A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancer

Luís, Carla; Dias, João; Firmino-Machado, João; Fernandes, Rute; Pereira, Deolinda; Baylina, Pilar; Fernandes, Rita; Soares, Raquel

doi:10.1007/s10549-022-06836-5

Cited by 4 publications

(4 citation statements)

References 51 publications

(59 reference statements)

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“…Breast-cancer-associated bASCs foster malignancy of breast cancer cells by the induction of epithelial–mesenchymal transition and by activation of stemness-associated genes. Mechanistic insight showed how obesity affects the phenotype of bASCs in the TME and highlights the molecular changes inside breast cancer cells upon interaction with cancer-educated bASCs [ 9 ]. Adipose tissue of obese individuals produces inflammatory cytokines and other mediators, creating an environment that promotes cancer invasion and metastasis [ 10 , 11 , 12 ].…”

Section: Preventionmentioning

confidence: 99%

Breast Cancer: Impact of New Treatments?

Storme

2023

Cancers

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Background: Breast cancer treatment has seen tremendous progress since the early 1980s, with the first findings of new chemotherapy and hormone therapies. Screening started in the same period. Methods: A review of population data (SEER and the literature) shows an increase in recurrence-free survival until 2000 and it stagnates afterwards. Results: Over the period 1980-2000, the 15% survival gain was presented by pharma as a contribution of new molecules. The contribution of screening during that same period was not implemented by them, although screening has been accepted as a routine procedure in the States since the 1980s and everywhere else since 2000. Conclusions: Interpretation of breast cancer outcome has largely focused on drugs, whereas other factors, such as screening, prevention, biologics, and genetics, were largely neglected. More attention should now be paid to examining the strategy based on realistic global data.

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Section: Preventionmentioning

confidence: 99%

Breast Cancer: Impact of New Treatments?

Storme

2023

Cancers

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“…Association between obesity and breast cancer incidence and mortality have been thoroughly examined in epidemiological, clinical, and preclinical studies. [26][27][28][29] Of interest, lifestyle factors that affect obesity, like the food environment index and exercise opportunities were also negatively associated with breast cancer mortality in the OLS and MGWR models. However, their effects were spatially nonstationary with regional-scale variation (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, county-level obesity emerged as a variable with a positive association with breast cancer mortality that had a stationary effect across the US, but that the association had slightly higher effect sizes in the Southern states. Association between obesity and breast cancer incidence and mortality have been thoroughly examined in epidemiological, clinical, and preclinical studies …”

Section: Discussionmentioning

confidence: 99%

Geographical Variation in Social Determinants of Female Breast Cancer Mortality Across US Counties

Anderson,

Herrera,

Mireku

et al. 2023

JAMA Netw Open

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ImportanceBreast cancer mortality is complex and traditional approaches that seek to identify determinants of mortality assume that their effects on mortality are stationary across geographic space and scales.ObjectiveTo identify geographic variation in the associations of population demographics, environmental, lifestyle, and health care access with breast cancer mortality at the US county-level.Design, Setting, and ParticipantsThis geospatial cross-sectional study used data from the Surveillance, Epidemiology, and End Results (SEER) database on adult female patients with breast cancer. Statistical and spatial analysis was completed using adjusted mortality rates from 2015 to 2019 for 2176 counties in the US. Data were analyzed July 2022.ExposuresCounty-level population demographics, environmental, lifestyle, and health care access variables were obtained from open data sources.Main Outcomes and MeasuresModel coefficients describing the association between 18 variables and age-adjusted breast cancer mortality rate. Compared with a multivariable linear regression (OLS), multiscale geographically weighted regression (MGWR) relaxed the assumption of spatial stationarity and allowed for the magnitude, direction, and significance of coefficients to change across geographic space.ResultsBoth OLS and MGWR models agreed that county-level age-adjusted breast cancer mortality rates were significantly positively associated with obesity (OLS: β, 1.21; 95% CI, 0.88 to 1.54; mean [SD] MGWR: β, 0.72 [0.02]) and negatively associated with proportion of adults screened via mammograms (OLS: β, −1.27; 95% CI, −1.70 to −0.84; mean [SD] MGWR: β, −1.07 [0.16]). Furthermore, the MGWR model revealed that these 2 determinants were associated with a stationary effect on mortality across the US. However, the MGWR model provided important insights on other county-level factors differentially associated with breast cancer mortality across the US. Both models agreed that smoking (OLS: β, −0.65; 95% CI, −0.98 to −0.32; mean [SD] MGWR: β, −0.75 [0.92]), food environment index (OLS: β, −1.35; 95% CI, −1.72 to −0.98; mean [SD] MGWR: β, −1.69 [0.70]), exercise opportunities (OLS: β, −0.56; 95% CI, −0.91 to −0.21; mean [SD] MGWR: β, −0.59 [0.81]), racial segregation (OLS: β, −0.60; 95% CI, −0.89 to −0.31; mean [SD] MGWR: β, −0.47 [0.41]), mental health care physician ratio (OLS: β, −0.93; 95% CI, −1.44 to −0.42; mean [SD] MGWR: β, −0.48 [0.92]), and primary care physician ratio (OLS: β, −1.46; 95% CI, −2.13 to −0.79; mean [SD] MGWR: β, −1.06 [0.57]) were negatively associated with breast cancer mortality, and that light pollution was positively associated (OLS: β, 0.48; 95% CI, 0.24 to 0.72; mean [SD] MGWR: β, 0.27 [0.04]). But in the MGWR model, the magnitude of effect sizes and significance varied across geographical regions. Inversely, the OLS model found that disability was not a significant variable for breast cancer mortality, yet the MGWR model found that it was significantly positively associated in some geographical locations.Conclusions and RelevanceThis cross-sectional study found that not all social determinants associated with breast cancer mortality are spatially stationary and provides spatially explicit insights for public health practitioners to guide geographically targeted interventions.

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“…Accumulating evidence indicates a strong association between obesity, T2D, and several types of cancer, including breast cancer [10][11][12][13]. High body mass index (BMI), insulin resistance, increased levels of leptin and aromatase enzymes, and inflammation of breast adipose tissue are believed to contribute to obesity-related post-menopausal breast cancer [13].…”

Section: Introductionmentioning

confidence: 99%

Obesity Associated with Prediabetes Increases the Risk of Breast Cancer Development and Progression—A Study on an Obese Rat Model with Impaired Glucose Tolerance

Kallamadi,

Esari,

Addi

et al. 2023

IJMS

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Patients with comorbidities of obesity and diabetes are recognized to be at high risk of breast cancer development and face worse breast cancer outcomes. Though several reports showed the reinforced link between obesity, diabetes, and prediabetes with breast cancer, the underlying molecular mechanisms are still unknown. The present study aimed to investigate the underlying molecular link between increased risks of breast cancer due to coincident diabetes or obesity using a spontaneous obese rat model with impaired glucose tolerance (WNIN/GR-Ob rat). A single dose of solubilized DMBA suspension (40 mg/kg body weight) was orally administered to the animals at the age of 60 days to induce breast tumors. The tumor incidence, latency period, tumor frequency, and tumor volume were measured. Histology, immunohistochemistry, and immunoblotting were performed to evaluate the tumor morphology and expression levels of signal molecules. The development of mammary tumors in GR-Ob rats was characterized by early onset and shorter latency periods compared to control lean rats. While 62% of obese rats developed breast tumors, tumor development in lean rats was only 21%. Overexpression of ER, PR, Ki67, and p53 markers was observed in tumor tissues of obese rats in comparison with lean rats. The levels of the hallmarks of cell proliferation and angiogenesis involved in IGF-1/PI3K/Akt/GSK3β/β-catenin signaling pathway molecules were upregulated in obese rat breast tumors compared to lean rats. Furthermore, obesity with prediabetes is associated with changes in IGF-1 signaling and acts on PI3K/Akt/GSK3β/β-catenin signaling, which results in rapid cell proliferation and development of breast tumors in obese rats than the lean rats. These results indicate that tumor onset and development were faster in spontaneous obese rat models with impaired glucose tolerance than in their lean counterparts.

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A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancer

Cited by 4 publications

References 51 publications

Breast Cancer: Impact of New Treatments?

Breast Cancer: Impact of New Treatments?

Geographical Variation in Social Determinants of Female Breast Cancer Mortality Across US Counties

Obesity Associated with Prediabetes Increases the Risk of Breast Cancer Development and Progression—A Study on an Obese Rat Model with Impaired Glucose Tolerance

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