The relation between excess adiposity and breast cancer in women: Clinical implications and management

Breast cancer (BC) is the most common cancer in women. While the combination of improved screening, earlier detection, and advances in therapeutics has resulted in lower BC mortality, BC survivors are now increasingly dying of cardiovascular disease. Cardiovascular disease in the leading cause of non-cancer related mortality among BC survivors. This situation underscores the critical need to research the role of modifiable cardiometabolic risk factors, such as excess adiposity, that will affect BC remission, long-term survivorship, and overall health and quality of life. First, this review summarizes the evidence on the connection between adipose tissue and BC. Then we review the data on weight trends after BC diagnosis with a focus on the effect of weight gain on BC recurrence and BC- and non-BC-related death. Finally, we provide a guide for weight management in BC survivors, considering the available data on the effect of weight loss interventions on BC. • There is complex and bidirectional relationship between adipose and breast tissues. • Changes in these dynamics may increase breast cancer risk. • In breast cancer survivors, excess adiposity is associated with worse outcomes. • Excess adiposity can be targeted to improve breast cancer outcomes. • There is limited guidance for weight management in breast cancer survivors.