Obesity and Breast Cancer: A Comprehensive Review

This report explores the complex relationship between obesity and breast cancer, examining the epidemiological evidence, potential mechanisms, and implications for public health. It delves into the role of inflammation, insulin resistance, and adipose tissue dysfunction in the development of breast cancer in obese women. The report also discusses the impact of obesity on breast cancer detection, treatment, and mortality rates. Finally, it provides recommendations for further research and highlights the importance of maintaining a healthy weight to reduce the risk of breast cancer.

EVIDENCE BASED PRACTICE

Introduction
The scenario describes the adverse effect of increasing excess weight in women as that can be a
cause of developing breast cancer in most of the cases. Obesity is generally known as a risk
factor for this health problem worldwide. Excess weight gaining can increase the aggression of
cancer cells and researchers have found that overweight promotes metastasis in breast cancer. In
the United States, this disease is one of the common cancer issues after developing skin cancer in
most of the women. Metastasis causes this vast majority of breast cancer deaths as this infection
spreads to the other parts of the body as well. In this case, after metastasis, lungs and bones can
be affected because of this issue. This report also indicates that after going through menopause,
20 to 40 percent of the women are more likely to build up this cancer in them. However, the
exact means, which is linked with obesity and breast cancer, is still unclear. It has been reported
that in this year, 252710 new cases have been diagnosed in the United States women and around
40610 women will be dying because of this diseases. According to Dr. Stephen Herzig, the risk
of recurrence of tumor can be reduced before the surgery takes place to removing the lump. Even
if the signaling pathways are being blocked and the metastases related genes are switched off,
then this process can be a therapeutic target. In order to stay fit and live a healthy life to avoid
breast cancer, women have to maintain a healthy weight.
Method
The databases, ProQuest and EBSCOHOST have been searched in order to undertake a literature
review. In this searching method, search terms like, “obesity”, “excessive weight”, “breast
cancer”, “skin cancer”, “metastases”, “cytokines”, “leptin”, and “breast cancer cells” have taken
place to acquire significant articles online. Information has been taken from the record of last 10
years (2008 to 2018) as there are more chances of gathering more related reports about this
breast cancer topic disease. Around 10 articles were picked up from a lot, which are relevant
with the keywords.
Author Name Year Journal Name Article name
Ackerman, S.E.,
Blackburn, O.A.,
Marchildon, F. and
2017 Current obesity
reports
Insights into the link
between obesity and
cancer.

Cohen, P.,
Sethi, A., Sethi, D.
and Barolia, D.K.
2015 JOURNAL OF
EVOLUTION OF
MEDICAL AND
DENTAL SCIENCES-
JEMDS
Breast cancer: is
obesity a risk factor?
Cardoso, F., Beishon,
M., Cardoso, M.J.,
Corneliussen-James,
D., Gralow, J. and
Mertz, S.
2016 Pfizer Inc., New York Global status of
advanced/metastatic
breast cancer. 2005-
2015 decade report.
Balaban, S., Shearer,
R.F., Lee, L.S., van
Geldermalsen, M.,
Schreuder, M., Shtein,
H.C., Cairns, R.,
Thomas, K.C.,
Fazakerley, D.J.,
Grewal, T. and Holst,
J.
2017 Cancer & metabolism Adipocyte lipolysis
links obesity to breast
cancer growth:
adipocyte-derived
fatty acids drive
breast cancer cell
proliferation and
migration.
Matthews, S.B. and
Thompson, H.J.
2016 International journal
of molecular sciences
The obesity-breast
cancer conundrum:
An analysis of the
issues.
Jackson, S.E.,
Heinrich, M., Beeken,
R.J. and Wardle, J.
2017 PloS one Weight loss and
mortality in
overweight and obese
cancer survivors: a
systematic review.
Vagenas, D., DiSipio, 2015 BMC cancer Weight and weight

T., Battistutta, D.,
Demark-Wahnefried,
W., Rye, S., Bashford,
J., Pyke, C., Saunders,
C. and Hayes, S.C.
change following
breast cancer:
evidence from a
prospective,
population-based,
breast cancer cohort
study.
Singhal, M., Vishnu,
V.M., Raju, S.R. and
Upadhyay, Y.
2013 Kidney (renal-cell) Interrelationship
between obesity and
cancer (A Review).
Humphries, M.P.,
Jordan, V.C. and
Speirs, V.
2015 BMC medicine Obesity and male
breast cancer:
provocative parallels?
Steele, C.B., Thomas,
C.C., Henley, S.J.,
Massetti, G.M.,
Galuska, D.A., Agurs-
Collins, T., Puckett,
M. and Richardson,
L.C.
2017 MMWR. Morbidity
and mortality weekly
report
Vital signs: trends in
incidence of cancers
associated with
overweight and
obesity—United
States, 2005–2014.
Essay
In most of the epidemiological studies, it has been published that the obesity is one of the biggest
risks for women around the world. This gradually helps the body developing breast cancer,
which is considered to be a lifestyle disease. The mechanism of getting breast cancer from
obesity is one of the complex ones to happen in human bodies (Cardoso et al., 2016). However,
excessive weight can be risk of cancer in women who are in postmenopausal stage and the
reverse effect is also there to those who are in their pre menopausal stage. It has been observed

that in obese women, big sizes of breasts causes them to delay in seeking medical attention,
diagnosis and there are poor response of surgery, chemotherapy and radiotherapy as well.
Epidemiology of breast cancer
This disease can happen to anyone, but this problem is generally a malignancy of breast, which is
common in women and on the other hand, rare in men to face. This disease is also one of those
critical cases, which can be handled and sometime cured if the problem is being diagnosed at an
early stage. Based on the last 10 years report, it was found that in the year 2012, 1.7 million new
breast cancer cases were diagnosed worldwide. Because of this issue, more than 700000 deaths
took place (Humphries et al., 2015). The considered age of developing this fatal disease can be
from 0 to 74 years and the average percentage of breast cancer stands at 4.6%. 1.4% percentage
is considered as the lifetime risk of dying from this disease. Most of the breast cancer disease
was reported from the United States as one out of every eight women, gets diagnosed with breast
cancer during their lifetime. Being more accurate on such reports, a statement can be considered
which says that in every two minutes, one woman is diagnosed with this issue and the number is
increasing day by day (Jackson et al., 2017).
In maximum cases, it has been detected that this happens to the women because of escorting an
indiscipline lifestyle. Consuming excessive alcoholic beverages, smoking and having an
unhealthy eating habit can be injurious to any healthy person (Matthews and Thompson, 2016).
These above-mentioned habits generally help gaining weight and disrupt the metabolic rate of
the body, which eventually does badly for the system and ends up developing a fatal disease like
breast cancer. On the early stage, this problem changes the reproductive patterns and slowly
destroys the energy level of body. After making the body system slow, it hinges on the entire
body, as this is the way to lead the body towards death. Apart from all these, there are also some
other reasons which are underlying of this disease (Sethi et al., 2015). Decades ago, the seminal
Calle and Kaaks review along with other reports, it was solidified that the expansion of potential
mechanism is beyond the metabolism of sex hormones as this deregulates the insulin signaling
along with altering the adipokine metabolism and chronic sub acute inflammation.
Inflammation from a structural viewpoint is a vital response for the tissue injury as this islinked
with adipocyte dysfunction induced by obesity. The negative feedback sphere is spoiled in the

pathological obesity and cancer states. Both of these states demonstrate chronic inflammation,
which is low-graded.
Obesity and breast cancer
Generally population of every state or country estimates because of the rate denominators were
an alteration for the yearly country population that gets estimated by the age, sexual category,
race and civilization the people follow or maintain. The United States Census Bureau has
produced this population estimation procedure collaborating with CDC along with the support
from the National Cancer Institute. Join point regression was allowed in different slopes for one
period duration. Colorectal cancer can help reducing colorectal cancer incidence as it has the
ability to detect the precancerous cysts before becoming cancerous. In the year 2014, more than
631604 persons were diagnosed cancer because of their excessive weight. This survey has
represented that 40% cases of cancer are diagnosed every year in the United States, which is
something like 1.6 million people (Ackerman, et al., 2017).
Obesity has been consistently related with breast cancer as it has the higher risk of colorectal
cancer in both men and women. Commencing the past researches, it is way more clear that there
is a stronger association involving obesity and the case of having larger colon adenomas. Recent
studies also clarifies that in gender differences, overweight men are more probable to increase
colorectal cancer than women are. Hypothesis is central adiposity and it arises more commonly
in men. This factor clarifies that the risk of building up colon cancer in men are more likely
(Sethi et al., 2015). For both men and women, waist fringe and the area of waist to hip relation
are strongly coupled with the risk of getting colorectal cancer. There is a hormone named
exogenous oestrogen helps reducing the risk of developing this cancer in women. This specific
process of hypothesis is approximate as circulating endogenous oestrogen stages are much higher
in heavy men and women (Singhal et al., 2013). After comparing with the lean people, this result
has come out.
Postmenopausal women are more supposed to develop breast cancer in them by 30% to 50%.
Central adiposity has been found as a dependent predictor of the breast cancer threat in women
who are in their postmenopausal stage. Comparing with the women who have done a hormone
alternation therapy is more expected to be risk free than the women who have never executed

this hormone replacement treatment (Steele et al., 2017). Obesity is eventually leading women
towards death as very obese women have breast cancer deaths and these loss rates are three times
advanced than the women who have a lean body frame. Obese women are likely to develop
cancer in different parts of their body as they are supposed to build up kidney, colon and breast
cancer. Most of the women gets this breast cancer in them as this disease can be developed
because of some irregular lifestyle routine and other habits which are very bad for the body.
The relationship of insulin resistance and the dysfunction of the adipose tissue are quite
complicated as these both diseases can be caused because of the other one. Insulin resistance can
be observed in obesity and the serum insulin intensity increase to prevent the hyperglycaemia
(Vagenas et al., 2015). Insulin normally normalizes the growth hormone receptors in the liver
and this stimulates the hepatic production of IGF-1. In obese people, the levels of free IGF-1 do
not respond to insulin administration and on the other hand, these IGF-1 levels are higher in
people with lean body frame. The following level of IGF-1 ultimately leads to lower the plasma
levels of IGF-1. Both of the insulin and IGF-1 hormones are considered to play an essential role
in this ailment development process by binding to the insulin receptor and IGF-1 receptor.
Medical studies have explained that patients who have a high level of IGF-1 can get an increased
risk of several types of cancer and this includes colorectal, prostate, and breast cancer at a
postmenopausal state.
During the year 2008 to 2014, based on the whole evidence of overweight and heaviness related
cancers, declines were observed (Singhal et al., 2013). The ratio was for cancers it was -2%,
colorectal cancer was -23% and cancers, which were not known to be associated with cancers,
was -13%. The increases of colorectal cancer transmission tests were likely to be contributed to
the decline in colorectal cancer. This tendency varied considerably by the age group and the rate
for all of the people whoever is suffering from overweight or obesity related cancers increased
among the age group of 20 to 49 years and also among 50 to 64 years (Balaban et al., 2017).
After the age group, 65 to 74 years, the colorectal cancer charges declined in almost all age
groups. However, the people who are aged between 20 to 49 years along with the age group of
more than or on people who are at 75 years. Since the year 2005, 224800 cases approximately
have been averted because of the colorectal cancer rates reduction.

In this same period, 211800 excessive cases have occurred from other overweight and obesity
associated cancers. This obesity related breast cancers have increased significantly in more than
32 states and no changes have been found in the 16 states and districts of Columbia. The
increased rate is around 0.3% to 1.8%, which is proving itself fatal for the obese people (Balaban
et al., 2017). From a very long time, it was proved that heaviness and the jeopardy of cancer are
connected with each other. “The International Agency for Cancer Research” and “The World
Cancer Research Fund” provided reports indicate that obese people are more prone to get cancer
in them. According to the recent study records from the United States it was said that the number
of white men are more supposed to get cancer especially those who are overweighed than of
black men. Nevertheless, the time, higher BMI was observed, at the same time, discussion was
also true.
Observation
In order to observe the health condition and for statistics records, there were 50 patients been
taken for the study. Among those 50 patients, 48% were in their pre-menopausal and rests of the
52% were in post-menopausal stage. All of the patients were in some age groups to track the
records of their health condition. There were four groups to understand the details about their
health condition. Among those groups, patients who were in the group 1 and 2 were considered
for developing early stage cancer and group 3 and 4 were considered as developing advanced
cancer in them. After this study, 44% patients were in their early stage and 56% were in their
advanced stage of cancer. In pre-menopausal stage, women were found that they weighed less
than 50kgs and 75% of them were in their advanced stage. However, women who were in their
post-menopausal stage weighed less than 50kgs and 45% of them were in their advanced stage.
There were differences with the weight of those patients but there was no differences found with
the controls they have. An association linking obesity and breast cancer has been recognized for
past 40 years but still the exact mechanism about this disease was not fully understood anyway.
Therefore, obesity is directly connected with the early stage of menarche along with the late age
of menopause and infertility. This issue eventually increases the risk of ovulatory cycles and
lifetime exposure of the mammary epithelium to oestrogen and this increases the risk of
developing breast cancer.

Conclusion
The emerging evidences and studies all across suggest that breast tumour cells are much more
flexible in adapting to metabolic environment and can change up accordingly. The timely
detection of the tumours or a lump that has formed is the second most important factor in
deciding the treatment course. Here, obese women suffering from overweight go bit back since it
is often difficult to detect the tumour or the lump. Here, In-Situ form of cancer is still a time
consuming process as it grows slowly over the years, often taking 15-20 years, but in cases for
invasive breast cancer it is much more dangerous as it has the ability to migrate and spread over
the lymph nodes and faster compared to In-Situ formation. Thus, it is always a debatable topic of
how obesity is a causal factor to breast cancer but studies require further implementations in
deciding how more and more remedies would come in and treatments would go across to avoid
the deadly disease.
Further research recommendations
About this very topic, if the researcher wants to get advancement on the result, then there are
many things, which they have to keep on their list as a priority. Instead of picking up 10 journals,
they have to consider researching on more journals and all of them have to be qualitative and
quantitative as these types of journals help acquiring more information about this disease.
Keeping an eye open for the recent news on breast cancer and research about this disease have to
be on the list as well. According to medical research, in every single year, there are a lot of
results and precautions but people are not aware of such techniques at all. Therefore, making the
assignment more informative with proper research on this topic will be highly appreciated.
Containing the recent few years’ research and following the methods, which are helpful losing
weights along with maintaining a healthy diet is also important as this is helping them gradually
reduce the risk of building up breast cancer in them.

References
Ackerman, S.E., Blackburn, O.A., Marchildon, F. and Cohen, P., 2017. Insights into the link
between obesity and cancer. Current obesity reports, 6(2), pp.195-203.
Balaban, S., Shearer, R.F., Lee, L.S., van Geldermalsen, M., Schreuder, M., Shtein, H.C., Cairns,
R., Thomas, K.C., Fazakerley, D.J., Grewal, T. and Holst, J., 2017. Adipocyte lipolysis links
obesity to breast cancer growth: adipocyte-derived fatty acids drive breast cancer cell
proliferation and migration. Cancer & metabolism, 5(1), p.1.
Cardoso, F., Beishon, M., Cardoso, M.J., Corneliussen-James, D., Gralow, J. and Mertz, S.,
2016. Global status of advanced/metastatic breast cancer. 2005-2015 decade report. Pfizer Inc.,
New York.
Humphries, M.P., Jordan, V.C. and Speirs, V., 2015. Obesity and male breast cancer:
provocative parallels?. BMC medicine, 13(1), p.134.
Jackson, S.E., Heinrich, M., Beeken, R.J. and Wardle, J., 2017. Weight loss and mortality in
overweight and obese cancer survivors: a systematic review. PloS one, 12(1), p.e0169173.
Matthews, S.B. and Thompson, H.J., 2016. The obesity-breast cancer conundrum: An analysis of
the issues. International journal of molecular sciences, 17(6), p.989.
Sethi, A., Sethi, D. and Barolia, D.K., 2015. Breast cancer: is obesity a risk factor?. JOURNAL
OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS, 4(96), pp.16136-16140.
Singhal, M., Vishnu, V.M., Raju, S.R. and Upadhyay, Y., 2013. Interrelationship between
obesity and cancer (A Review). Kidney (renal-cell), 1(2.5), pp.42-5.
Steele, C.B., Thomas, C.C., Henley, S.J., Massetti, G.M., Galuska, D.A., Agurs-Collins, T.,
Puckett, M. and Richardson, L.C., 2017. Vital signs: trends in incidence of cancers associated
with overweight and obesity—United States, 2005–2014. MMWR. Morbidity and mortality
weekly report, 66(39), p.1052.
Vagenas, D., DiSipio, T., Battistutta, D., Demark-Wahnefried, W., Rye, S., Bashford, J., Pyke,
C., Saunders, C. and Hayes, S.C., 2015. Weight and weight change following breast cancer:

evidence from a prospective, population-based, breast cancer cohort study. BMC cancer, 15(1),
p.28.