2023-10-22 12:04:59
Many breast cancer survivors take a hormonal medication after cancer treatment to prevent a recurrence, but new research suggests that these medications may be less effective in women who are obese.
Breast cancer cells in hormone-positive breast cancers are fueled by estrogen, a female sex hormone. Aromatase inhibitor medications reduce estrogen levels by stopping an enzyme in adipose tissue called aromatase from converting other hormones into estrogen.
Compared with normal-weight breast cancer survivors, women who were obese were 18% more likely to have a recurrence even when taking an aromatase inhibitor, and this increased risk was even greater among survivors who were severely obese, the researchers found.
“Postmenopausal women with hormone-receptor-positive breast cancer and obesity who are treated with aromatase inhibitors have an increased risk of having a recurrence of their disease,” said study author Sixten Harberg, a researcher in the department of oncology. at Aarhus University Hospital in Denmark.
However, he added, “Treatment with aromatase inhibitors remains the treatment of choice for this group of patients and reduces the rate of breast cancer recurrence and (death) in this group of patients.”
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It is not fully understood how, or even if, obesity increases the risk of breast cancer recurrence in women taking aromatase inhibitors. “Obesity can affect the response to cancer treatment, as obesity alters the metabolism and distribution of drugs,” Harberg said.
Fat cells store estrogen, and women who are obese have more fat tissue, which could explain why aromatase inhibitors are less effective at suppressing estrogen in these women.
“The underlying mechanisms are multifactorial, and more clinical studies are needed to understand how obesity is linked to breast cancer progression,” Harberg said.
For the study, researchers analyzed data from 13,230 breast cancer survivors who had been diagnosed with hormone-positive breast cancer and were taking aromatase inhibitors to prevent a recurrence. Of these, there were 1,587 recurrences that occurred during a little more than six years of follow-up. Women who were obese or severely obese and were treated with aromatase inhibitors were more likely to have a recurrence of their cancer than their counterparts who were of normal weight, the findings showed.
Women who were overweight, but not obese, had a higher risk of breast cancer recurrence, but the results were not considered statistically significant.
The study was published online Oct. 13 in JAMA Network Open.
While more studies are needed to see how weight affects the risk of breast cancer recurrence in women taking aromatase inhibitors, being overweight or obese is known to increase the risk of complications after surgery to treat breast cancer. said Dr. Vivian Jolley Bea, section chief of breast surgical oncology in the department of surgery at NewYork-Presbyterian Brooklyn Methodist Hospital in New York City.
“Postmenopausal women with hormone-receptor-positive breast cancer and obesity who are treated with aromatase inhibitors have a higher risk of having a recurrence of their disease,” said the study author.
Many breast cancer survivors are not aware that their weight plays a role in their risk of recurrence, but this knowledge can be empowering, Bea said.
“Maintaining a normal weight, eating a healthy diet and exercising regularly can help reduce the risk of a breast cancer recurrence,” she said. There is overwhelming evidence linking obesity to 13 types of cancer, and obesity also increases the risk of dying from cancer, said Dr. Carmen Calfa, a breast medical oncologist and co-medical director of Survivorship at Sylvester Comprehensive Cancer Center in Miami. .
“Fortunately, unlike genetics and other risk factors, body weight is modifiable and (this study) highlights the importance of programs that incorporate nutrition and exercise3;after a cancer diagnosis,” she said.
“This can empower women to play a critical role in reducing their risk of breast cancer recurrence,” Calfa added.
Source: INFOBAE
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