Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities
Ce dossier présente un ensemble d'articles sur le rôle de l'obésité dans l'étiologie des cancers, sa prévention, sa prise en charge et son impact sur la survie des patients atteints d'un cancer
Purpose : To summarize the evidence of an association between obesity and breast cancer prognosis.
Methods : We reviewed the literature regarding overweight and obesity and breast cancer survival outcomes, overall and with regard to breast cancer subtypes, breast cancer therapies, biologic mechanisms, and possible interventions. We summarize our findings and provide clinical management recommendations.
Results : Obesity is associated with a 35% to 40% increased risk of breast cancer recurrence and death and therefore poorer survival outcomes. This is most clearly established for estrogen receptor–positive breast cancer, with the relationship in triple-negative and human epidermal growth factor receptor 2–positive subtypes less well established. A range of biologic mechanisms that may underlie this association has been identified. Weight loss and lifestyle interventions, as well as metformin and other obesity-targeted therapies, are promising avenues that require further study.
Conclusion : Obesity is associated with inferior survival in breast cancer. Understanding the nature and mechanisms of this effect provides an important opportunity for interventions to improve the diagnosis, treatment, and outcomes of obese patients with breast cancer.
Journal of Clinical Oncology , résumé, 2015