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Chan DS, Vieira R, Abar L, Aune D, Balducci K, Cariolou M, Greenwood DC, Markozannes G, Nanu N, Becerra‐Tomás N, Giovannucci EL, Gunter MJ, Jackson AA, Kampman E, Lund V, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley‐Gieser D, Mitrou P, Wiseman M, Cross AJ, Riboli E, Clinton SK, McTiernan A, Norat T, Tsilidis KK. Postdiagnosis body fatness, weight change and breast cancer prognosis: Global Cancer Update Program (CUP global) systematic literature review and meta-analysis. Int J Cancer 2023; 152:572-599. [PMID: 36279884 PMCID: PMC10092239 DOI: 10.1002/ijc.34322] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/29/2022] [Accepted: 09/05/2022] [Indexed: 02/01/2023]
Abstract
Previous evidence on postdiagnosis body fatness and mortality after breast cancer was graded as limited-suggestive. To evaluate the evidence on body mass index (BMI), waist circumference, waist-hip-ratio and weight change in relation to breast cancer prognosis, an updated systematic review was conducted. PubMed and Embase were searched for relevant studies published up to 31 October, 2021. Random-effects meta-analyses were conducted to estimate summary relative risks (RRs). The evidence was judged by an independent Expert Panel using pre-defined grading criteria. One randomized controlled trial and 225 observational studies were reviewed (220 publications). There was strong evidence (likelihood of causality: probable) that higher postdiagnosis BMI was associated with increased all-cause mortality (64 studies, 32 507 deaths), breast cancer-specific mortality (39 studies, 14 106 deaths) and second primary breast cancer (11 studies, 5248 events). The respective summary RRs and 95% confidence intervals per 5 kg/m2 BMI were 1.07 (1.05-1.10), 1.10 (1.06-1.14) and 1.14 (1.04-1.26), with high between-study heterogeneity (I2 = 56%, 60%, 66%), but generally consistent positive associations. Positive associations were also observed for waist circumference, waist-hip-ratio and all-cause and breast cancer-specific mortality. There was limited-suggestive evidence that postdiagnosis BMI was associated with higher risk of recurrence, nonbreast cancer deaths and cardiovascular deaths. The evidence for postdiagnosis (unexplained) weight or BMI change and all outcomes was graded as limited-no conclusion. The RCT showed potential beneficial effect of intentional weight loss on disease-free-survival, but more intervention trials and well-designed observational studies in diverse populations are needed to elucidate the impact of body composition and their changes on breast cancer outcomes.
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Affiliation(s)
- Doris S.M. Chan
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rita Vieira
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Leila Abar
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Dagfinn Aune
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of NutritionBjørknes University CollegeOsloNorway
- Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Katia Balducci
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Margarita Cariolou
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Georgios Markozannes
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Neesha Nanu
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Nerea Becerra‐Tomás
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Nutrition, Harvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Marc J. Gunter
- Nutrition and Metabolism Section, International Agency for Research on CancerLyonFrance
| | - Alan A. Jackson
- Faculty of Medicine, School of Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute of Health Research Cancer and Nutrition CollaborationSouthamptonUK
| | - Ellen Kampman
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Vivien Lund
- World Cancer Research Fund InternationalLondonUK
| | - Kate Allen
- World Cancer Research Fund InternationalLondonUK
| | | | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | | | | | | | | | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Steven K. Clinton
- Division of Medical Oncology, The Department of Internal MedicineCollege of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State UniversityColumbusOhioUSA
| | - Anne McTiernan
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Teresa Norat
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- World Cancer Research Fund InternationalLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
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A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancer. Breast Cancer Res Treat 2023; 198:89-101. [PMID: 36576677 PMCID: PMC9883351 DOI: 10.1007/s10549-022-06836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/02/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Obesity and breast cancer are two major pathologies closely associated with increasing incidence and mortality rates, especially amongst women. The association between both diseases have been thoroughly discussed but much is still to uncover. AIM The aim of this study is to analyse tumour characteristics and clinical outcomes of overweight and obese women to disclosure potential associations and better understand the impact of obesity in breast cancer. MATERIALS AND METHODS Clinicopathological information of 2246 women were extracted from the institutional database of comprehensive cancer centre in Portugal diagnosed between 2012 and 2016. Women were stratified according to body mass index as normal, overweight, and obese. Patients' demographic information and tumour features (age, family history, topographic localization, laterality, histological type, and receptor status) were taken as independent variables and overall survival, tumour stage, differentiation grade and bilaterality were considered clinical outcomes. RESULTS The main results reveal that overweight and obesity are predominantly associated with worse outcomes in breast cancer patients. Obese patients present larger (p-value: 0.002; OR 1.422; 95% CI 1.134-1.783) and more poorly differentiated tumours (p-value: 0.002; OR 1.480; 95% CI 1.154-1.898) and tend to have lower overall survival although without statistical significance (p-value: 0.117; OR 1.309; 95% CI 0.934-1.833). Overweighted women are more likely to have bilateral breast cancer (p-value: 0.017; OR 3.076; 95% CI 1.225-7.722) than obese women. The results also reveal that overweight women present less distant metastasis (p-value: 0.024; OR 0.525; 95%CI 0.299-0.920). Topographic localization and laterality did not achieve statistical significance.
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Berishvili AI, Kedrova AG, Greyan TA, Zaitseva OV. Obesity and breast cancer. TUMORS OF FEMALE REPRODUCTIVE SYSTEM 2022. [DOI: 10.17650/1994-4098-2022-18-3-40-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The paper presents an analysis of the latest literature data on the problem of obesity and breast cancer (BC). This review presents modern approaches to the diagnosis of BC in obese patients, new molecular methods of breast imaging, analyzes the features of the course of BC with obesity depending on menstrual status, molecular biological subtypes of the tumor, the mechanisms of the development of BC against the background of obesity.
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Affiliation(s)
- A. I. Berishvili
- Department of Obstetrics and Gynecology, Academy of Postgraduate Education, Federal Research and Clinical Center, Federal Biomedical Agency; Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
| | - A. G. Kedrova
- Department of Obstetrics and Gynecology, Academy of Postgraduate Education, Federal Research and Clinical Center, Federal Biomedical Agency; Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation; Institute of Oncology and Neurosurgery, E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
| | - T. A. Greyan
- Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
| | - O. V. Zaitseva
- Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
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Cortesi L, Galli GR, Domati F, Conte L, Manca L, Berio MA, Toss A, Iannone A, Federico M. Obesity in Postmenopausal Breast Cancer Patients: It Is Time to Improve Actions for a Healthier Lifestyle. The Results of a Comparison Between Two Italian Regions With Different "Presumed" Lifestyles. Front Oncol 2021; 11:769683. [PMID: 34869002 PMCID: PMC8637830 DOI: 10.3389/fonc.2021.769683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/20/2021] [Indexed: 11/21/2022] Open
Abstract
Background Adult body fatness is a convincing risk factor for postmenopausal breast cancer. With the aim to compare the different breast cancer (BC) features in Northern and Southern Italy, we investigated the relationship between BMI and BC characteristic in two groups of patients referred in the Modena and Lecce breast units. Materials and Methods A retrospective analysis of a continuous series of BC patients referred to the Città di Lecce Hospital and the Modena Cancer Center, from January 2019 to December 2020 was performed. We identified four groups of BMI at BC diagnosis: underweight, BMI <18.5 kg/m2; normal weight, BMI ≥ 18.5–24.9 kg/m2; overweight, BMI ≥ 25.0–29.9 kg/m2; obese, BMI ≥30.0 kg/m2. BC characteristics and clinical outcomes were analyzed by the Kolmogorov-Smirnov test and Mann-Whitney U test; categorical data were compared using Pearson’s chi-square test, and dicotomic data were compared by odds ratio. Results Nine hundred seventy-seven BC patients were included in the analysis. Overall, 470 were from Modena and 507 from Lecce. No differences were observed in the mean age of BC patients of Modena (61,42) and Lecce (62,08). No statistical differences between the two populations were shown in terms of tumor characteristics and pathological stage. Conversely, a statistical difference of BMI between the BC patients coming from Modena and Lecce (25.87 and 27.81, respectively; p = 0.000001) was found. BC patients diagnosed in Lecce at age ≥70 years had higher median BMI compared with the ones from Modena (p = 0.000002). The increased BMI in this aged population was also associated to larger tumor size (p = 0.040). Conclusion The rate of overweight and obesity was higher in BC women living in Southern Italy, despite the presumed nutrition according to the so-called Mediterranean type dietary pattern. Unexpectedly, an increased BMI rate and a relationship with larger tumor size were found in Southern BC patients aged ≥70 years. Our findings strongly support the need for promoting a healthier lifestyle model in Italy, with the aim of reducing the rate of the obesity and, consequently, the increased risk of BC.
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Affiliation(s)
- Laura Cortesi
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Giulia Raffaella Galli
- Breast Unit City of Lecce Hospital, Gruppo Villa Maria (GVM) Care & Research, Lecce, Italy
| | - Federica Domati
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luana Conte
- Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics, University of Salento, Lecce, Italy.,Laboratory of Interdisciplinary Research Applied to Medicine, University of Salento and Azienda Sanitaria Locale (ASL), Lecce, Italy
| | - Luigi Manca
- Breast Unit City of Lecce Hospital, Gruppo Villa Maria (GVM) Care & Research, Lecce, Italy
| | - Maria Antonietta Berio
- Breast Unit City of Lecce Hospital, Gruppo Villa Maria (GVM) Care & Research, Lecce, Italy
| | - Angela Toss
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy.,Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Iannone
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Federico
- Breast Unit City of Lecce Hospital, Gruppo Villa Maria (GVM) Care & Research, Lecce, Italy
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Influence of serum inflammatory cytokines on cytochrome P450 drug metabolising activity during breast cancer chemotherapy: a patient feasibility study. Sci Rep 2021; 11:5648. [PMID: 33707475 PMCID: PMC7952716 DOI: 10.1038/s41598-021-85048-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/22/2021] [Indexed: 11/16/2022] Open
Abstract
Individual response to chemotherapy in patients with breast cancer is variable. Obesity and exercise are associated with better and worse outcomes, respectively, and it is known that both impact the systemic cytokine milieu. Cytochrome P450 (CYP) enzymes are responsible for the metabolism of many chemotherapy agents, and CYP enzyme activity has been shown to be modified by inflammatory cytokines in vitro and in vivo. Cytokine-associated changes in CYP metabolism may alter chemotherapy exposure, potentially affecting treatment response and patient survival. Therefore, better understanding of these biological relationships is required. This exploratory single arm open label trial investigated changes in in vivo CYP activity in twelve women treated for stage II or III breast cancer, and demonstrated for the first time the feasibility and safety of utilising the Inje phenotyping cocktail to measure CYP activity in cancer patients receiving chemotherapy. Relative CYP activity varied between participants, particularly for CYP2C9 and CYP2D6, and changes in serum concentrations of the inflammatory cytokine monocyte chemoattractant protein 1 inversely correlated to CYP3A4 activity during chemotherapy. Future use of phenotyping cocktails in a clinical oncology setting may help guide drug dosing and improve chemotherapy outcomes. Clinical Trial Registration: Trial was retrospectively registered to the Australia New Zealand Clinical Trial Registry (ANZCTR). ACTRN12620000832976, 21 Aug 2020, https://www.anzctr.org.au/ACTRN12620000832976.aspx.
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Abusanad A, Alghamdi B, Alghamdi R, Khallaf R, Faisal K, Bishnaq R. The association of body mass index and adverse clinicopathological characteristics in non-metastatic breast cancer. J Family Med Prim Care 2020; 9:4190-4195. [PMID: 33110830 PMCID: PMC7586531 DOI: 10.4103/jfmpc.jfmpc_596_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/10/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022] Open
Abstract
Background Obesity is a global health problem. It is becoming increasingly prevalent in Saudi Arabia. High body mass index (BMI) is a risk factor for many diseases, including cancer. Noticeably, breast cancer (BC) cases in Saudi Arabia occur at a younger age than in western countries. Different lifestyle behaviors such as maintaining healthy body weight and physical activity may play a role in this. In this study, we investigated the association between BMI and BC adverse clinicopathological features. Methods This retrospective study was conducted by reviewing the records of women with non-metastatic BC over 4 years. The association between BMI and patients' demographics, BC histological type, receptor status, differentiation grade, tumor size, involvement of axillary lymph nodes, and performed procedures were analyzed. Result 315 patients with non-metastatic BC were studied. The mean age at the time of diagnosis was 52.43 years ± 11.63. The mean BMI was 30.21 ± 5.77. The mean tumor size was 3.19 cm ± 3.52. The mean age of diagnosis is significantly higher in obese women than in other BMI groups (P = 0.025). Obese female patients aged ≥40 were more likely to present with larger tumor (P = 0.022) and numerically higher pathological axillary lymph nodes, trending toward statistical significance (P = 0.092). Conclusion The relationship between BMI and developing more aggressive BC is still not clear; in this study, we found that obese patients presented at an older age, with larger tumor and more pathologic lymph nodes. Further research to understand the impact of this finding on outcomes is warranted.
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Affiliation(s)
- Atlal Abusanad
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Bashayer Alghamdi
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Reema Alghamdi
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Raghad Khallaf
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Konooz Faisal
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Raghad Bishnaq
- Department of Internal Medicine and Medical Oncology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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7
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Shamshirian A, Heydari K, Shams Z, Aref AR, Shamshirian D, Tamtaji OR, Asemi Z, Shojaie L, Mirzaei H, Mohammadi N, Zibaee B, Karimifar K, Zarandi B, Hedayatizadeh-Omran A, Alizadeh-Navaei R. Breast cancer risk factors in Iran: a systematic review & meta-analysis. Horm Mol Biol Clin Investig 2020; 41:/j/hmbci.ahead-of-print/hmbci-2020-0021/hmbci-2020-0021.xml. [PMID: 33079703 DOI: 10.1515/hmbci-2020-0021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran. METHODS We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models. RESULTS Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47-2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95%CI 0.84-1.74), passive smokers (OR: 1.68, 95%CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19-5.63), abortion (OR: 1.84, 95%CI 1.35-2.33), sweets consumption (OR: 1.71, 95%CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32-0.83), nulliparity (OR: 0.68, 95%CI 0.39-0.96), 13-24 months of breastfeeding (OR: 0.68, 95%CI 0.46-0.90), daily exercise (OR: 0.59, 95%CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10-0.46). CONCLUSIONS This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development.
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Affiliation(s)
- Amir Shamshirian
- Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Science, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Keyvan Heydari
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Zahra Shams
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Amir Reza Aref
- Department of Medical Oncology, Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Danial Shamshirian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Omid Reza Tamtaji
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Layla Shojaie
- Department of Medicine, Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Neda Mohammadi
- Student Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Behdad Zibaee
- Student Research Committee, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
| | - Keyvan Karimifar
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Bahman Zarandi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
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Asante EC, Pallegar NK, Hoffmann AJ, Viloria-Petit AM, Christian SL. Adipose Tissue from Lean and Obese Mice Induces a Mesenchymal to Epithelial Transition-Like Effect in Triple Negative Breast Cancers Cells Grown in 3-Dimensional Culture. Int J Mol Sci 2020; 21:E6439. [PMID: 32899433 PMCID: PMC7503907 DOI: 10.3390/ijms21176439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/01/2023] Open
Abstract
Breast cancer is the second leading cause of cancer-related mortality among women globally with obesity being one risk factor. Obese breast cancer patients have at least a 30% increased risk of death from breast cancer compared to non-obese breast cancer patients because they present with larger tumors and generally have increased rates of metastasis. Moreover, obese breast cancer patients respond more poorly to treatment compared to non-obese patients, particularly pre-menopausal women diagnosed with triple negative breast cancer (TNBC). To help understand the molecular mechanisms underlying the increased metastasis associated with obesity, we previously established a three-dimensional culture system that permits the co-culture of adipocytes and TNBC cells in a manner that mimics an in vivo milieu. Using this system, we demonstrate that white adipose tissue from both lean and obese mice can induce a partial mesenchymal-to-epithelial transition (MET). Triple negative breast cancer cells adopt an epithelial morphology and have an increased expression of some epithelial markers, but they maintain the expression of mesenchymal markers, furnishing the breast cancer cells with hybrid properties that are associated with more aggressive tumors. Thus, these data suggest that adipose tissue has the potential to promote secondary tumor formation in lean and obese women. Further work is needed to determine if targeting the partial MET induced by adipose tissue could reduce metastasis.
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Affiliation(s)
- Emmanuel C. Asante
- Department of Biochemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada; (E.C.A.); (N.K.P.); (A.J.H.)
| | - Nikitha K. Pallegar
- Department of Biochemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada; (E.C.A.); (N.K.P.); (A.J.H.)
| | - Alica J. Hoffmann
- Department of Biochemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada; (E.C.A.); (N.K.P.); (A.J.H.)
| | - Alicia M. Viloria-Petit
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Sherri L. Christian
- Department of Biochemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada; (E.C.A.); (N.K.P.); (A.J.H.)
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Wang J, Cai Y, Yu F, Ping Z, Liu L. Body mass index increases the lymph node metastasis risk of breast cancer: a dose-response meta-analysis with 52904 subjects from 20 cohort studies. BMC Cancer 2020; 20:601. [PMID: 32600328 PMCID: PMC7325029 DOI: 10.1186/s12885-020-07064-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/11/2020] [Indexed: 12/31/2022] Open
Abstract
Background Since body mass index (BMI) is a convincing risk factor for breast cancer, it is speculated to be associated with lymph node metastasis. However, epidemiological studies are inconclusive. Therefore, this study was conducted to investigate the effect of BMI on the lymph node metastasis risk of breast cancer. Methods Cohort studies that evaluating BMI and lymph node metastasis in breast cancer were selected through various databases including PubMed, PubMed Central (PMC), Web of science, the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals (VIP) and Wanfang Data Knowledge Service Platform (WanFang) until November 30, 2019. The two-stage, random effect meta-analysis was performed to assess the dose-response relationship between BMI and lymph node metastasis risk. Between-study heterogeneity was assessed using I2. Subgroup analysis was done to find possible sources of heterogeneity. Results We included a total of 20 studies enrolling 52,904 participants. The summary relative risk (RR) (1.10, 95%CI: 1.06–1.15) suggested a significant effect of BMI on the lymph node metastasis risk of breast cancer. The dose-response meta-analysis (RR = 1.01, 95%CI: 1.00–1.01) indicated a positive linear association between BMI and lymph node metastasis risk. For every 1 kg/m2 increment of BMI, the risk of lymph node metastasis increased by 0.89%. In subgroup analyses, positive linear dose-response relationships between BMI and lymph node metastasis risk were observed among Asian, European, American, premenopausal, postmenopausal, study period less than 5 years, and more than 5 years groups. For every 1 kg/m2 increment of BMI, the risk of lymph node metastasis increased by 0.99, 0.85, 0.61, 1.44, 1.45, 2.22, and 0.61%, respectively. Conclusion BMI significantly increases the lymph node metastasis risk of breast cancer as linear dose-response reaction. Further studies are needed to identify this association.
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Affiliation(s)
- Junyi Wang
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Yaning Cai
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Fangfang Yu
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China.
| | - Li Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.
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Lifestyle Intervention on Body Weight and Physical Activity in Patients with Breast Cancer can reduce the Risk of Death in Obese Women: The EMILI Study. Cancers (Basel) 2020; 12:cancers12071709. [PMID: 32605075 PMCID: PMC7407899 DOI: 10.3390/cancers12071709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 12/28/2022] Open
Abstract
Background obesity and sedentary lifestyle have been shown to negatively affect survival in breast cancer (BC). The purpose of this study was to test the efficacy of a lifestyle intervention on body mass index (BMI) and physical activity (PA) levels among BC survivors in Modena, Italy, in order to show an outcome improvement in obese and overweight patients. Methods: This study is a single-arm experimental design, conducted between November 2009 and May 2016 on 430 women affected by BC. Weight, BMI, and PA were assessed at baseline, at 12 months, and at the end of the study. Survival curves were estimated among normal, overweight, and obese patients. Results: Mean BMI decreased from baseline to the end of the study was equal to 2.9% (p = 0.065) in overweight patients and 3.3% in obese patients (p = 0.048). Mean PA increase from baseline to the end of the study was equal to 125% (p < 0.001) in normal patients, 200% (p < 0.001) in overweight patients and 100% (p < 0.001) in obese patients. After 70 months of follow-up, the 5-year overall survival (OS) rate was 96%, 96%, and 93%, respectively in normal, obese, and overweight patients. Overweight patients had significantly worse OS than normal ones (HR = 3.69, 95%CI = 1.82–4.53 p = 0.027) whereas no statistically significant differences were seen between obese and normal patients (HR 2.45, 95%CI = 0.68–8.78, p = 0.169). Conclusions: A lifestyle intervention can lead to clinically meaningful weight loss and increase PA in patients with BC. These results could contribute to improving the OS in obese patients compared to overweight ones.
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11
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Obesity and Breast Cancer: A Case of Inflamed Adipose Tissue. Cancers (Basel) 2020; 12:cancers12061686. [PMID: 32630445 PMCID: PMC7352736 DOI: 10.3390/cancers12061686] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is associated with an increased risk of estrogen receptor-positive breast cancer in postmenopausal women and a worse prognosis for all major breast cancer subtypes regardless of menopausal status. While the link between obesity and the pathogenesis of breast cancer is clear, the molecular mechanism of this association is not completely understood due to the complexity of both obesity and breast cancer. The aim of this review is to highlight the association between obesity and breast cancer and discuss the literature, which indicates that this association is due to chronic adipose tissue inflammation. We will discuss the epidemiological data for the association between breast cancer incidence and progression as well as the potential molecular mechanisms for this association. We will focus on the role of inflammation within the adipose tissue during the pathogenesis of breast cancer. A better understanding of how obesity and adipose tissue inflammation affects the pathogenesis of breast cancer will lead to new strategies to reduce breast cancer risk and improve patient outcomes for obese patients.
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Gondo N, Sawaki M, Hattori M, Yoshimura A, Kotani H, Adachi Y, Kataoka A, Sugino K, Mori M, Horisawa N, Terada M, Ozaki Y, Iwata H. Impact of BMI for clinical outcomes in Japanese breast cancer patients. Jpn J Clin Oncol 2020; 50:230-240. [PMID: 31958129 DOI: 10.1093/jjco/hyz175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/25/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The relationship between the body mass index (BMI) at the time of breast cancer diagnosis and the prognosis of breast cancer patients has not yet been clarified. We investigated the impact of obesity for clinical outcomes in Japanese breast cancer patients. METHODS Women with primary breast cancer operated between 2002 and 2014 were identified. All patients are categorized into four groups according to BMI. The range of BMI is <18.5 kg/m2, from 18.5 to 24.9 kg/m2, 25 to 29.9 kg/m2, >30 kg/m2 in underweight, normal, overweight and obesity groups, respectively. The correlation between BMI and overall survival (OS), breast cancer-specific survival (BCSS) and disease-free survival (DFS) were statistically analyzed. RESULTS From the database of our institution, we identified 3223 patients. The median follow-up period was 57 months (1-149). We categorized 2257 (70.0%), 318 (9.9%), 545 (16.9%) and 103 (3.2%) patients into normal, underweight, overweight obesity groups respectively. There were189 patients (5.9%) deaths due to breast cancer recurrence (137 patients) and other disease (52 patients). Obesity groups was significantly high compared with normal groups for OS (adjusted HR, 2.43; 95% CI, 1.38-4.28; P < 0.001), BCSS (adjusted HR, 2.73; 95% CI, 1.15-6.44; P = 0.02) and DFS (adjusted HR, 1.83; 95% CI, 1.11-3.02; P = 0.017) by multivariate analysis. Especially, OS (adjusted HR, 4.87; 95% CI, 2.15-11.04; P < 0.001), BCSS (adjusted HR, 4.51; 95% CI, 1.52-13.34; P < 0.001) and DFS (adjusted HR, 4.87; 95% CI, 1.02-4.89; P = 0.04) were statistically insignificant in postmenopausal ER-positive breast cancer patients. CONCLUSION Obesity might be risk factor for OS, BCSS and DFS, especially postmenopausal ER-positive women.
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Affiliation(s)
- Naomi Gondo
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Masaya Hattori
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Haruru Kotani
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Yayoi Adachi
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Ayumi Kataoka
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Kayoko Sugino
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Makiko Mori
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Nanae Horisawa
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Mitsuo Terada
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Yuri Ozaki
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan, 1-1, Kanokoden, Chikusa-ku, Nagoya-city, Aichi 464-8681, Japan
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Juárez-Cruz JC, Zuñiga-Eulogio MD, Olea-Flores M, Castañeda-Saucedo E, Mendoza-Catalán MÁ, Ortuño-Pineda C, Moreno-Godínez ME, Villegas-Comonfort S, Padilla-Benavides T, Navarro-Tito N. Leptin induces cell migration and invasion in a FAK-Src-dependent manner in breast cancer cells. Endocr Connect 2019; 8:1539-1552. [PMID: 31671408 PMCID: PMC6893313 DOI: 10.1530/ec-19-0442] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/31/2019] [Indexed: 12/24/2022]
Abstract
Breast cancer is the most common invasive neoplasia, and the second leading cause of the cancer deaths in women worldwide. Mammary tumorigenesis is severely linked to obesity, one potential connection is leptin. Leptin is a hormone secreted by adipocytes, which contributes to the progression of breast cancer. Cell migration, metalloproteases secretion, and invasion are cellular processes associated with various stages of metastasis. These processes are regulated by the kinases FAK and Src. In this study, we utilized the breast cancer cell lines MCF7 and MDA-MB-231 to determine the effect of leptin on FAK and Src kinases activation, cell migration, metalloprotease secretion, and invasion. We found that leptin activates FAK and Src and induces the localization of FAK to the focal adhesions. Interestingly, leptin promotes the activation of FAK through a Src- and STAT3-dependent canonical pathway. Specific inhibitors of FAK, Src and STAT3 showed that the effect exerted by leptin in cell migration in breast cancer cells is dependent on these proteins. Moreover, we established that leptin promotes the secretion of the extracellular matrix remodelers, MMP-2 and MMP-9 and invasion in a FAK and Src-dependent manner. Our findings strongly suggest that leptin promotes the development of a more aggressive invasive phenotype in mammary cancer cells.
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Affiliation(s)
| | | | - Monserrat Olea-Flores
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | | | | | - Carlos Ortuño-Pineda
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | | | | | - Teresita Padilla-Benavides
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Napoleón Navarro-Tito
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
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Ayoub NM, Yaghan RJ, Abdo NM, Matalka II, Akhu-Zaheya LM, Al-Mohtaseb AH. Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study. J Obes 2019; 2019:3820759. [PMID: 31019808 PMCID: PMC6452538 DOI: 10.1155/2019/3820759] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/15/2019] [Accepted: 03/03/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To investigate the association between obesity and breast cancer clinicopathologic characteristics at presentation along with prognostic impact among Jordanian breast cancer patients. Such data are lacking in Arabian countries. METHODS In this retrospective study, 348 breast cancer patients were included. Analyses were conducted for associations between body mass index (BMI) and age at diagnosis, tumor clinicopathologic characteristics, and molecular subtypes. Eight prognostic factors were considered, and total prognostic scores were calculated. The analysis was stratified by menopausal status. Multivariate logistic stepwise regression analysis was conducted to identify predictors for breast cancer recurrence and death. RESULTS Mean age at diagnosis was 50.98 ± 10.96 years. Mean BMI at diagnosis was 29.52 ± 5.32 kg/m2. Mean age at diagnosis was significantly higher for overweight and obese patients compared to underweight/normal patients (P < 0.001). A significant positive correlation was observed between patient age and BMI at diagnosis (r = 0.251, P < 0.001). Grade of carcinoma was significantly correlated with BMI in the whole population examined (P=0.003). Obese breast cancer patients had significantly higher prognostic scores compared to nonobese cases, indicating worse prognostic features at presentation (P=0.034). Stratification of data analysis based on menopausal status revealed significant associations between obesity and each of tumor stage and grade among postmenopausal but not premenopausal patients (P=0.019 and P=0.031, respectively). Similarly, postmenopausal obese patients had significantly higher prognostic scores compared to nonobese counterparts (P=0.007), indicating worse prognosis, a finding which was also absent among premenopausal breast cancer patients. No significant association between BMI with expression status of hormone receptors, HER2, lymphovascular invasion, and molecular subtypes was found among patients. BMI was a significant predictor for disease recurrence in which obese breast cancer patients had greater odds (2-fold) to develop locoregional and distant recurrence compared to nonobese cases (P=0.011). CONCLUSIONS Obesity was associated with advanced stage and grade of breast carcinoma at diagnosis. The impact of BMI on clinicopathologic characteristics and prognosis was confined to postmenopausal cases. Jordanian obese breast cancer patients are at greater risk of breast cancer recurrence and reduced survival compared to their nonobese counterparts.
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Affiliation(s)
- Nehad M. Ayoub
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Rami J. Yaghan
- Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Nour M. Abdo
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Ismail I. Matalka
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Laila M. Akhu-Zaheya
- Department of Adults Health Nursing, Faculty of Nursing, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Alia H. Al-Mohtaseb
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
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15
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Breast Cancer: Metastasis, Molecular Subtypes, and Overweight and Obesity in Veracruz, Mexico. Clin Breast Cancer 2018; 19:e166-e171. [PMID: 30236925 DOI: 10.1016/j.clbc.2018.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/11/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION We assessed the association between overweight, obesity, and morbid obesity with the incidence of the most aggressive breast cancer subtypes in women. METHODS AND MATERIALS A cross-sectional study was performed. We conducted a record review to identify the following aspects: body mass index, sociodemographic features, tumor characteristics, and reproductive and molecular aspects. Descriptive statistics and univariate analysis were performed to identify the association between the molecular subtypes and the study variables. In addition, we used multivariate analysis to identify the association between obesity and the presence of metastatic lymph nodes. RESULTS We included 1446 women with an average age of 52.5 ± 12.1 years. Of the 1446 patients, 47% were premenopausal and 75% were overweight. Univariate analysis indicated a statistically significant association between obesity and advanced disease stage, as well as nulliparity and multiparity. Similar results were found for women with morbid obesity. Model 1 of the multivariate analysis showed an association between the presence of metastatic lymph nodes and obesity (odds ratio [OR], 1.6; P = .008) and histologic grade 2 or 3 (OR, 2.4; P = .003). Using model 2, an association was identified between an advanced disease stage and 2 factors: morbid obesity (OR, 1.9; P = .02) and positive human epidermal growth factor receptor 2 (OR, 1.8; P = .045). CONCLUSION We found that obesity is associated with the more advanced stages of breast cancer. Further studies are needed to evaluate the role of obesity in breast cancer progression in women.
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16
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Sun L, Zhu Y, Qian Q, Tang L. Body mass index and prognosis of breast cancer: An analysis by menstruation status when breast cancer diagnosis. Medicine (Baltimore) 2018; 97:e11220. [PMID: 29952978 PMCID: PMC6039647 DOI: 10.1097/md.0000000000011220] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To examine whether obesity/overweight is a risk predictor for breast cancer recurrence and death by menopausal status in a retrospective study. METHODS We performed a retrospective analysis of 1017 breast cancer patients treated in our hospital from January 2004 to December 2012. Three groups were divided according to body mass index (BMI) when breast cancer diagnosis: normal weight, BMI < 25.0 kg/m; overweight, 25.0≤BMI < 30.0 kg/m; and obesity, BMI≥30.0 kg/m. The clinicopathological characteristics and clinical outcomes of patients within 5 years following breast cancer diagnosed were analyzed. Subgroup analyses of BMI on breast cancer prognosis were analyzed according to the menopausal status when breast cancer diagnosis. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Overweight and obesity groups were associated with larger size tumors, older age, increased proportion of postmenopausal patients and less patients choosing anthracycline and/or taxane regimen. The 5-year disease-free survival (DFS) and overall survival (OS) decreased in overweight and obese patients (P < .001), and both overweight and obesity were independent predictors for increased risks of breast cancer relapse and death (P < .001). When stratified by menopausal status, both overweight and obesity were associated with reduced 5-year DFS and OS in postmenopausal patients (P < .050), and multivariate analysis showed that the risk of relapse and breast cancer mortality in these 2 groups also increased (P < .050). Among premenopausal patients, the risks of relapse and death were significantly increased in obesity group rather than overweight group by multivariate analysis. CONCLUSION Overweight and obesity might be independently associated with poorer prognosis for breast cancer patients, and the effects of overweight on the breast cancer prognosis seem to be related to menopausal status.
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Affiliation(s)
- Li Sun
- Department of Breast Surgery
| | | | - Qi Qian
- Department of Breast Surgery
| | - Liming Tang
- Department of General Surgery, the Affiliated Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, China
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Krishnan K, Baglietto L, Stone J, McLean C, Southey MC, English DR, Giles GG, Hopper JL. Mammographic density and risk of breast cancer by tumor characteristics: a case-control study. BMC Cancer 2017; 17:859. [PMID: 29246131 PMCID: PMC5732428 DOI: 10.1186/s12885-017-3871-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 12/04/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In a previous paper, we had assumed that the risk of screen-detected breast cancer mostly reflects inherent risk, and the risk of whether a breast cancer is interval versus screen-detected mostly reflects risk of masking. We found that inherent risk was predicted by body mass index (BMI) and dense area (DA) or percent dense area (PDA), but not by non-dense area (NDA). Masking, however, was best predicted by PDA but not BMI. In this study, we aimed to investigate if these associations vary by tumor characteristics and mode of detection. METHODS We conducted a case-control study nested within the Melbourne Collaborative Cohort Study of 244 screen-detected cases matched to 700 controls and 148 interval cases matched to 446 controls. DA, NDA and PDA were measured using the Cumulus software. Tumor characteristics included size, grade, lymph node involvement, and ER, PR, and HER2 status. Conditional and unconditional logistic regression were applied as appropriate to estimate the Odds per Adjusted Standard Deviation (OPERA) adjusted for age and BMI, allowing the association with BMI to be a function of age at diagnosis. RESULTS For screen-detected cancer, both DA and PDA were associated to an increased risk of tumors of large size (OPERA ~ 1.6) and positive lymph node involvement (OPERA ~ 1.8); no association was observed for BMI and NDA. For risk of interval versus screen-detected breast cancer, the association with risk for any of the three mammographic measures did not vary by tumor characteristics; an association was observed for BMI for positive lymph nodes (OPERA ~ 0.6). No associations were observed for tumor grade and ER, PR and HER2 status of tumor. CONCLUSIONS Both DA and PDA were predictors of inherent risk of larger breast tumors and positive nodal status, whereas for each of the three mammographic density measures the association with risk of masking did not vary by tumor characteristics. This might raise the hypothesis that the risk of breast tumours with poorer prognosis, such as larger and node positive tumours, is intrinsically associated with increased mammographic density and not through delay of diagnosis due to masking.
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Affiliation(s)
- Kavitha Krishnan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Laura Baglietto
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Gustave Roussy, F-94805 Villejuif, France
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Perth, Australia
| | | | - Melissa C. Southey
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Australia
| | - Dallas R. English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - Graham G. Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton, VIC 3053 Australia
- Seoul Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
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Wang J, Wu Y, Guo J, Fei X, Yu L, Ma S. Adipocyte-derived exosomes promote lung cancer metastasis by increasing MMP9 activity via transferring MMP3 to lung cancer cells. Oncotarget 2017; 8:81880-81891. [PMID: 29137230 PMCID: PMC5669856 DOI: 10.18632/oncotarget.18737] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/12/2017] [Indexed: 12/28/2022] Open
Abstract
Obesity is involved in tumor progression. However, the corresponding mechanisms remain largely unknown. Here, we report that adipocytes increase the invasive ability of tumor cells by producing exosomes with a high level of MMP3. Compared with 3T3-L1 cells, 3T3-L1 adipocytes are enriched in MMP3 protein and can transfer MMP3 to 3LL lung cancer cells. Then, MMP3 activates MMP9 activity in 3LL cells and promotes invasion in vitro and in vivo via MMP9. Furthermore, MMP3 protein levels in lung tumor tissues from obese patients are increased compared with those of non-obese patients. In addition, MMP3 protein levels are positively correlated with MMP9 activity in tumor tissues. Therefore, our results reveal a novel mechanism in the adipocyte-derived exosome-mediated promotion of lung tumor metastasis, which extends our knowledge regarding obesity and tumor progression.
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Affiliation(s)
- Jiaoli Wang
- Department of Respiratory Medicine, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, China
| | - Yilei Wu
- Department of General Surgery, Ruian People's Hospital, Wenzhou, China
| | - Jufeng Guo
- Department of Breast Surgery, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, China
| | - Xuefeng Fei
- Institute of Immunology, Zhejiang University School of Medicine, Hangzhou, China
| | - Lei Yu
- Laboratory of Cancer Epigenetics, Department of Medical Oncology, Biomedical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shenglin Ma
- Department of Oncology, Nanjing Medical University, Affiliated Hangzhou Hospital (Hangzhou First People's Hospital), Hangzhou, China
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Atique S, Hsieh CH, Hsiao RT, Iqbal U, Nguyen PAA, Islam MM, Li YCJ, Hsu CY, Chuang TW, Syed-Abdul S. Viral warts (Human Papilloma Virus) as a potential risk for breast cancer among younger females. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 144:203-207. [PMID: 28495003 DOI: 10.1016/j.cmpb.2017.03.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION There have been several reports on the role of human papillomavirus (HPV) in the etiology of breast cancer. To our knowledge, this is first study to use disease-disease association data-mining approach to analyzing viral warts and breast cancer to be conducted in Taiwanese population. MATERIALS AND METHODS We analyzed the Taiwan's National Health Insurance database (NHIDM data comprising of 23 million patient data) to examine the association between viral warts and female breast carcinoma. The patients were categorized into three groups: breast cancer only, viral warts only, and those with both breast cancer and viral warts. The Cox proportion hazard regression analysis was used to measure the effect of HPV on the time to breast cancer diagnosis. Multivariable analyzes and stratified analyzes using hazard ratios (HRs) were presented with 95% confidence intervals (CIs) after adjusting for age, and CCI. RESULT Among 807,578 HPV population, we identified 6014 breast cancer cases. The HPV group was associated with a significantly higher risk of developing breast cancer (HR, 1.18; 95% CI, 1.15-1.21; p< 0.001) compared with the non-HPV group. HPV patients with age group 18-39 was slightly higher risk of breast cancer occurrence (HR, 1.07; 95% CI, 1.01-1.13; p<.05). The risk of breast cancer in 10-year incidence was 7% higher for females less than 40 years and 23% for over 40 year's patients when compared with non-HPV patients of the same age group. CONCLUSION Our study indicates that women who develop viral warts are at a significantly higher risk of developing breast cancer than women who have not diagnosed with viral warts. Thus, the presence of viral warts is a potential risk to breast cancer. Therefore, we suggest patients diagnosed with viral warts may get early screening for breast cancer.
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Affiliation(s)
- Suleman Atique
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology (CoMST), Taipei Medical University Taiwan, Wuxing Street 250, Xinyi 11031, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Chung-Ho Hsieh
- Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Ruei-Ting Hsiao
- Institute of Biomedical Informatics, National Yang-Ming University, Taiwan
| | - Usman Iqbal
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan; Global Health and Development Deparrtment, College of Public health, Taipei Medical University, Taipei, Taiwan; Health Informatics Unit, COMSATS Institute of Information Technology, Islamabad, Pakistan
| | - Phung Anh Alex Nguyen
- Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Md Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology (CoMST), Taipei Medical University Taiwan, Wuxing Street 250, Xinyi 11031, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology (CoMST), Taipei Medical University Taiwan, Wuxing Street 250, Xinyi 11031, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan; Department. of Dermatology, Wan Fang Hospital, Taipei, Taiwan
| | - Chien-Yeh Hsu
- Global Health and Development Deparrtment, College of Public health, Taipei Medical University, Taipei, Taiwan; Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shabbir Syed-Abdul
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology (CoMST), Taipei Medical University Taiwan, Wuxing Street 250, Xinyi 11031, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan.
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de Fátima Guerreiro Godoy M, Silva EB, de Godoy JMP. Bioimpedance to screen for abdominal fat in patients with breast cancer treatment-related lymphedema. Breast Dis 2017; 36:73-6. [PMID: 27662273 DOI: 10.3233/bd-160215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND One of the dreaded complications after the treatment of breast cancer is lymphedema. Therapies used in the treatment of breast cancer such as surgery, radiotherapy, hormone therapy and chemotherapy may be adversely affected by obesity. AIM The objective of this study was to use bioimpedance to assess abdominal fat in women with breast cancer treatment-related lymphedema and suggest this as a screening method. METHODS Forty-five female patients with clinical diagnosis of breast cancer treatment-related lymphedema were evaluated in this quantitative cross-sectional study. A control group, composed of 38 patients with varicose veins and women attending a social support group, was matched for age and body mass index (BMI). All participants were submitted to a bioimpedance evaluation (In Body S 10), with particular attention being paid to abdominal fat and their BMI. The unpaired t -test, Fisher Exact test and Mann-Whitney test were used for statistical analysis and an alpha error of 5%. RESULTS There was no significant difference (p -value = 0.23) in the mean BMI between the study group (27.79 kg∕m2) and the control group (28.80 kg∕m2). The mean abdominal circumference, a measure of abdominal fat, of the women in the study group was 130.54 cm2 and for the control group it was 102.24 cm2 (p -value = 0.0037). Thus the study group had more abdominal fat (p -value = 0.0003). Moreover, on comparing obese patients in the two groups, the study group had more abdominal fat (p -value = 0.02). However, no significant difference was observed comparing non-obese patients (p -value = 0.6). The comparison of obese patients with non-obese patients in the control group identifies an association between obesity and abdominal fat (p -value < 0.04). CONCLUSION Overweight and obese women with breast cancer treatment-related lymphedema are more likely to have increased abdominal fat than the general population with bioimpedance.
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Affiliation(s)
| | | | - Jose Maria Pereira de Godoy
- Cardiovascular Surgery Department, Medicine School, Sao Jose do Rio Preto (FAMERP), Brazil.,CNPq (National Council for Research and Development), Brazil
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Lu CW, Lo YH, Chen CH, Lin CY, Tsai CH, Chen PJ, Yang YF, Wang CH, Tan CH, Hou MF, Yuan SSF. VLDL and LDL, but not HDL, promote breast cancer cell proliferation, metastasis and angiogenesis. Cancer Lett 2016; 388:130-138. [PMID: 27940127 DOI: 10.1016/j.canlet.2016.11.033] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 12/13/2022]
Abstract
Abnormal lipoprotein profiles are associated with breast cancer progression. However, the mechanisms linking abnormal lipoprotein levels to breast cancer progression, especially metastasis, remain unclear. Herein, we found that L1 and L5 subfractions of LDL and VLDL, but not HDL, enhanced breast cancer cell viability. L1, L5, and VLDL also increased the in vitro tumorigenesis of breast cancer cells in anchorage-independent soft agar assay. In addition, L1, L5, and VLDL, but not HDL, increased the levels of mesenchymal markers Slug, Vimentin, and β-Catenin, and promoted breast cancer cell migration and invasion. L1, L5, and VLDL increased Akt Ser473 phosphorylation and promoted cell migration, which were reversed by the PI3K/Akt inhibitor wortmannin. Further in vitro angiogenesis assay and cytokine array analysis demonstrated that L1, L5, and VLDL enhanced secretion of angiogenic factors in breast cancer cells and promoted angiogenic activity. However, only VLDL reduced anchorage-dependent cell death and promoted lung metastasis in nude mice. In summary, our data suggest that L1, L5, and especially VLDL promote breast cancer progression and metastasis through Akt-induced EMT and angiogenesis, and provide a novel mechanism of how dyslipoproteinemia promotes breast cancer progression.
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Affiliation(s)
- Chun-Wun Lu
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsuan Lo
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chu-Huang Chen
- Lipid Science and Aging Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Lipid and Glycoimmune Research Center, Changhua Christian Hospital, Changhua, Taiwan; Vascular and Medicinal Research, Texas Heart Institute, Houston, TX 77030, USA
| | - Ching-Yi Lin
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hao Tsai
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Jung Chen
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Fang Yang
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chie-Hong Wang
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Feng Hou
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Division of General and Gastroenterological Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; National Sun Yat-Sen University-Kaohsiung Medical University Joint Research Center, Kaohsiung, Taiwan; Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
| | - Shyng-Shiou F Yuan
- Translational Research Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Korde LA, Partridge AH, Esser M, Lewis S, Simha J, Johnson RH. Breast Cancer in Young Women: Research Priorities. A Report of the Young Survival Coalition Research Think Tank Meeting. J Adolesc Young Adult Oncol 2016; 4:34-43. [PMID: 26812429 DOI: 10.1089/jayao.2014.0049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Breast cancer in young women is a significant issue-7% of all female breast cancer is diagnosed in women under 40 years of age. Young women with breast cancer (YWBC) face significant and unique challenges, including a higher likelihood of biologically aggressive disease and metastatic disease at diagnosis, leading to poorer prognosis, more aggressive treatment and long-term treatment-related toxicities, and unique psychosocial concerns. This article summarizes the Young Survival Coalition (YSC) Research Think Tank Meeting, held in Arlington, Virginia, in February 2013, and presents the process that led to YSC's priorities for YWBC research. The meeting's participants focused on six broad categories of investigation in which additional advancements in research on YWBC are crucial: risk factors; treatment; fertility; pregnancy-associated breast cancer; quality of life and survivorship; and metastasis. Several key themes emerged from this meeting. Researchers and advocates felt that a large-scale data registry focused on YWBC is necessary to collect quality information to guide future research for YWBC. This database should include clinical data, genomic profiling of primary tumor and metastatic sites, and an increased focus on fertility and pregnancy following breast cancer treatment. The participants also felt that more must be done to elucidate how and why YWBC develop more aggressive tumors, and to what degree treatment should be modified for young women. The discussions summarized here led to the formulation of YSC's Research Agenda, published in May 2014.
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Affiliation(s)
- Larissa A Korde
- 1 Division of Medical Oncology, University of Washington , Seattle, Washington
| | | | | | - Stacy Lewis
- 3 Young Survival Coalition , New York, New York
| | - Joy Simha
- 3 Young Survival Coalition , New York, New York
| | - Rebecca H Johnson
- 4 Mary Bridge Children's Hospital , Multicare Health System, Tacoma, Washington
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Kolb R, Sutterwala FS, Zhang W. Obesity and cancer: inflammation bridges the two. Curr Opin Pharmacol 2016; 29:77-89. [PMID: 27429211 DOI: 10.1016/j.coph.2016.07.005] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/05/2016] [Accepted: 07/06/2016] [Indexed: 12/14/2022]
Abstract
Obesity is a growing public health problem and affects 35% US adults. Obesity increases the risk of many cancer types and is associated with poor outcomes. Clinical management of cancer patients has been essentially the same between normal weight and obese individuals. Understanding causal mechanisms by which obesity drives cancer initiation and progression is essential for the development of novel precision therapy for obese cancer patients. One caveat is that various mechanisms have been proposed for different cancer types for their progression under obesity. Since obesity is known to have global impact on inflammation, here we will summarize recent literature and discuss the potential of inflammation being the common causal mechanism to promote cancer promotion across cancer types.
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Affiliation(s)
- Ryan Kolb
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Fayyaz S Sutterwala
- Division of Infectious Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Weizhou Zhang
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Interdisciplinary Graduate Program in Immunology, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Medical Scientist Training Program, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Free Radical and Radiation Biology Program, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Cancer Genes and Pathway Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
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Feng YH, Chen WY, Kuo YH, Tung CL, Tsao CJ, Shiau AL, Wu CL. Elovl6 is a poor prognostic predictor in breast cancer. Oncol Lett 2016; 12:207-212. [PMID: 27347126 DOI: 10.3892/ol.2016.4587] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 04/29/2016] [Indexed: 12/26/2022] Open
Abstract
Elongation of long chain fatty acids family member 6 (Elovl6) has been demonstrated to be involved in insulin resistance, obesity and lipogenesis. In addition, it has been reported that the protein is upregulated in human hepatocellular carcinoma and is implicated in nonalcoholic steatohepatitis-associated liver carcinogenesis. Excess body weight has been associated with an increased risk of postmenopausal breast cancer and poor prognosis. However, the connection between Elovl6 expression and outcome of breast cancer remains uncertain. Therefore, the present study used immunohistochemical analysis to investigate the expression of Elovl6 in breast cancer tissues from patients who had undergone curative mastectomy. Out of a total of 70 patients, 37.1% of patients exhibited positive Elovl6 expression in breast cancer tissue, whilst 62.9% were considered as negative. Positive Elov16 expression correlated with positive lymph node involvement and shorter recurrence-free survival. However, Elovl6 expression had no association with primary tumor size, lymph node metastasis, stage, grade, estrogen receptor, progesterone receptor, HER2 and age. Therefore, positive Elovl6 expression is a poor prognostic factor in patients with breast cancer that have previously undergone surgery, and may function as a potential therapeutic approach in the future, particularly in the scope of obesity related disease.
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Affiliation(s)
- Yin-Hsun Feng
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan R.O.C.; Department of Nursing, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan 71703, Taiwan R.O.C
| | - Wei-Yu Chen
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan R.O.C
| | - Yu-Hsuan Kuo
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan R.O.C
| | - Chao-Ling Tung
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan R.O.C
| | - Chao-Jung Tsao
- Department of Hematology and Oncology, Chi-Mei Medical Center, Tainan 73657, Taiwan R.O.C
| | - Ai-Li Shiau
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan R.O.C
| | - Chao-Liang Wu
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan R.O.C
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Baghestani AR, Zayeri F, Akbari ME, Shojaee L, Khadembashi N, Shahmirzalou P. Fitting Cure Rate Model to Breast Cancer Data of Cancer Research Center. Asian Pac J Cancer Prev 2015; 16:7923-7. [DOI: 10.7314/apjcp.2015.16.17.7923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rahimi Z, Kasraei R, Najafi F, Tanhapoor M, Abdi H, Rahimi Z, Vaisi-Raygani A, Aznab M, Moradi M. Cancer notification at a referral hospital of Kermanshah, Western Iran (2006-2009). Asian Pac J Cancer Prev 2015; 16:133-7. [PMID: 25640340 DOI: 10.7314/apjcp.2015.16.1.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer is a major public health problem and the leading cause of mortality in both males and females in developed and developing countries. The incidence of cancer is gender dependent. Among Iranians, it is the third cause of death. MATERIALS AND METHODS The information recorded in the files of all patients (7,695 individuals) pathologically diagnosed with cancer in Imam Reza referral hospital of Kermanshah University of Medical Sciences during the four year period of 2006-2009 were reviewed and analyzed using SPSS statistical software package version 16.0. RESULTS Around 61.6% of reported cancer cases were males and 38.4% were females. The most prevalent reported malignant tumors occurred at the age group of 70-79 years in males and in females these tumors were presented in the ages of 60-69 years. The most prevalent cancers among studied patients were gastrointestinal (GI) cancers with a frequency of 22.9% [gastric 10.7%, colorectal 6.9%, and esophageal 6%]. The second, third and forth prevalent cancers were blood at 16.4%, lung 13.5% and bladder 12.8%, respectively. In males the cancers of GI (25.6%) were the most prevalent followed in order of frequency by bladder (18%), blood (17.6%), lung (17.4%) and prostate (6.8%) . In females the most frequent recorded cancer was breast (24.1%) followed in order of frequency by GI (20.5%), blood (14.4%), lung (7.3%), uterus (6.2%) and ovary (5.1%) . Breast cancer was the most prevalent cancer (27%) in the age group of 40-49 years. CONCLUSIONS The present study provides frequency data for various types of cancers in both males and females from a referral hospital of Kermanshah that are comparable with some reports from other areas of the country.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran E-mail : ,
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Karimi A, Delpisheh A, Sayehmiri K, Saboori H, Rahimi E. Predictive factors of survival time of breast cancer in kurdistan province of Iran between 2006-2014: a cox regression approach. Asian Pac J Cancer Prev 2015; 15:8483-8. [PMID: 25339051 DOI: 10.7314/apjcp.2014.15.19.8483] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease. MATERIALS AND METHODS In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model. RESULTS the mean age of patients was 46.10±10.81 years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was 75%±0.43. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= 11%±0.10). CONCLUSIONS Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.
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Affiliation(s)
- Asrin Karimi
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran E-mail :
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Li J, Zhou C, Li J, Su Z, Sang H, Jia E, Si D. Global correlation analysis for microRNA and gene expression profiles in human obesity. Pathol Res Pract 2015; 211:361-8. [PMID: 25701361 DOI: 10.1016/j.prp.2014.11.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/31/2014] [Accepted: 11/07/2014] [Indexed: 02/01/2023]
Abstract
Obesity is an increasing health problem associated with major adverse consequences for human health. MicroRNAs (miRNAs), small endogenous non-coding RNAs, regulate the expression of genes that play roles in human body via posttranscriptional inhibition. To identify the miRNAs and their target genes involved in obesity, we downloaded the miRNA and gene expression profiles from gene expression omnibus (GEO) database and analyzed the differentially expressed miRNAs (DEMs) and differentially expressed genes (DEGs) in adipose tissues from obese subjects compared to those from non-obese subjects. Then, we constructed the miRNA-target interaction network and conducted functional enrichment analysis of DEGs, and the targets negatively correlated with DEMs. We identified a total of 16 miRNAs and 192 genes that showed a significantly different expression and 3002 miRNA-target interaction pairs, including 182 regulatory pairs in obesity. Target genes of DEMs were found mainly enriched in several functions, such as collagen fibril organization, extracellular matrix part, and extracellular matrix structural constituent. Moreover, hsa-miR-425 and hsa-miR-126 had a significant number of target genes and hsa-miR-16/COL12A1 and hsa-miR-634/SLC4A4 interaction pairs are significantly co-expressed, suggesting that they might play important roles in the pathogenesis of obesity. Our study provides a bioinformatic basis for further research of molecular mechanism in obesity.
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Affiliation(s)
- Jiayu Li
- Department of Cardiology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China
| | - Changyu Zhou
- Digest Department, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China.
| | - Jiarui Li
- Pharmacy Department, Tumor Hospital of Jilin Province, Changchun 130012, China
| | - Ziyuan Su
- Research Center of TCM, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, China
| | - Haiyan Sang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China
| | - Erna Jia
- Digest Department, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China
| | - Daoyuan Si
- Department of Cardiology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China
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Kruk J. Overweight, Obesity, Oxidative Stress and the Risk of Breast Cancer. Asian Pac J Cancer Prev 2014; 15:9579-86. [DOI: 10.7314/apjcp.2014.15.22.9579] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bouguerra H, Guissouma H, Labidi S, Stambouli N, Marrakchi R, Chouaib S, Elgaaied ABA, Boussen H, Gati A. Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors. Asian Pac J Cancer Prev 2014; 15:6805-10. [DOI: 10.7314/apjcp.2014.15.16.6805] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zhang F, Wang CS, Sun B, Tian GB, Cao FL, Cheng YF. Lack of any prognostic value of body mass index for patients undergoing chemoradiotherapy for esophageal squamous cell carcinoma. Asian Pac J Cancer Prev 2014; 15:3075-9. [PMID: 24815450 DOI: 10.7314/apjcp.2014.15.7.3075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between body mass index(BMI) and outcomes after chemoradiotherapy(CRT) has not been systematically addressed. The purpose of this study was to evaluate the effect of BMI on survival in patients with esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS Sixty ESCC cases were retrospectively reviewed in this study. Patient overall survival(OS) and disease-free survival (DFS) were compared between two groups (BMI<24.00 kg/m2 and BMI≥24.00 kg/m2). RESULTS There were 41 patients in the low/normal BMI group (BMI<24.00 kg/m2) and 19 in the high BMI group (BMI≥24.00 kg/m2). No significant differences were observed in patient characteristics between these. We found no difference in 2-year OS and DFS associated with BMI (p=0.763 for OS; p=0.818 for DFS) using the Kaplan-Meier method. Univariate analysis revealed that higher clinical stage was prognostic for worse 2-year OS and DFS, metastasis for 2-year OS, lymph node status for 2-year DFS, while age, gender, smoking, drinking, tumor location and BMI were not prognostic. There were no differences in the 2-year OS (hazard ratio=1.117; p=0.789) and DFS(hazard ratio=1.161; p=0.708) between BMI groups in multivariate analysis, whereas we found statistical differences in the 2-year OS and DFS associated with clinical stage, gender and tumor infiltration (p<0.04), independent of age, smoking, drinking, tumor location, the status of lymph node metastases and BMI. CONCLUSIONS BMI was not associated with survival in patients with ESCC treated with CRT as primary therapy. BMI should not be considered a prognostic factor for patients undergoing CRT for ESCC.
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Affiliation(s)
- Fang Zhang
- Cancer Centre, the First Hospital of Zibo, Zibo, China E-mail :
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