Obesity and  Breast Cancer

Principal Investigator:  Robert Clarke, Ph.D., D.Sc.

This is a funded study to support the development of a multi-institutional, multinational, and multidisciplinary DOD Breast Cancer Center of Excellence. The overarching goal of this center is to address the question “What are the roles of obesity in affecting breast cancer risk and mortality?” 

Obesity is a major problem and affects both the development and progression of breast cancer. Greater than 20% of the adults in more than half of the states within the U.S. are now reported to be obese. Paradoxically, premenopausal breast cancer risk is lower but postmenopausal breast cancer risk is higher in obese women.  

Obesity is more prevalent among African American women, yet these women have a higher risk of developing premenopausal and a lower risk of developing postmenopausal breast cancer than Caucasian women.

Breast cancer mortality in obese women is greater than that of non-obese women, independent of menopausal status. Consistent with a role for estrogen production in adipose tissues, the greatest increase in mortality is seen in obese postmenopausal women with estrogen receptor (ER) positive tumors (RR=3.3; CI=1.1-10.4). 

Body weight measured at different times during life also contributes to breast cancer risk, with an increased risk in women who experienced a high birth weight or low body mass index (BMI) during childhood. Thus, the timing of obesity and body weight also is important. While complex, the influence of obesity at different times of life on outcomes of breast cancer risk and mortality is of great importance for many women.

We will develop a detailed plan to study, in human populations, factors involved in mediating the effects of pubertal, premenopausal, and postmenopausal obesity on breast cancer risk. Animal studies will be designed to complement the human studies, generate novel ways to address our central question, and to provide direct mechanistic information on the biological processes that underlie the associations between obesity and breast cancer. 

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