Obesity Impact on Breast Cancer Prognosis

Obesity, characterised by excess body fat accumulation, exerts a multifaceted influence on breast cancer outcomes through metabolic, hormonal and inflammatory pathways. Women with higher body mass index (BMI) at diagnosis experience inferior disease-free and overall survival, particularly in postmenopausal and hormone receptor-positive subtypes. Adipose tissue dysfunction promotes chronic low-grade inflammation, dysregulated adipokine secretion and elevated oestrogen production, all of which enhance tumour proliferation, angiogenesis and metastatic potential. Moreover, obesity alters pharmacokinetics and fosters chemoresistance through shifts in fatty acid metabolism and activation of survival pathways. Weight changes after diagnosis likewise bear prognostic significance, with both substantial gain and unintended loss linked to increased mortality. These findings underscore the urgent need for integrated care strategies that combine oncological treatment with weight management, nutritional counselling and exercise interventions to mitigate the adverse impact of obesity on breast cancer survival and quality of life.

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Obesity Impact on Breast Cancer Prognosis publication trend

The graph below shows the total number of articles in obesity impact on breast cancer prognosis across all publications each year (not limited to Nature Index journals).

Technical terms

Body Mass Index (BMI): A ratio of weight (kg) to height (m²) used to categorise underweight, normal weight, overweight and obesity.

Fatty Acid Oxidation (FAO): A mitochondrial metabolic pathway that breaks down fatty acids to generate acetyl-CoA and ATP, influencing cell survival and drug response.

Pathological Complete Response (pCR): The absence of invasive cancer cells in breast tissue and lymph nodes following neoadjuvant therapy, used as a surrogate for long-term outcome.

Adipokines: Bioactive peptides secreted by adipose tissue, such as leptin and adiponectin, that modulate inflammation, insulin sensitivity and tumour behaviour.

References

1. Induction of Fatty Acid Oxidation Underlies DNA Damage‐Induced Cell Death and Ameliorates Obesity‐Driven Chemoresistance. Advanced Science (2023).
2. The association between body fatness and mortality among breast cancer survivors: results from a prospective cohort study. European Journal of Epidemiology (2023).
3. Impact of body mass index in therapeutic response for HER2 positive breast cancer treated with neoadjuvant targeted therapy: a multi-center study and meta-analysis. npj Breast Cancer (2023).