Obesity and breast cancer:current status,challenges,and emerging precision weight management interventions

KE Xiao-ting; ZHANG Liu-lu

doi:10.13820/j.cnki.gdyx.20252078

Abstract：Obesity,a global public health crisis,is intricately linked to the development and poor prognosis of breast cancer(BC).This article aims to systematically review the complex relationship between obesity and BC,the evi-dence base and core controversies surrounding current weight management interventions,the dilemmas in research and practice,and to explore emerging trends and future directions in precision weight management.Based on existing epidemi-ological,basic research,and clinical intervention evidence,combined with international guidelines and the latest ad-vances,a comprehensive critical analysis and review were conducted.Obesity significantly increases the risk of BC in postmenopausal women and adversely impacts patient prognosis(e.g.,increasing recurrence and mortality risks,reducing efficacy of endocrine therapy).Mechanisms involve dysregulated endocrine function of adipose tissue,chronic inflamma-tion,insulin resistance,and other pathways.Lifestyle interventions(diet,physical activity,behavior)are the cornerstone of weight management,but long-term adherence and sustained effectiveness pose major challenges.Bariatric surgery demonstrates significant potential for risk reduction and improved prognosis in specific populations,yet its application is limited.Current research faces bottlenecks in translating evidence,insufficient strength of guideline recommendations,and a lack of individualized strategies.Weight management is a critical component in both BC prevention and comprehensive survivorship care.Future research should focus on conducting high-quality,long-term intervention trials,delving dee-per into the mechanisms linking obesity to carcinogenesis and prognosis,and vigorously promoting precision,integrated weight management models based on molecular subtypes,metabolic profiles,and digital technologies to optimize survival outcomes and quality of life for BC patients.