Obesity, which is rising in incidence worldwide, is important with regard to the treatment of breast cancer, disease progression, and carcinogenesis. Obesity is a risk factor for the development of hormone receptor-positive breast cancer in postmenopausal women and is associated with reduced benefits from treatment. Furthermore, irrespective of breast cancer subtype, obesity is associated with worse outcomes after diagnosis. There is increasing evidence of specific biological underpinnings for these observations, including higher circulating estrogen levels, insulin resistance, altered levels of adipokines, and the consequences of chronic in-breast inflammation. Increasing adiposity also has important implications for local therapy including surgery and radiotherapy. This chapter reviews the complex interactions between obesity and breast cancer.
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