Brustkrebs und Adipositas

Adipositas hat weltweit eine zunehmende Inzidenz und ist mit vielen Komorbiditäten assoziiert. Auch verschiedene Karzinomerkrankungen treten bei Adipositas vermehrt auf. Adipositas ist z.B. ein unabhängiger Risikofaktor für die Entstehung des postmenopausalen Hormonrezeptor-positiven Mammakarzinoms. Der genaue Pathomechanismus ist weiterhin Gegenstand der Forschung. Fest steht aber, dass bei einer Brustkrebserkrankung ein erhöhter BMI mit einem schlechteren Überleben assoziiert ist. In diesem Beitrag wird die Evidenz der Korrelation von Adipositas zum Mammakarzinom vorgestellt.

Publication History

Article published online:
10 June 2022

• Literatur

• 1 Robert Koch-Institut. Krebs in Deutschland 2015/2016;12. Ausgabe. Im Internet (Stand: 02.03.2021). https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2019/krebs_in_deutschland_2019.pdf;jsessionid=3C66C6D81D886A29D14B19FA7E296E29.1_cid290?__blob=publicationFile
• 2 Kurth B-M. Erste Ergebnisse aus der “Studie zur Gesundheit Erwachsener in Deutschland” (DEGS). Bundesgesundheitsblatt 2012; 980-990 DOI: 10.1007/s00103-011-1504-5.
• 3 The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects). Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: A pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet 2014; 383: 970-983 DOI: 10.1016/S0140-6736(13)61836-X. (PMID: 24269108)
• 4 Di Angelantonio E, Bhupathiraju SN, Wormser D. et al. Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016; 388: 776-786 DOI: 10.1016/S0140-6736(16)30175-1. (PMID: 27423262)
• 5 Dobbins M, Decorby K, Choi BCK. The Association between Obesity and Cancer Risk: A Meta-Analysis of Observational Studies from 1985 to 2011. ISRN Prev Med 2013; 2013 DOI: 10.5402/2013/680536.
• 6 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Interdisziplinäre S3-Leitlinie für die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms 2020. Im Internet (Stand: 02.03.2021). https://www.awmf.org/uploads/tx_szleitlinien/032–045OLl_S3_Mammakarzinom_2020–02.pdf
• 7 World Health Organization. Research on the menopause in the 1990s: Report of a WHO Scientific Group. Geneva; 1996. Im Internet (Stand: 02.03.2021). https://apps.who.int/iris/handle/10665/41841
• 8 AICR/WCRF. Diet, nutrition, physical activity and breast cancer 2018. Im Internet (Stand: 02.03.2021). https://www.wcrf.org/sites/default/files/Breast-Cancer-2017-Report.pdf
• 9 Suzuki R, Orsini N, Saji S. et al. Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status – a metaanalysis. Int J Cancer 2009; 124: 698-712 DOI: 10.1002/ijc.23943. (PMID: 18988226)
• 10 Pergola GD, Silvestris F. Obesity as a major risk factor for cancer. J Obes 2013; 291546 DOI: 10.1155/2013/291546. (PMID: 24073332)
• 11 Bhaskaran K, Douglas I, Forbes H. et al. Body-mass index and risk of 22 specific cancers: A population-based cohort study of 5·24 million UK adults. Lancet 2014; 384: 755-765 DOI: 10.1016/S0140-6736(14) 60892-8. (PMID: 25129328)
• 12 Renehan AG, Tyson M, Egger M. et al. Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. Lancet 2008; 371: 569-578 DOI: 10.1016/S0140-6736(08)60269-X. (PMID: 18280327)
• 13 Chan DSM, Vieira AR, Aune D. et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 2014; 1901- 1914; DOI: 10.1093/annonc/mdu042. (PMID: 24769692)
• 14 Neuhouser ML, Aragaki AK, Prentice RL. et al. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Oncol 2015; 1: 611-621 DOI: 10.1001/jamaoncol.2015.1546. (PMID: 26182172)
• 15 Ewertz M, Jensen M-B, Ká G. et al. Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol 2011; 29: 25-31 DOI: 10.1200/JCO.2010.29.7614. (PMID: 21115856)
• 16 Shang E, Beck G. Special anaesthesiological requirements in bariatric surgery. Anasthesiol Intensivmed Notfallmed Schmerzther 2009; 44: 623-624 DOI: 10.1055/s-0029-1241165. (PMID: 19750440)
• 17 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Interdisziplinäre Leitlinie der Qualität S3 zur „Prävention und Therapie der Adipositas“ 2014; 2. Auflage. Im Internet (Stand: 02.03.2021). https://www.awmf.org/uploads/tx_szleitlinien/050–001l_S3_Adipositas_Pr%C3%A4vention_Therapie_2014–11-abgelaufen.pdf
• 18 Ahn J, Schatzkin A, Lacey JV JR. et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med 2007; 167: 2091-2102 DOI: 10.1001/archinte.167.19.2091. (PMID: 17954804)
• 19 Eliassen AH, Colditz GA, Rosner B. et al. Adult weight change and risk of postmenopausal breast cancer. JAMA 2006; 296: 193-201 DOI: 10.1001/jama.296.2.193. (PMID: 16835425)
• 20 Winder AA, Kularatna M, MacCormick AD. Does Bariatric Surgery Affect the Incidence of Breast Cancer Development? A Systematic Review. Obes Surg 2017; 27: 3014-3020 DOI: 10.1007/s11695-017-2901-5. (PMID: 28840450)
• 21 Tao W, Santoni G, Euler-Chelpin MV. et al. Cancer Risk After Bariatric Surgery in a Cohort Study from the Five Nordic Countries. Obes Surg 2020; 3761–3767 DOI: 10.1007/s11695-020-04751-6.
• 22 Sjöström L, Gummesson A, David Sjöström C. et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): A prospective, controlled intervention trial. Lancet Oncology 2009; 10: 653-662 DOI: 10.1016/S1470-2045(09)70159-7.
• 23 Åsa A, Taube M, Peltonen M. et al. Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study. Gynecol Oncol 2017; 145: 224-229 DOI: 10.1016/j.ygyno.2017.02.036. (PMID: 28259424)
• 24 Bhardwaj P, Au CC, Benito-Martin A. et al. Estrogens and breast cancer: Mechanisms involved in obesity-related development, growth and progression. J Steroid Biochem Mol Biol 2019; 189: 161-170 DOI: 10.1016/j.jsbmb.2019.03.002. (PMID: 30851382)
• 25 Lippmann ME, Bickson RB, Gelmann EP. et al. Growth regulation of human breast carcinoma occurs through regulated growth factor secretion. J Cell Biochem 1987; 35: 1-16 DOI: 10.1002/jcb.240350102.
• 26 Enriori CL, Orsini W, Del Carmen Cremona M. et al. Decrease of circulating level of SHBG in postmenopausal obese women as a risk factor in breast cancer: Reversible effect of weight loss. Gynecol Oncol 1986; 23: 77-86 DOI: 10.1016/0090-8258(86)90118-6. (PMID: 3943755)
• 27 Andò S, Gelsomino L, Panza S. et al. Obesity, Leptin and Breast Cancer: Epidemiological Evidence and Proposed Mechanisms. Cancers (Basel) 2019; 11 DOI: 10.3390/cancers11010062. (PMID: 30634494)
• 28 Díez JJ, Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol 2003; 148: 293-300 DOI: 10.1530/eje.0.1480293. (PMID: 12611609)
• 29 Solinas G, Vilcu C, Neels JG. et al. JNK1 in hematopoietically derived cells contributes to diet-induced inflammation and insulin resistance without affecting obesity. Cell Metab 2007; 6: 386-397 DOI: 10.1016/j.cmet.2007.09.011. (PMID: 17983584)
• 30 Stumvoll M, Nurjhan N, Perriello G. et al. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med 1995; 333: 550-554 DOI: 10.1056/NEJM199508313330903. (PMID: 7623903)
• 31 Decensi A, Puntoni M, Goodwin P. et al. Metformin and cancer risk in diabetic patients: A systematic review and meta-analysis. Cancer Prev Res (Phila) 2010; 3: 1451-1461 DOI: 10.1158/1940-6207.CAPR-10-0157. (PMID: 20947488)
• 32 Martinez JA, Chalasani P, Thomson CA. et al. Phase II study of metformin for reduction of obesity-associated breast cancer risk: A randomized controlled trial protocol. BMC Cancer 2016; 16: 500 DOI: 10.1186/s12885-016-2551-3. (PMID: 27430256)
• 33 Metformin CD. A potentially winning therapeutic strategy to prevent breast cancer progression in overweight postmenopausal patients. Transl Cancer Res 2018; 7: 1306-1309 DOI: 10.21037/tcr.2018.08.31.
• 34 Atoum MF, Alzoughool F, Linkage Between A-H-H. Obesity Leptin and Breast Cancer. Breast Cancer (Auckl) 2020; 14: 1178223419898458 DOI: 10.1177/1178223419898458.
• 35 Kiesel L, Eichbaum C, Baumeier A. et al. Obesity Epidemic-The Underestimated Risk of Endometrial Cancer. Cancers (Basel) 2020; 12 DOI: 10.3390/cancers12123860. (PMID: 33371216)
• 36 McNelis JC, Olefsky JM. Macrophages, immunity, and metabolic disease. Immunity 2014; 41: 36-48 DOI: 10.1016/j.immuni.2014.05.010. (PMID: 25035952)
• 37 Holzer RG, Park E-J, Li N. et al. Saturated fatty acids induce c-Src clustering within membrane subdomains, leading to JNK activation. Cell 2011; 147: 173-184 DOI: 10.1016/j.cell.2011.08.034. (PMID: 21962514)
• 38 Freedman LS, Clifford C, Messina M. Analysisof Dietary Fat, Calories, Body Weight, and the Development of Mammary Tumors in Rats and Mice: A Review. Cancer Res 1990; 50: 5710-5719