Gershuni Victoria M, Ahima Rexford S, Tchou Julia
Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104, USA.
Department of Endocrinology, Diabetes and Metabolism, Division, Hospital of the University of Pennsylvania, 3400, Civic Center Boulevard, Building 421, Philadelphia, PA 19104, USA.
Curr Surg Rep. 2016 Apr;4. doi: 10.1007/s40137-016-0134-5. Epub 2016 Mar 21.
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.
随着美国肥胖症患病率持续上升，我们开始阐明肥胖相关的慢性炎症、内分泌功能障碍和激素产生作为乳腺癌风险增加驱动因素的复杂作用。流行病学数据表明，肥胖（体重指数>30）与乳腺癌发病率增加、预后较差和死亡率较高有关。从机制上讲，肥胖和过多的脂肪量代表着一种慢性炎症、胰岛素抵抗、脂肪因子失衡和雌激素信号增加的状态。这种促肿瘤环境通过乳腺组织的异常生长、增殖和存活来刺激癌症发展。重要的是，肥胖是一个可改变的风险因素；通过包括饮食和运动改变在内的行为改变实现体重减轻后，可观察到细胞增殖、细胞凋亡、循环雌激素和胰岛素敏感性的变化。
