Department of Internal Medicine, NewYork-Presbyterian Weill Cornell, New York, NY, USA.
Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Cancer Causes Control. 2024 Nov;35(11):1413-1432. doi: 10.1007/s10552-024-01884-2. Epub 2024 Jul 16.
Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer deaths in women, with psychosocial stress commonly cited by patients as one of its causes. While there is conflicting epidemiological evidence investigating the association between psychosocial stress and breast cancer incidence and progression, there is reason to believe that interventions aimed at reducing stress pharmacologically or psychologically may improve breast cancer outcomes. The aim of this review is to discuss the molecular and biological mechanisms of stress-attributed breast cancer incidence and progression, including the induction of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS), as well as decreased immune function and stress hormone-induced resistance to chemotherapy. Moreover, these mechanisms have been cited as potential therapeutic targets of pharmacologic and psychological interventions that may improve the care, well-being and survival of breast cancer patients. Further research is recommended to investigate whether interventions in the primary care setting for women with risk factors for breast cancer development may lead to a decreased incidence of invasive breast tumors.
乳腺癌是最常见的癌症，也是女性癌症死亡的第二大主要原因，患者普遍将心理社会压力列为其病因之一。虽然有一些流行病学证据表明心理社会压力与乳腺癌的发生和进展之间存在关联，但有理由相信，旨在通过药理学或心理学手段减轻压力的干预措施可能会改善乳腺癌的结局。本文旨在讨论与应激相关的乳腺癌发生和进展的分子和生物学机制，包括下丘脑-垂体-肾上腺 (HPA) 轴和交感神经系统 (SNS) 的诱导，以及免疫功能下降和应激激素诱导的化疗耐药。此外，这些机制被认为是可能改善乳腺癌患者护理、幸福感和生存的药理学和心理学干预的潜在治疗靶点。建议进一步研究，以调查在有乳腺癌发生风险因素的女性的初级保健环境中进行干预是否会降低浸润性乳腺癌肿瘤的发病率。
