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Zentralbl Gynakol 2003; 125(1): 6-16
DOI: 10.1055/s-2003-40362
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Senkung des Brustkrebsrisikos

Reduction of the risk of breast cancerB. Gerber, I. Mylonas1
  • 1I. Frauenklinik - Klinikum Innenstadt, Ludwig-Maximilians-Universität München - München
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Publication History

Publication Date:
01 July 2003 (online)

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Zusammenfassung

Etliche Aspekte der Ernährung und Lebensgewohnheiten könnten für die Entwicklung unterschiedlicher Krebsarten in westlichen Ländern verantwortlich sein. Vor allem die Unterschiede zwischen den Brustkrebsraten zwischen den einzelnen Ländern, den Änderungen der Krebsinzidenz unter Emigranten und den raschen Wandel dieser Inzidenz in den verschiedenen Ländern deuten darauf hin. Der Anstieg der Mammakarzinominzidenz in den modernen Industrieländern wird sehr häufig mit veränderten Umweltbedingungen in Zusammenhang gebracht. Mit zunehmender Aufklä rung in der Bevölkerung und steigendem Gesundheitsbewusstsein werden verschiedenste Faktoren gesucht, die maßgeblich zur Entstehung von Brustkrebs beitragen oder diesen selbst auslösen. Durch Ausschaltung dieser vermeintlich krebserregenden Umweltfaktoren oder aber gezielten Ersatz von Defiziten würde letztlich ein präventiver Ansatz verfügbar sein. Der karzinogene Effekt von Ernährung und Lebensgewohnheiten könnte indirekt durch Zellstimulierungen (Alkohol, Hormonersatztherapie), Hemmung von DNA-Reparaturmechanismen (Mangel an Vitaminen), Beeinflussung des Östrogenmetabolismus (Phytoestrogene) oder als produktiver Faktor des Wachstums von Tumoren (Körpermassenindex) zurückzuführen sein. Einige „Substanzen” sind direkte Karzinogene, wie z. B. aromatische Kohlenwasserstoffe in Tabak oder polyzyklische aromatische Kohlenwasserstoffe im gebratenen Fleisch. Individuelle Wirkungsunterschiede von Nahrungsstoffen auf das Brustepithel könnte durch genetische Polymorphismen bedingt sein. In dieser Übersicht konzentrieren wir uns auf gegenwärtige Daten bezü glich der Wirkung von Ernährung und Lebensgewohnheiten auf das Risiko der Entstehung von Brustkrebs. Gesunde Lebensgewohnheiten, welche u. a. aus einer „gesunden” Ernährung, physischer Aktivität und Verzicht auf Stimulanzien besteht, wird von Beginn der Kindheit über das ganze Leben empfohlen.

Abstract

Aspects of nutrition and lifestyle may be largely responsible for the development of common cancers in Western countries, as indicated by the large differences in breast cancer rates between countries, the striking changes in these rates among migrating populations, and the rapid changes over time within countries. The better informed and increasingly health-conscious population of the present day are intensively seeking to identify and eliminate these putative carcinogenic risk factors and to exploit the preventive effects that have been attributed to certain dietary components. Nutrition and ‘lifestyle’ may exert its carcinogenic effects indirectly by cell stimulations (alcohol, hormon replacement therapy), inhibition of DNA-repair mechanisms (lack of vitamines), effecting estrogen metabolism (phytoestrogenes), or as promotors to enhance growth of tumors (body mass index). Some ‘substances’ may act as a carcinogenic itself, e. g. aromatic hydrocarbons in tobacco or increased polycyclic aromatic hydrocarbons in well done meat. Individual differences in the effects of nutritional factors on mammary epithelia could be caused by genetic polymorphisms. In this critical review, we focus on current data regarding the effect of nutrition and lifestyle, on the risk of developing breast cancer. A health lifestyle, consisting of „healthy diet”, physical activity, renunciation of stimulants, is recommended from childhood throughout life.

Schlüsselwörter

Brustkrebs - Ernährung - Lebensgewohnheiten - Prävention - Risikofaktoren

Key words

Breast cancer - nutrition - lifestyle - prevention - risk factors

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Prof. Dr. med. Bernd Gerber

I. Frauenklinik, Klinikum Innenstadt · Ludwig-Maximilians-Universität München

Maistraße 11

80337 München

Phone: +49/89/51 60-45 13

Fax: +49/89/51 60-46 62

Email: bernd.gerber@fk-i.med.uni-muenchen.de

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