The relation between obesity and breast cancer risk in women by considering menstruation status and geographical variations: a systematic review and meta-analysis

Breast cancer risk of hormone replacement therapy in Japanese women with schizophrenia on antipsychotic treatment: A retrospective cohort study

PURPOSE

This study aimed to identify the risk factors for breast cancer onset in patients with schizophrenia who are receiving antipsychotic treatment. The focus was on understanding how baseline patient characteristics and treatment factors influence breast cancer risk in this population.

METHODS

A retrospective cohort study was conducted using a nationwide claims database in Japan, including 12,479 patients with schizophrenia who were receiving antipsychotic medications. The primary outcome was the development of breast cancer. Multivariate Cox regression analysis was employed to identify independent risk factors, with sensitivity analyses conducted using the jackknife and elastic net methods.

RESULTS

Among the 12,479 patients, 22 developed breast cancer during the follow-up period. Baseline age of 38 years or older (hazard ratio (HR) = 4.87, 95 % confidence interval (CI) = 1.41-16.87, p = 0.013) and the use of progestogens (HR = 4.47, 95 % CI = 1.04-19.18, p = 0.044) were identified as independent risk factors for breast cancer onset. Sensitivity analyses confirmed the robustness of these findings, although the study's limited number of events highlighted potential variability in the HRs.

CONCLUSION

The results suggest that certain treatment factors, particularly the use of progestogens, may increase the risk of breast cancer in patients with schizophrenia who are receiving antipsychotic treatment. Given these findings, careful consideration of treatment plans, including the dosage and duration of hormone replacement therapy and adjustments in antipsychotic treatment, may be warranted. Further research is needed to clarify the interactions between mental disorders, treatment factors, and breast cancer risk.

Insights on the association of anthropometric and metabolic variables with tumor features and genomic risk in luminal early breast cancer: Results of a multicentric prospective study

BACKGROUND

Hormone receptor-positive (HR+)/HER2-negative (HER2-) early-stage breast cancers (EBC) are treated with adjuvant endocrine therapy (ET), with chemotherapy (CT) reserved for high-risk cases. Obesity is linked to increased recurrence risk. The Oncotype DX® assay predicts prognosis and CT benefit. The PRO BONO study evaluated Oncotype DX test's impact on treatment decisions and explored associations between genomic risk, tumor features, and patient metabolic profiles.

MATERIALS AND METHODS

Patients with HR+ /HER2-EBC undergoing Oncotype DX testing were enrolled. Body mass index (BMI), tumor characteristics (ER, PR, Ki67, grading, size, nodal status), a large panel of metabolic analytes, and Oncotype DX Recurrence Score® (RS) results were collected. Treatment recommendations (ET vs CT-ET) were recorded pre- and post-Oncotype DX, and concordance was determined using Cohen's Kappa. Associations were tested using Chi-Square test and Spearman Correlation.

RESULTS

Of the 248 EBC patients (2019-2021), Oncotype DX testing reduced CT use by 47.7 %. Higher RS positively correlated with serum triglycerides and inversely with GIP (all p < 0.05). No significant association was found between patient BMI and RS result. Conversely, tumor size positively correlated with BMI (p = 0.0286) and with serum levels of leptin (p = 0.0079), PAI-1 (p = 0.0083), C-peptide (p = 0.0124), GIP (p = 0.0036), GLP-1 (p = 0.0476), glucagon (p = 0.0224), and insulin (p = 0.0327). A BMI≥ 30 and higher GLP-1 levels (>148.85pg/ml) were independently associated with increased odds of having larger tumor size (>2 cm).

CONCLUSIONS

Recurrence Score result significantly impacts treatment decisions in HR+ /HER2-EBC. RS result was not associated with BMI, although unfavorable metabolic profiles and obesity-related markers correlated with larger tumors. These findings highlight the need to further investigate the link between metabolic profiles and breast cancer biology.

Molecular Subtypes and Mechanisms of Breast Cancer: Precision Medicine Approaches for Targeted Therapies

Breast cancer remains one of the most prevalent diseases worldwide, primarily affecting women. Its heterogeneous nature poses a significant challenge in the development of effective and targeted treatments. Molecular characterization has enabled breast cancer to be classified into four main subtypes: luminal A, luminal B, HER2-positive, and triple-negative breast cancer, based on hormone receptor expression and HER2 status. A deeper understanding of these molecular markers and their associated signaling pathways, such as MAPK and PI3K/AKT, is essential for improving prognosis and optimizing treatment strategies. Currently, several therapeutic agents are utilized in neoadjuvant and adjuvant therapies, often in combination with surgical interventions. However, emerging evidence highlights the growing challenge of drug resistance, which significantly limits the efficacy of existing treatments. Addressing this issue may require innovative approaches, including combination therapies and precision medicine strategies, tailored to the molecular profile of each patient. Therefore, a comprehensive understanding of the pathophysiologic mechanisms driving breast cancer progression and resistance is crucial for the development of advanced targeted therapies with greater precision and efficacy. This review aims to explore recent advancements in molecular research related to breast cancer subtypes and provide a critical analysis of current therapeutic approaches within the framework of precision medicine.

Obesity and Risk of Pre- and Postmenopausal Breast Cancer in Africa: A Systematic Review

Background and Aims: Several epidemiological studies have investigated the relationship between anthropometric factors and breast cancer (BC), but the results, particularly for premenopausal BC, remain inconsistent and contradictory. The aim of this systematic review is to present an overview of studies examining the association between obesity and BC risk in African women, by menopausal status. Methods: PubMed, Scopus, Web of Science, and Google Scholar were searched until 17 February 2025 to identify published articles. The review included original studies, with no restrictions on publication date or language. The exposures studied were height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The quality of the studies was assessed using the National Institute of Health (NIH). Study selection and data extraction were carried out by two authors separately. Results: A total of fifteen case-control studies were included in this systematic review, comprising 45,056 subjects (7221 cases and 37,835 controls). Among them, fourteen studies reported stratified results for pre- and postmenopausal women, and one reported findings for only premenopausal BC. We found that BMI was associated with an increased risk of BC in both premenopausal and postmenopausal women, though the associations varied across studies. Height was associated with an increased risk of pre- and postmenopausal BC. WHR was positively associated with BC in pre- and postmenopausal women, while WC showed a positive association with the risk of postmenopausal BC, and inconsistent results with premenopausal BC. Finally, a higher HC was positively associated with premenopausal and postmenopausal BC. Conclusions: The risk of developing BC is higher in obese postmenopausal women. The protective role of BMI has not been demonstrated in African premenopausal women. WHR is a risk factor for premenopausal and postmenopausal BC. There is a need to study the influence of stages of overweight and obesity on BC risk in a large sample of African women in-depth.

Comprehensive Analysis of Predictors and Outcomes in Breast Cancer Screening in Romania: Insights from Demographic, Clinical, and Lifestyle Factors

Background/Objectives: The primary purpose of this study is to provide a more in-depth insight into various demographic, clinical, and lifestyle factors in relation to breast cancer and to predict the extent to which certain variables described as "predictors" might lead to further investigation. By analyzing a large cohort, we are able to provide valuable and up-to-date information on breast cancer screening, support breast specialists, and further enhance international screening guidelines. Methods: We screened for breast cancer in a population of women aged 50 to 69 years by using the standardized breast cancer imaging screening method (breast mammography) and ultrasonography as a complementary imagistic tool, and we compared the results with the gold standard, breast biopsy. For this, 58,760 women with no known history of breast cancer coming from 4 major regions of Romania (North-East, North-West, South-East, and West) were first evaluated through mammography. Out of these, 3197 women with positive mammograms subsequently underwent a breast ultrasound examination. The remaining 688 patients with positive breast ultrasound were further referred for a breast biopsy. Results: The statistical analysis revealed several predictors such as the body mass index (BMI), positive family medical history of breast cancer, age at first birth, and age at menopause that influenced the progression from mammography (first stage of the screening program) towards echography (additional imaging modality). Furthermore, we established that age, age at first birth, and BMI are significant predictors of progression from echography towards biopsy (the last stage of the screening program). Furthermore, by analyzing the number of positive biopsies (688) out of the total number of patients in the study (58,760), we calculated a total breast cancer detection rate of 8 per 1000 patients. Lastly, by studying the patient demographics in the context of breast cancer (BC) screening, we observed that participants coming from an urban environment presented a higher rate of positive mammographic results as compared to ones of rural provenience. Conclusions: Our study analyzed a large cohort of patients and offers real world data which shows that multiple factors were positively associated with an increased risk of BC. Older age, older age at first birth, and an older menopausal age are all estrogen-dependent risk factors that were linked with an increased breast cancer risk in our study. Furthermore, our findings concerning the rural/urban disparities and regional differences highlight the need for region-specific interventions to address lifestyle risk factors, improve healthcare access, and enhance breast cancer screening and follow-up protocols, particularly in underserved areas like the North-East and South-East regions.

Effects of BMI on prognosis, disease-free survival and overall survival of breast cancer

BACKGROUND

Obese breast cancer patients have worse prognosis than normal weight patients, but the level at which obesity is prognostically unfavorable is unclear. This study aimed to investigate different effects of Body Mass Index (BMI) on prognosis disease-free survival and overall survivor of breast cancer patients.

METHOD

This retrospective cohort study analyzed the medical records of breast cancer patients who sought treatment at Namazi hospital in Shiraz, Iran between 2014 and 2019. Three groups of patients were divided according to BMI. Menopausal status, BMI status, clinicopathological characteristics, treatment, and overall survival (OS), and disease free survival (DFS) were comprehensively evaluated. The World Health Organization (WHO) BMI classification was used to categorize patients into three groups: normal weight (BMI < 25.0 kg/m2), overweight (25.0 ≤ BMI < 30.0 kg/m2), and obese (BMI ≥ 30.0 kg/m2).

RESULTS

Of the 7134 breast cancer patients, the majority (42.6%) were in 25-30 kg/m2. Menopausal status significantly were associated with obesity (P < 0 .001). The majority of patients were categorized as grade 2 and stage 2 according to the BMI categories (P = 0.12, P = 0.08, respectively). BMI categories regardless of menopausal status displayed increased 1, 3, and 5-year DFS and 5- year OS in stage 1 and increased 1, 3, and 5-year OS and 1 and 3-year DFS in stage 2. In stage 3, the risks of relapse and death were significantly decreased in all three groups of BMI patients with post-menopausal period.

CONCLUSION

Obesity leads to worse DFS and OS in patients with BC and the effects of obesity on the breast cancer prognosis seem to be clinically related to menopausal status. Once validated, these results should be considered in the development of prevention programs.

Breast Cancer Risk and Management in the Endocrine Clinic: A Comprehensive Review

OBJECTIVE

This review seeks to provide endocrine clinicians with a comprehensive analysis of breast cancer risk, diagnostic modalities and management strategies in women with endocrine disorders, with particular emphasis on the influence of metabolic factors such as diabetes and obesity, and the role of Menopausal Hormone Therapy (MHT).

DESIGN

The review examines a spectrum of endocrine disorders commonly encountered in clinical practice, including Multiple Endocrine Neoplasia Types 1 (MEN1), 2 (MEN2) and 4 (MEN4), Von Hippel-Lindau syndrome (VHL), Pheochromocytoma and Paraganglioma (PPGL), Acromegaly, Hyperprolactinaemia, Polycystic Ovary Syndrome (PCOS), Congenital Adrenal Hyperplasia (CAH), Turner Syndrome, alongside metabolic conditions such as diabetes and obesity and the effects of MHT. The review critically appraises each disorder's association with breast cancer risk, screening implications and therapeutic management.

PATIENTS

This analysis focuses on women with the aforementioned endocrine and metabolic disorders, assessing their specific breast cancer risk profiles, informed by the latest clinical evidence and molecular insights.

MEASUREMENTS

The review comprehensively evaluates current evidence-based approaches to screening, diagnostic accuracy and treatment in this patient cohort. Emphasis is placed on the metabolic derangements, hormonal influences and genetic predispositions that modulate breast cancer risk, providing disorder-specific recommendations for individualised care.

RESULTS

The findings indicate a significantly elevated breast cancer risk in patients with MEN1, necessitating early initiation of MRI screening by age 40. In MEN2, emerging evidence suggests that combining RET inhibitors with endocrine therapy may yield clinical benefits, although further research is needed to validate this approach. The breast cancer risk associated with MEN4 and VHL syndromes, while documented, remains less well-characterised, requiring further investigation. Diabetes and obesity are confirmed as major modifiable risk factors, particularly in postmenopausal women, where hyperinsulinemia and metabolic dysfunction contribute to increased incidence and poorer outcomes, notably in triple-negative breast cancer (TNBC). The role of MHT, particularly combined oestrogen-progestogen therapy, is strongly associated with increased breast cancer risk, particularly for hormone receptor-positive malignancies, necessitating cautious use and personalised treatment planning. In contrast, oestrogen-only MHT appears to confer a reduced risk in women post-hysterectomy. For patients with PCOS, CAH and Turner Syndrome, while definitive evidence of elevated breast cancer risk is lacking, individualised screening strategies and careful hormone therapy management remain essential due to the complex interplay of hormonal and metabolic factors.

CONCLUSIONS

The review highlights the need for personalised breast cancer screening and management protocols in women with endocrine and metabolic disorders. For high-risk groups such as MEN1 patients, early initiation of MRI screening is warranted. In women with diabetes and obesity, targeted interventions addressing hyperinsulinemia and metabolic dysfunction are critical to mitigating their increased cancer risk. The association between MHT and breast cancer underscores the importance of individualised risk stratification in hormone therapy administration, particularly in women with predisposing genetic or endocrine conditions. Enhanced surveillance tailored to the unique risk profiles of endocrine disorder patients will facilitate early detection and improve clinical outcomes. However, further large-scale studies are necessary to refine these associations and develop robust, evidence-based guidelines.

Impact of obesity on pathological complete remission in early stage breast cancer patients after neoadjuvant chemotherapy: a retrospective study from a German University breast center

PURPOSE

Breast cancer is a primary cause of cancer-related death among women worldwide. Neoadjuvant chemotherapy (NACT) is a cornerstone treatment for locally advanced, non-metastatic breast cancer. Achieving pathological complete response (pCR) is often used as a surrogate marker for long-term outcomes. This study examines the impact of obesity, defined by a body mass index (BMI) over 30 kg/m2, on achieving pCR in patients with early stage breast cancer (eBC) undergoing NACT.

METHODS

A retrospective analysis was conducted on patients with eBC treated with NACT at the University of Tübingen. The primary objective was to assess the impact of obesity on achieving pCR. Logistic regression analysis was used to determine the association between pre-treatment BMI and pCR, adjusting for covariates such as age, tumor stage, grading, and chemotherapy intensity.

RESULTS

The study included 325 patients, with 24% classified as obese. While the univariate logistic regression analysis showed no significant impact of obesity on the odds ratio of achieving pCR, the multivariate analysis, accounting for covariates, demonstrated that obese patients had a significantly higher likelihood of achieving pCR.

CONCLUSION

In this retrospective study, obesity significantly affected the likelihood of achieving pCR in patients with eBC cancer undergoing NACT after adjusting for covariates. While obesity is a known risk factor for breast cancer development and progression, its impact on the efficacy of NACT in terms of achieving pCR was positive in our study. These findings contribute to the ongoing debate in the literature, though the retrospective design and potential uncontrolled factors should be considered.

Implications of obesity and insulin resistance for the treatment of oestrogen receptor-positive breast cancer

Breast cancer is the most common cancer in women, and incidence rates are rising, it is thought in part, due to increasing levels of obesity. Endocrine therapy (ET) remains the cornerstone of systemic therapy for early and advanced oestrogen receptor-positive (ER + ) breast cancer, but despite treatment advances, it is becoming more evident that obesity and insulin resistance are associated with worse outcomes. Here, we describe the current understanding of the relationship between both obesity and diabetes and the prevalence and outcomes for ER+ breast cancer. We also discuss the mechanisms associated with resistance to ET and the relationship to treatment toxicity.

Risk for Second Primary Ovarian Cancer: A Large Population Based on Surveillance, Epidemiology, and End Results Database

INTRODUCTION

This study aims to evaluate the likelihood of developing a second primary ovarian cancer (OC) considering factors including age, race, and the types of initial malignancies encountered.

METHODS

This study employed a retrospective cohort approach, compiling data on individuals diagnosed with OC from the Surveillance, Epidemiology, and End Results (SEER) program databases spanning the years 1975-2019. The analysis used standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) to determine the likelihood of developing OC. The result was further refined by categorizing the data based on patient age, race background, first primary cancer types, the time elapsed since the second primary cancer diagnosis, and radiotherapy treatment.

RESULTS

A total of 1,536,151 patients with second primary cancer being OC were included. The SIR of the second primary OC was observed to be elevated among patients between the ages of 18-64 years (SIR: 1.09, 95% CI: 1.06-1.13). In contrast, for patients who were 65 years of age or older, the SIR for a second primary OC was found to be relatively lower (SIR: 0.87, 95% CI: 0.83-0.91). A lowering, however, not statistically significant, of the SIR of the second primary OC in patients with white race was presented. Within 2 months to 1-year diagnosis interval, the SIR of the second primary OC was highest (SIR: 1.48, 95% CI: 1.37-1.61). Liver, gallbladder, intrahepatic, and other bile ducts (SIR: 2.00, 95% CI: 1.38-2.81), and breast cancer (SIR: 1.20, 95% CI: 1.15-1.25) had higher SIRs of second primary OC.

CONCLUSION

This study identifies age, ethnicity, the time span between the diagnoses, and the types of initial cancers as factors correlated with the occurrence of a second primary OC. Our findings suggest that targeted surveillance should be considered for high-risk groups.

The Significance of Comprehensive Metabolic Phenotypes in Cancer Risk: A Japan Multi-Institutional Collaborative Cohort Study

SIGNIFICANCE

The prospective cohort study in a large Japanese population suggested that metabolic phenotypes are important risk factors for total and some site-specific cancers in Japanese adults. Moreover, the risk of each site-specific cancer may differ according to metabolic phenotypes.

Double-Edged Sword Effect of Diet and Nutrition on Carcinogenic Molecular Pathways in Breast Cancer

Environmental exposure to a mixture of chemical xenobiotics acts as a double-edged sword, promoting or suppressing tumorigenesis and the development of breast cancer (BC). Before anything else, we are what we eat. In this review, we highlight both "the good" and "the bad" sides of the daily human diet and dietary patterns that could influence BC risk (BCR) and incidence. Thus, regularly eating new, diversified, colorful, clean, nutrient-rich, energy-boosting, and raw food, increases apoptosis and autophagy, antioxidation, cell cycle arrest, anti-inflammation, and the immune response against BC cells. Moreover, a healthy diet could lead to a reduction in or the inhibition of genomic instability, BC cell stemness, growth, proliferation, invasion, migration, and distant metastasis. We also emphasize that, in addition to beneficial compounds, our food is more and more contaminated by chemicals with harmful effects, which interact with each other and with endogenous proteins and lipids, resulting in synergistic or antagonistic effects. Thus, a healthy and diverse diet, combined with appropriate nutritional behaviors, can exert anti-carcinogenic effects and improve treatment efficacy, BC patient outcomes, and the overall quality of life of BC patients.

Systematic Review and Meta-Analysis of Lifestyle and Reproductive Factors Associated with Risk of Breast Cancer in Asian Women

BACKGROUND

Assessing breast cancer risks from lifestyle and reproductive factors is critical for developing population-specific risk prediction tools. However, limited studies have evaluated these risks in recent Asian birth cohorts.

METHODS

We systematically reviewed articles published from January 2010 to December 2023, examining breast cancer risk factors in Asian women. Data were described narratively, estimates pooled, and prevalence and attributable proportions compared across Asian populations.

RESULTS

Of the 128 studies reviewed, 103 reported adjusted effect sizes for meta-analysis. Lifestyle and reproductive factors were predictive of breast cancer risk in Asian women, with varying impacts on premenopausal and postmenopausal women. Relative risks were similar within Asian populations and in comparison to European populations, except for menarche, menopause, and hormone receptor therapy. However, risk factor distributions differed across populations. While alcohol intake (21%) and oral contraceptive use (20%) emerged as the most attributable modifiable risk factors in Europeans, passive smoking (24%) and higher BMI (17%, ≥24 kg/m2 among postmenopausal women) were predominant in Asians.

CONCLUSIONS

Our study shows that while the effects of lifestyle and reproductive breast cancer risk factors are largely similar across different populations, their distributions vary.

IMPACT

Our analysis underscores the importance of considering population-specific risk factor distributions when developing risk prediction tools for Asian populations.

Reproductive Risk Factor Patterns in Caribbean Women With Breast Cancer Across 4 Generations

Importance

Breast cancer (BC) is commonly diagnosed among Caribbean women. Shifts in reproductive patterns modify the incidence of BC diagnosis and age at BC diagnosis in population-based studies; however, reproductive patterns in Caribbean women remain understudied.

Objective

To describe the temporal trends in reproductive patterns and age at BC diagnosis in Caribbean-born women.

Design, Setting, and Participants

A cross-sectional observational study-the Caribbean Women's Cancer Study-was conducted, with data on reproductive patterns known to affect BC risk collected in The Bahamas, Barbados, Cayman Islands, Dominica, Haiti, Jamaica, and Trinidad and Tobago. Participants were recruited prospectively. The sample included women born in Caribbean countries and diagnosed with invasive BC and/or ovarian cancer from June 1, 2010, to June 30, 2018, and was divided into 4 birth cohorts (born before 1950, 1950-1959, 1960-1969, and in or after 1970). Data were analyzed between August 1, 2023, and July 31, 2024.

Exposures

Receipt of a BC diagnosis and birth in a Caribbean country.

Main Outcomes and Measures

Change in reproductive patterns between birth cohorts, including age at BC diagnosis, family history of cancer, age at first pregnancy, number of pregnancies, number of full-term pregnancies, number of siblings, age at menarche and menopause, estrogen receptor status, and germline pathogenic/likely pathogenic variants.

Results

Of 1015 participants diagnosed with BC and ovarian cancer, 995 women (mean [SD] age, 46.6 [10.8] years; 605 [81.8%] Afro-Caribbean, 98 [13.2%] East Indian, 22 [3.0%] White, and 12 [1.6%] >1 race) received a diagnosis of invasive BC. Comparison from older to younger birth cohorts (presented in the order of born before 1950, 1950-1959, 1960-1969 and in or after 1970) showed an increased proportion of women experiencing menarche at age 12 years or younger (33.0% vs 47.3% vs 45.5% vs 57.9%; P < .001), women with no pregnancies (6.8% vs 6.8% vs 10.5% vs 22.8%; P < .001), and nulliparous women (8.6% vs 9.2% vs 13.9% vs 27.6%; P < .001). Younger age at BC diagnosis was observed in women experiencing menarche at age 12 years or younger (mean [SD], 45.0 [10.5] years) vs 15 years or older (mean [SD], 49.1 [11.2] years) and in nulliparous women (mean [SD], 42.1 [11.2] years) vs 3 or more full-term pregnancies (mean [SD], 49.9 [10.6] years; P < .001). For every year of first pregnancy delay, women had a 4% increased chance of being diagnosed with estrogen receptor-positive tumors (odds ratio, 1.04; 95% CI, 1.01-1.08; P = .02).

Conclusions and Relevance

In this cross-sectional study, between each 10-year birth cohort, women diagnosed with BC had a lower age at menarche, number of pregnancies, and number of full-term pregnancies. These findings suggest that interventions targeting other BC risk factors need to be implemented.

Pregnancy, abortion, and birth control methods' complicity with breast cancer occurrence

Reproductive factors play significantly important roles in determining the breast cancer (BC) risk. The impact of pregnancy, abortion, and birth control methods on tumor development remains unclear. It has been found that early full-term pregnancies in young women can lower their lifetime risk of developing the type of cancer in question. However, having a first full-term pregnancy at an older age can increase this risk. The relationship between pregnancy and breast cancer (BC) is, however, much more complicated. Both induced and spontaneous abortions lead to sudden changes in hormonal balance, which could cause different effects on sensitive breast epithelial cells, making abortion a potential risk factor for breast cancer. The influence of hormonal contraception on carcinogenesis is not comprehensively understood, and therefore, more exhaustive analysis of existing data and further investigation is needed. This review explores how the mentioned reproductive factors affect the risk of breast cancer (BC), focusing on the molecular mechanisms that contribute to its complexity. By comprehending this intricate network of relationships, we can develop new strategies for predicting and treating the disease.

A contemporary review of breast cancer risk factors and the role of artificial intelligence

Background

Breast cancer continues to be a significant global health issue, necessitating advancements in prevention and early detection strategies. This review aims to assess and synthesize research conducted from 2020 to the present, focusing on breast cancer risk factors, including genetic, lifestyle, and environmental aspects, as well as the innovative role of artificial intelligence (AI) in prediction and diagnostics.

Methods

A comprehensive literature search, covering studies from 2020 to the present, was conducted to evaluate the diversity of breast cancer risk factors and the latest advances in Artificial Intelligence (AI) in this field. The review prioritized high-quality peer-reviewed research articles and meta-analyses.

Results

Our analysis reveals a complex interplay of genetic, lifestyle, and environmental risk factors for breast cancer, with significant variability across different populations. Furthermore, AI has emerged as a promising tool in enhancing the accuracy of breast cancer risk prediction and the personalization of prevention strategies.

Conclusion

The review highlights the necessity for personalized breast cancer prevention and detection approaches that account for individual risk factor profiles. It underscores the potential of AI to revolutionize these strategies, offering clear recommendations for future research directions and clinical practice improvements.

Determinants of breast cancer among women attending oncology units in selected health facilities of Hawassa City, Sidama Region, Southern Ethiopia, 2023: case-control study

Background

The incidence of breast cancer (BC) is rampantly increasing in developing countries particularly Ethiopia. Unfortunately, the morbidity and mortality rates are sharply increasing, and because of this, families are suffering from socioeconomic crises. Despite this, there is limited evidence on the determinants of breast cancer in Ethiopia as well as in the study area.

Objective

To identify the determinants of BC among women attending oncology units in selected hospitals in Hawassa City, Ethiopia, in 2023.

Method

A hospital-based, case-control study with 300 patients (75 cases and 225 controls) was carried out in Hawassa from June to July 2023. A simple random sampling technique was used to select cases and controls. Data were collected via pretested and structured digitally installed questionnaires with Kobo collection/smartphones. The data were exported from the server to SPSS version 27 for analysis. Descriptive analysis of univariate, bivariate, and multivariable logistic regression data was conducted to determine the associations between breast cancer incidence and independent factors.

Results

A total of 300 women participated in this study for a response rate of 100%. The mean ( ± SD) ages of the respondents were 37.2 ( ± 14.8) and 36.6 ( ± 15.1) years for the cases and controls, respectively. According to the multivariate logistic regression model, postmenopausal status [AOR: 2.49; 95% CI (1.18, 5.23)], family history of cancer [AOR: 2.33; 95% CI (1.12, 4.82)], oral contraceptives [AOR: 2.74; 95% CI (1.34, 5.99)], overweight and/or obesity [AOR: 2.29; 95% CI: (1.14, 4.59)], and consumption of solid oil [AOR: 2.36; 95% CI (1.20, 4.67)] were independently associated with BC risk.

Conclusion

This study revealed important risk factors for BC. Therefore, women should adopt healthier lifestyles through healthy nutrition and regular exercise to reduce the risk of developing BC. In addition, early detection and regular screening are proactive approaches for detecting BC.

Antidiabetic Drugs in Breast Cancer Patients

Diabetes is one of the leading chronic conditions worldwide, and breast cancer is the most prevalent cancer in women worldwide. The linkage between diabetes and its ability to increase the risk of breast cancer should always be analyzed in patients. This review focuses on the impact of antihyperglycemic therapy in breast cancer patients. Patients with diabetes have a higher risk of developing cancer than the general population. Moreover, diabetes patients have a higher incidence and mortality of breast cancer. In this review, we describe the influence of antidiabetic drugs from insulin and metformin to the current and emerging therapies, incretins and SGLT-2 inhibitors, on breast cancer prognosis. We also emphasize the role of obesity and the metastasis process in breast cancer patients who are treated with antidiabetic drugs.

The Microbiome in the Obesity-Breast Cancer Axis: Diagnostic and Therapeutic Potential

A growing body of evidence has demonstrated a relationship between the microbiome, adiposity, and cancer development. The microbiome is emerging as an important factor in metabolic disease and cancer pathogenesis. This review aimed to highlight the role of the microbiome in obesity and its association with cancer, with a particular focus on breast cancer. This review discusses how microbiota dysbiosis may contribute to obesity and obesity-related diseases, which are linked to breast cancer. It also explores the potential of the gut microbiome to influence systemic immunity, leading to carcinogenesis via the modulation of immune function. This review underscores the potential use of the microbiome profile as a diagnostic tool and treatment target, with strategies including probiotics, fecal microbiota transplantation, and dietary interventions. However, this emphasizes the need for more research to fully understand the complex relationship between the microbiome, metabolic disorders, and breast cancer. Future studies should focus on elucidating the mechanisms underlying the impact of the microbiome on breast cancer and exploring the potential of the microbiota profile as a biomarker and treatment target.