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Obesity and Hormone Therapy

Posted 6/16/2010

Posted in

As we all know, there is a great deal of interest in the relationship between obesity and breast cancer. Weight (that is, too much of it) is associated with a higher risk of developing breast cancer in the first place and then with a higher risk of recurrence. I write this shortly after returning from my daily stint at the gym--and you can be sure that the possibility of reducing my risk is the reason that I go.

In the new issue of the Journal of Clinical Oncology, there is an article about this and, even more interesting for me, this editorial by Pamela Goodwin, MD from the University of Toronto. Here is the introductory paragraph and then a link to read more. The bottom line, once again, is that it seems to be important and helpful to keep our weight down.

Obesity and Hormone Therapy in Breast Cancer: An Unfinished Puzzle

Pamela J. Goodwin, Samuel Lunenfeld Research Institute, Mount Sinai Hospital and Princess Margaret Hospital, University of

Toronto, Toronto, Ontario, Canada

Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada

See accompanying article doi: 10.1200/JCO.2009.27.2021

The relationship between obesity and breast cancer is a complex

one.1 Obesity is associated with breast cancer risk in qualitatively

different ways before and after menopause (with decreased risk in

premenopausal women and increased risk in postmenopausal

women), whereas similar associations of obesity with prognosis are

seen in pre- and postmenopausal women (obese women in both

groups experience poorer outcomes). This complexity likely reflects,

at least in part, the variable relationships between obesity and estrogen

(a major contributor to the growth of hormone receptor-positive

breast cancer) before and after menopause. Before menopause, obesity

may interfere with normal menstrual cycling, potentially leading

to reductions in estrogen levels; after menopause, increased production

of estrogen in excess adipose tissue in obese women is associated

with higher estrogen levels. It is likely that the complexity of the

relationship between obesity and breast cancer also reflects important

contributions of obesity-related factors other than estrogen to both

breast cancer risk and prognosis.2 These factors include insulin, adipocytokines

such as leptin, and adiponectin, as well as inflammatory

markers such as C-reactive protein and interleukins.

http://jco.ascopubs.org/cgi/reprint/JCO.2010.29.5113v1

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