Associations between obesity, metabolic health, and the risk of breast cancer in East Asian women

Park, Boyoung; Kim, Soyeoun; Kim, Hayoung; Cha, Chihwan; Chung, Min Sung

doi:10.1038/s41416-021-01540-5

Cited by 14 publications

(17 citation statements)

References 32 publications

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“… 9 Furthermore, the results of a meta-analysis of studies in East Asian women showed that obesity is independently associated with increased risk of breast cancer in postmenopausal women. 27 Although all of these factors were considered in the China Guideline for the Screening and Early Detection of Female Breast Cancer, 19 the recommended starting age of screening for women at average and increased risk was based on expert opinion and lacked population-based evidence in Chinese women. Evidence of a risk-adapted starting age of screening is needed to determine populations at high risk and promote screening of these individuals, which can further aid in efficient allocation of limited medical resources, especially in developing countries such as China.…”

Section: Discussionmentioning

confidence: 99%

“…9 Furthermore, the results of a meta-analysis of studies in East Asian women showed that obesity is independently associated with increased risk of breast cancer in postmenopausal women. 27 Although all of these factors were considered in the China Guideline for the Screening and Early Detection of Female Breast Cancer, 19 the recommended starting age of screening for women at average and increased risk was based on expert opinion and lacked population-based evidence in Chinese women. Evidence of a risk-adapted starting age of screening is needed to determine populations at high risk and promote screening of To date, studies focused on risk-adapted starting ages of breast cancer screening have been conducted with the Swedish family cancer data sets by Mukama et al 11,18,28 These authors considered a family history of breast cancer, reproductive profile (eg, age at first live birth and parity), and other family history of cancers separately in their study, which makes it difficult for individuals with more than 1 category of risk factors to decide when to screen.…”

Section: Sensitivity Analysismentioning

confidence: 99%

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Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China

et al. 2022

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ImportanceAlthough current guidelines highlight the need for earlier screening in women at increased risk of breast cancer in China, data on risk-adapted starting ages of screening are limited.ObjectiveTo explore the risk-adapted starting age of breast cancer screening in China, with comprehensive consideration of breast cancer risk factors.Design, Setting, and ParticipantsA multicenter community-based cohort study was conducted under the framework of the Cancer Screening Program in Urban China. Data were collected from January 1, 2013, to December 31, 2018, for unscreened community-dwelling women aged 40 to 74 years without a history of cancer, kidney dysfunction, or severe heart, brain, or lung disease. Data analysis was performed from October 1, 2021, to August 16, 2022.ExposuresBaseline characteristics associated with breast cancer, including first-degree family history of breast cancer, benign breast disease, breastfeeding, age at menarche, and body mass index.Main Outcomes and MeasuresOutcomes included breast cancer diagnosis and age at diagnosis. Risk-adapted starting age of screening was defined as the age at which women with different levels of breast cancer risk attained a 10-year cumulative risk level similar to women aged 50 years in the general population.ResultsOf the 1 549 988 women enrolled in this study, 3895 had breast cancer (median follow-up, 4.47 [IQR, 3.16-6.35] years). Participants were divided into different risk groups according to breast cancer risk scores (driven by risk factors including first-degree family history of breast cancer, benign breast disease, breastfeeding, age at menarche, and body mass index). Using the 10-year cumulative risk of breast cancer at age 50 years in the general population as a benchmark (2.65% [95% CI, 2.50%-2.76%]), the optimal starting age of screening for women with high, medium, or low risk of breast cancer was identified as 43, 48, or after 55 years, respectively. An online calculator was developed to calculate an individual’s optimal starting age of screening.Conclusions and RelevanceThis study identifies the risk-adapted starting age of breast cancer screening based on the principle of equal management of equal risks, which may inform updates of current screening guidelines.

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Section: Discussionmentioning

confidence: 99%

“…9 Furthermore, the results of a meta-analysis of studies in East Asian women showed that obesity is independently associated with increased risk of breast cancer in postmenopausal women. 27 Although all of these factors were considered in the China Guideline for the Screening and Early Detection of Female Breast Cancer, 19 the recommended starting age of screening for women at average and increased risk was based on expert opinion and lacked population-based evidence in Chinese women. Evidence of a risk-adapted starting age of screening is needed to determine populations at high risk and promote screening of To date, studies focused on risk-adapted starting ages of breast cancer screening have been conducted with the Swedish family cancer data sets by Mukama et al 11,18,28 These authors considered a family history of breast cancer, reproductive profile (eg, age at first live birth and parity), and other family history of cancers separately in their study, which makes it difficult for individuals with more than 1 category of risk factors to decide when to screen.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China

et al. 2022

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“…Obesity and obesity-driven metabolic dysfunction in postmenopausal women are risk factors for breast cancer 32 . A recent study of 173 postmenopausal patients with breast cancer showed that the SUV ratio of the VAT and SAT correlated significantly with that of axillary lymph node metastasis 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Hence, the metabolic activity of VAT may be a surrogate marker for tumor progression, and glucose metabolism could be measured using 18 F-FDG PET/CT. Obesity and obesity-driven metabolic dysfunction in postmenopausal women are risk factors for breast cancer 32 . A recent study of 173 postmenopausal patients with breast cancer showed that the SUV ratio of the VAT and SAT correlated significantly with that of axillary lymph node metastasis 9 .…”

Section: Discussionmentioning

confidence: 99%

18F-FDG uptake of visceral adipose tissue on preoperative PET/CT as a predictive marker for breast cancer recurrence

Kim

Bae

Ahn

et al. 2022

Sci Rep

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Glucose utilization by visceral adipose tissue (VAT) reflects inflammatory activity, which also promotes tumor growth and carcinogenesis. The effect of metabolically active VAT on survival outcomes in breast cancer is unknown. We investigated survival outcomes in patients with breast cancer based on the standardized uptake value (SUV) of VAT (SUVmean-VAT) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). A total of 148 patients with breast cancer were divided into high- and low groups according to their SUVmean-VAT and SUVmax-tumor. Clinical characteristics and survival outcomes were compared between the groups. High SUVmean-VAT was associated with poor recurrence-free survival (RFS; hazard ratio [HR], 2.754; 95% confidence interval [CI], 1.090–6.958, p = 0.032) and distant metastasis-free survival (DMFS; HR, 3.500; 95% CI, 1.224–10.01, p = 0.019). Multivariate analysis showed that high SUVmean-VAT was a significant factor for poor RFS and poor DMFS (p = 0.023 and 0.039, respectively). High SUVmax-tumor was significantly associated with short RFS (p = 0.0388). Tumors with a high SUV tended to have a short DMFS, although the difference was not significant (p = 0.0718). Our findings showed that upregulated glucose metabolism in the VAT measured using 18F-FDG PET/CT may be a prognostic biomarker for adverse outcomes in breast cancer.

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“…Furthermore, obesity is an important risk factor for many chronic noncommunicable diseases. Many studies have shown that obesity is strongly associated with a substantial increase in many major chronic diseases, such as cardiovascular diseases [3,4], diabetes [4][5][6], many types of cancer [7,8] and even all-cause mortality [9]. Although lifestyle interventions are considered as an effective treatment for obesity, they are difficult to maintain in terms of efficacy and continuity of treatment, especially in individuals who are severely obese or have multiple comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Elevation of Serum Spermidine in Obese Patients: Results from a Cross-Sectional and Follow-Up Study

Gao

Zhang

et al. 2022

Nutrients

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Background: Spermidine, a natural polyamine, appears to be a promising intervention for the treatment of obesity in animal studies, but epidemiological studies on the association between spermidine and obesity are inadequate. Methods: In the cross-sectional study, a total of 4230 eligible Chinese rural participants aged ≥ 35 years at baseline were recruited, of whom 1738 completed the two-year follow-up. Serum spermidines were measured using high-performance liquid chromatography with a fluorescence detector. Obesity and change in BMI were used as outcomes. Multivariable logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Results: Participants who were obese had higher serum spermidine concentrations than those who were of normal weight (median (IQR), 27.2 ng/mL (14.8–53.4 ng/mL) vs. 23.8 ng/mL (12.8–46.6 ng/mL), p = 0.002). Compared with participants in the first quartile, those in the third quartile (OR 1.327, 95% CI 1.050 to 1.678) and the fourth quartile (OR 1.417, 95% CI 1.121 to 1.791) had a significantly increased risk of prevalent obesity after adjustment for confounding factors. In the follow-up study, participants in the third quartile (OR 0.712, 95% CI 0.535 to 0.946) and the fourth quartile (OR 0.493, 95% CI 0.370 to 0.657) had significantly lower risks of an increase in BMI after adjustment for confounding factors, with the lowest quartile as the reference. Meanwhile, we found a nonlinear relationship between spermidine and BMI in the follow-up study (p < 0.001). Conclusions: Serum spermidine was positively associated with increased odds of obesity in the cross-sectional study but reduced odds of an increase in BMI in the follow-up study among Chinese adults. Future studies are warranted to determine the exact mechanism underlying the association between spermidine and obesity and the scope for interventions.

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Associations between obesity, metabolic health, and the risk of breast cancer in East Asian women

Cited by 14 publications

References 32 publications

Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China

Use of Breast Cancer Risk Factors to Identify Risk-Adapted Starting Age of Screening in China

18F-FDG uptake of visceral adipose tissue on preoperative PET/CT as a predictive marker for breast cancer recurrence

Elevation of Serum Spermidine in Obese Patients: Results from a Cross-Sectional and Follow-Up Study

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