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Obesity increases breast cancer risk and progression in postmenopausal women. The Akt/mTOR signaling pathway is activated in tumors in response to increased levels of obesity-related growth factors, including insulin-like growth factor (IGF)-1. Hence, we evaluated energy balance modulation as a mechanism for breast cancer prevention through modulation of Akt/mTOR. Studies suggest that dietary calcium can decrease weight gain, although an exact mechanism is not yet identified. Therefore, we investigated the effects of low-fat (10 kcal % fat) or high-fat (45 kcal % fat) diets containing either calcium phosphate (dairy) or calcium carbonate (supplement) on body weight in ovariectomized (OVX) C57BL/6 mice to determine if dietary calcium could overcome the effects of a high-fat diet. We showed that dairy decreased body weight, with no effect on food consumption. However, it is not known if restoration of normal weight can reverse mammary tumor progression and/or Akt/mTOR pathway activation. To evaluate this, mice were fed a control diet, a calorie restricted regimen, or a diet-induced obesity (DIO) regimen for 17 weeks, after which the DIO mice were switched to the control diet, and this resulted in a 20% weight loss and mice of equal weight to control mice. MMTV-Wnt-1 mammary tumor cells were orthopically injected at week 20, following weight loss. At week 22, mice began placebo or RAD001, an mTOR inhibitor, treatment by oral gavage. Tumor growth and Akt/mTOR signaling were enhanced in formerly obese mice, despite reduction in weight, adiposity and serum hormone levels. RAD001 decreased tumor growth in the CR and control group, but was less effective in the formerly obese mice. In an additional study, we added a DIO gourp which was not switched to the control diet, and found that circulating IGF-1 levels remained significantly elevated in formerly obese mice relative to control and were comparable to levels in the DIO mice. We found that the mechanism of tumor progression was through enhanced Akt/mTOR signaling in both obese and formerly obese mice. Based on the Akt/mTOR activation in MMTV-Wnt-1 tumor growth and progression, we next investigated the anticancer effects of ursolic acid (UA), a pentacyclic triterpene. It was previously shown that UA can affect Akt signaling. Our results showed that UA was effective decreasing tumor growth and Akt/mTOR signaling. Taken together, our findings show that the growth-enhancing effects of obesity on mammary tumor may persist even after weight loss and suggest that a combination of dietary and pharmacologic interventions targeting IGF-1/Akt/mTOR may be an effective strategy in the treatment of postmenopausal breast cancer. / text

Contexte : L’exposition professionnelle aux sous-produits de combustion est répandue et peut contribuer à l'étiologie du cancer du sein. Cette étude vise à estimer l’association entre l’exposition professionnelle à certains sous-produits de combustion et le risque postménopausique de cancer du sein. Méthodes : Cette étude cas-témoins populationnelle comprenait des femmes ménopausées âgées de 47-75 ans résidant à Montréal, Québec (2008-2011). Les cas incluaient 695 femmes ayant reçu un diagnostic cancer du sein malin et 608 témoins sélectionnés aléatoirement à partir de la Liste électorale du Québec, appariés aux cas en fréquence (groupes d'âge de 5 ans). L’information sur les facteurs de risque et l'historique professionnel a été recueillie par entrevue. Des hygiénistes industriels ont évalué l'exposition à 293 agents, dont six sous-produits de combustion. Le risque de cancer du sein associé à l'exposition professionnelle à certains sous-produits a été estimé, pour l'ensemble des tumeurs et leurs sous-types moléculaires, par régression logistique inconditionnelle avec rapports de cotes ajustés (RC) et intervalles de confiance à 95 % (IC 95%). Résultats : Des associations positives suggestives ont été trouvées entre l'exposition aux hydrocarbures aromatiques polycycliques et certains sous-types moléculaires de tumeurs : toutes tumeurs, RC=1,18 (IC95%=0,80-1,76), tumeurs luminales A, RC=1,25 (IC95%=0,81-1,93) et tumeurs luminales B, RC=2,09 (IC95%=0,87-4,60). Un risque élevé a été observé avec l'exposition aux fumées de cuisson pour les tumeurs HER2-enrichies (RC=2,63, IC95%=0,98-6,40). Conclusion : L'exposition à certains sous-produits de combustion peut augmenter le risque de certains sous-types moléculaires de cancer du sein. Des études futures explorant cette association sont justifiées. / Background: Postmenopausal breast cancer is the most common cancer among women, yet little is known about its association with occupational exposures. Exposure to combustion by-products is widespread in occupational settings and may contribute to breast cancer etiology. Here, we sought to estimate the association between lifetime occupational exposure to select combustion by-products and the risk of postmenopausal breast cancer. Methods: This population-based case-control study included postmenopausal women residing in Montreal, Quebec (2008-2011). Cases comprised 695 women aged 47-75 years diagnosed with incident malignant breast cancer, and 608 controls randomly selected from the Quebec Electoral List, frequency-matched to cases (5-year age groups). Information on risk factors and employment history was collected by interview. Exposure to 293 agents, including six combustion by-products was assessed by industrial hygienists. Unconditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for breast cancer risk, both overall and by tumor molecular subtypes, to occupational exposure to select combustion by-products. Results: We found suggestive positive associations between exposure to polycyclic aromatic hydrocarbons and certain molecular subtypes of tumors: for all tumors, OR=1.18 (95% CI: 0.80-1.76), Luminal A tumors, OR=1.25 (95% CI: 0.81-1.93) and Luminal B tumors, OR=2.09 (95% CI: 0.87-4.60). Elevated risked were observed for exposure to cooking fumes for HER2-enriched tumors (OR=2.63, 95% CI: 0.98-6.40). Conclusion: Exposure to select combustion by-products may increase the risk of certain hormonal subtypes of breast cancer. Future studies exploring this association are warranted.