedCrossRef Gnant M, Pfeiler G, Stöger H, et al. The predictive impact of body mass index on the efficacy of extended adjuvant endocrine treatment with anastrozole in postmenopausal patients with breast cancer: an analysis of the randomized ABCSG-6a trial. Br J Cancer. 2013;109:589–96.PubMedCrossRef
27.
Zurück zum Zitat Gnant M, Mlineritsch B, Schippinger W, et al. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N Engl J Med. 2009;360:679–91.PubMedCrossRef Gnant M, Mlineritsch B, Schippinger W, et al. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N Engl J Med. 2009;360:679–91.PubMedCrossRef
28.
Zurück zum Zitat Pfeiler G, Königsberg R, Fesl C, et al. Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol. 2011;29:2653–9.PubMedCrossRef Pfeiler G, Königsberg R, Fesl C, et al. Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol. 2011;29:2653–9.PubMedCrossRef
29.
Zurück zum Zitat Goodwin PJ, Pritchard KI. Obesity and hormone therapy in breast cancer: an unfinished puzzle. J Clin Oncol. 2010;28:3405–7.PubMedCrossRef Goodwin PJ, Pritchard KI. Obesity and hormone therapy in breast cancer: an unfinished puzzle. J Clin Oncol. 2010;28:3405–7.PubMedCrossRef
30.•
Zurück zum Zitat Erickson K, Patterson RE, Flatt SW, et al. Clinically defined type 2 diabetes mellitus and prognosis in early-stage breast cancer. J Clin Oncol. 2011;29:54–60. The study included a large number of study participants from the United States with median 10-year follow-up. The study observed that higher hemoglobin A1c, a clinical marker of abnormal glucose metabolism, was significantly associated with increased mortality from breast cancer.PubMedCrossRef Erickson K, Patterson RE, Flatt SW, et al. Clinically defined type 2 diabetes mellitus and prognosis in early-stage breast cancer. J Clin Oncol. 2011;29:54–60. The study included a large number of study participants from the United States with median 10-year follow-up. The study observed that higher hemoglobin A1c, a clinical marker of abnormal glucose metabolism, was significantly associated with increased mortality from breast cancer.PubMedCrossRef
31.
Zurück zum Zitat Goodwin PJ, Ennis M, Pritchard KI, et al. Insulin- and obesity-related variables in early-stage breast cancer: correlations and time course of prognostic associations. J Clin Oncol. 2012;30:164–71.PubMedCrossRef Goodwin PJ, Ennis M, Pritchard KI, et al. Insulin- and obesity-related variables in early-stage breast cancer: correlations and time course of prognostic associations. J Clin Oncol. 2012;30:164–71.PubMedCrossRef
32.
Zurück zum Zitat Duggan C, Irwin ML, Xiao L, et al. Associations of insulin resistance and adiponectin with mortality in women with breast cancer. J Clin Oncol. 2011;29:32–9.PubMedCrossRef Duggan C, Irwin ML, Xiao L, et al. Associations of insulin resistance and adiponectin with mortality in women with breast cancer. J Clin Oncol. 2011;29:32–9.PubMedCrossRef
33.
Zurück zum Zitat Irwin ML, Duggan C, Wang CY, et al. Fasting C-peptide levels and death resulting from all causes and breast cancer: the health, eating, activity, and lifestyle study. J Clin Oncol. 2011;29:47–53.PubMedCrossRef Irwin ML, Duggan C, Wang CY, et al. Fasting C-peptide levels and death resulting from all causes and breast cancer: the health, eating, activity, and lifestyle study. J Clin Oncol. 2011;29:47–53.PubMedCrossRef
34.
Zurück zum Zitat Minicozzi P, Berrino F, Sebastiani F, et al. High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease. Eur J Cancer. 2013 pii: S0959-8049(13)00759-4. doi: 10.1016/j.ejca.2013.08.004. Minicozzi P, Berrino F, Sebastiani F, et al. High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease. Eur J Cancer. 2013 pii: S0959-8049(13)00759-4. doi: 10.​1016/​j.​ejca.​2013.​08.​004.
35.••
Zurück zum Zitat Bjørge T, Lukanova A, Jonsson H, et al. Metabolic syndrome and breast cancer in theme-can (metabolic syndrome and cancer) project. Cancer Epidemiol Biomarkers Prev. 2010;19:1737–45. This study includes a large number of study participants from three European countries with 11-year follow-up. The study measured several metabolic outcomes and concluded that metabolic syndrome is associated with death from breast cancer and that glucose also was an independent factor contributing to increased death.PubMedCrossRef Bjørge T, Lukanova A, Jonsson H, et al. Metabolic syndrome and breast cancer in theme-can (metabolic syndrome and cancer) project. Cancer Epidemiol Biomarkers Prev. 2010;19:1737–45. This study includes a large number of study participants from three European countries with 11-year follow-up. The study measured several metabolic outcomes and concluded that metabolic syndrome is associated with death from breast cancer and that glucose also was an independent factor contributing to increased death.PubMedCrossRef
Metadaten
Titel
The Association Between Adiposity and Breast Cancer Recurrence and Survival: A Review of the Recent Literature
verfasst von
Maria Azrad
Wendy Demark-Wahnefried
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Current Nutrition Reports / Ausgabe 1/2014
Elektronische ISSN: 2161-3311
DOI
https://doi.org/10.1007/s13668-013-0068-9

Weitere Artikel der Ausgabe 1/2014

Current Nutrition Reports 1/2014 Zur Ausgabe

Dietary Patterns and Behavior (LM Steffen, Section Editor)

DASH and Mediterranean-Type Dietary Patterns to Maintain Cognitive Health

Dietary Patterns and Behavior (LM Steffen, Section Editor)

Dietary Patterns and Sugar-Sweetened Beverage Consumption among Adolescents and Adults

Dietary Patterns and Behavior (LM Steffen, Section Editor)

Metabolomic Biomarkers Reflect Usual Dietary Pattern: A Review

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.