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Panminerva Medica 2001 June;43(2):123-33

lingua: Inglese

Breast cancer and obesity

La Guardia M., Giammanco M. *

From the Institute of Physiology and Human Nutrition
*Department of Surgery, Anatomy and Oncology Discipline University of Palermo, Palermo, Italy


Epidemiological evi­dence ­links ­breast can­cer, a typ­i­cal endo­crine-relat­ed ­tumor, ­with “west­ern” life­style, in par­tic­u­lar eat­ing hab­its. Yet, ­it’s nec­es­sary to dis­tin­guish pre­men­o­pau­sal ­from post­men­o­pau­sal ­breast can­cer. Visceral obes­ity and ­body ­weight ­gain are con­sid­ered respon­sible ­for the ­increased ­risk of post­men­o­pau­sal ­breast can­cer. In ­fact, the mam­mary ­gland is sen­si­tive to the lev­el of cir­cu­lat­ing estro­gens, vis­cer­al obes­ity is usu­al­ly asso­ciat­ed ­with high­er lev­els of ­free ster­oid hor­mones, and the adi­pose tis­sue per­forms impor­tant endo­crine func­tion (“clear­ance” and aro­mat­isa­tion of andro­gens, reg­u­la­tion of ­free tes­tot­e­rone/­DHEAS ­molar ­ratio). Before men­o­pause, ovar­ian poly­cys­to­sis is ­often ­seen ­with ­android obes­ity, and ­breast can­cer ­risk ­could ­arise; how­ev­er, as vis­cer­al obes­ity is gen­er­al­ly ­less fre­quent, genet­ic fac­tors are ­more impor­tant ­than nutri­tion­al ­ones. Furthermore, vari­a­tions ­have ­been record­ed in the secre­tion of insu­lin and insu­lin-­like ­growth fac­tors, ­involved in the gen­e­sis of the ­breast can­cer. High ­body ­weight and ­male fat dis­tri­bu­tion neg­a­tive­ly influ­ence prog­no­sis of ­breast can­cer, too; ­this asso­ci­a­tion is ­linked ­with the pres­ence of estro­gen and pro­ges­te­rone recep­tors in tumo­ral ­cells. Links ­between ­diet qual­ity and ­breast can­cer ­risk are ­shown: ­increased use of sat­u­rat­ed ­fats and ani­mal pro­teins, and a con­se­quent­ly ­decreased use of veg­e­ta­bles, ­legumes and ­fruit, con­sti­tut­ing the so-­called “Mediterranean ­diet”, are con­sid­ered respon­sible for the ­increased ­risk of ­breast can­cer. Lower fat and alco­hol inges­tion, the use of die­tary ­fibre and a high­er use of com­plex car­bo­hy­drates ­could ­reduce ­breast can­cer ­risk. Finally, start­ing ­from the ­results of our pre­vi­ous ani­mal research­es, we sug­gest ­using a tryp­to­phan ­devoid ­diet for a few ­days for pre­men­o­pau­sal wom­en ­with ­male obes­ity and alter­a­tions to the men­stru­al ­cycle.

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