Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, New York 14214, USA
Address for correspondence: Paola Muti, Department of Social and Preventive Medicine, 270 Farber Hall, 3435 Main Street, University at Buffalo, State University of New York, Buffalo, NY 14214. Voice: 716-829-2975; fax: 716-829-2979. muti{at}buffalo.edu
Breast cancer is the most common cause of cancer death in women
worldwide. Rates vary about fivefold around the world, but they
are increasing in regions that until recently had low rates
of the disease. Despite the numerous uncertainties surrounding
the etiology of breast cancer, intensive epidemiological, clinical,
and genetic studies have identified a number of biologic and
social traits as risk factors associated with it. Principal
among them are the evidence of BRCA1 and BRCA2 susceptibility
genes, familial history of breast cancer, age, higher socioeconomic
status, ionizing radiation, tallness in adult life, alcohol
consumption, and a variety of hormonal and metabolic factors.
Among the hormonal influences, a relevant etiological function
has been ascribed to unopposed exposure to elevated levels of
estrogens and androgens. In addition, new epidemiological evidence
indicates that among the metabolic factors, glucose metabolism,
hyperinsulinemic insulin resistance, and insulin-like growth
factor bioavailability may also play a role in breast cancer.
These endocrine and metabolic factors may represent future targets
for breast cancer prevention.
