:Worldwide, breast cancer (BC) is the most common malignancy in women, in regard to incidence and mortality. In recent years, the negative role of obesity during BC development and progression has been made abundantly clear in several studies. However, the distribution of body fat may be more important to analyze than the overall body weight. In our review of literature, we reported some key findings regarding the role of obesity in BC development, but focused more on central adiposity. Firstly, the adipose microenvironment in obese people bears many similarities with the tumor microenvironment, in respect to associated cellular composition, chronic low-grade inflammation, and high ratio of reactive oxygen species to antioxidants. Secondly, the adipose tissue functions as an endocrine organ, which in obese people produces a high level of tumor-promoting hormones, such as leptin and estrogen, and a low level of the tumor suppressor hormone, adiponectin. As follows, in BC this leads to the activation of oncogenic signaling pathways: NFκB, JAK, STAT3, AKT. Moreover, overall obesity, but especially central obesity, promotes a systemic and local low grade chronic inflammation that further stimulates the increase of tumor-promoting oxidative stress. Lastly, there is a constant exchange of information between BC cells and adipocytes, mediated especially by extracellular vesicles, and which changes the transcription profile of both cell types to an oncogenic one with the help of regulatory non-coding RNAs.

Central European Institute of Technology Masaryk University 62100 Brno Czech Republic Masaryk Memorial Cancer Institute Department of Comprehensive Cancer Care 60200 Brno Czech Republic

Department of Plastic Surgery University of Medicine and Pharmacy Iuliu Hatieganu 400337 Cluj Napoca Romania

MEDFUTURE Research Center for Advanced Medicine University of Medicine and Pharmacy Iuliu Hatieganu 23 Marinescu Street 400337 Cluj Napoca Romania

MEDFUTURE Research Center for Advanced Medicine University of Medicine and Pharmacy Iuliu Hatieganu 23 Marinescu Street 400337 Cluj Napoca Romania Babeș Bolyai University Faculty of Biology and Geology 42 Republicii Street 400015 Cluj Napoca Romania

MEDFUTURE Research Center for Advanced Medicine University of Medicine and Pharmacy Iuliu Hatieganu 23 Marinescu Street 400337 Cluj Napoca Romania Research Center for Functional Genomics Biomedicine and Translational Medicine Iuliu Hatieganu University of Medicine and Pharmacy 23 Marinescu Street 400337 Cluj Napoca Romania Department of Functional Genomics and Experimental Pathology The Oncology Institute Prof Dr Ion Chiricuta Republicii 34th street 400015 Cluj Napoca Romania

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