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Overlooked hormone drives postmenopausal breast cancer in obese women

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An overlooked fat-derived hormone may drive higher breast cancer death risk in postmenopausal women with obesity, an analysis suggests.

The review identifies oestrone, a form of oestrogen produced in fat tissue, as a major driver of oestrogen receptor positive (ER+) breast cancer, the most common and deadly form of the disease in postmenopausal women.

ER+ means the cancer grows in response to oestrogen. It also raises the possibility that treatment could be improved with the addition of weight-loss drugs known as GLP-1 receptor agonists.

The analysis was led by Joyce Slingerland, who co-leads the Cancer Host Interaction Program at Georgetown University’s Lombardi Comprehensive Cancer Center in the US.

She said postmenopausal women with obesity are more likely to be diagnosed with ER+ breast cancer and are two to three times more likely to die from it.

Slingerland said: “That’s particularly concerning because it’s estimated that obesity will affect nearly half of women in the United States by the end of the decade.”

Before menopause, the most abundant oestrogen in women is 17β-oestradiol, produced primarily by the ovaries.

After menopause, its levels fall dramatically and oestrone becomes the most abundant form circulating in the blood.

Despite their similar chemical structure, the research suggests these two forms of oestrogen behave very differently.

While 17β-oestradiol turns on genes that reduce inflammation, oestrone does the opposite, activating genes that trigger intense inflammatory activity.

In the context of obesity, levels of oestrone are two to four times higher in fat, breast and other tissues.

The analysis suggests these elevated levels set off a cascade that causes precancerous changes and activates cancer-fuelling genes.

Previous research by the team showed that oestrone-fuelled inflammation activates genes involved in a process that promotes cancer spread.

When researchers treated obese mice with ER+ breast cancer with oestrone, their tumours grew faster and rapidly spread throughout the body compared with mice treated with 17β-oestradiol.

Slingerland said: “Our work has provided some of the causal links between oestrone and the worse outcomes seen in postmenopausal women with ER-positive breast cancer who are obese.

“Simply put, these two oestrogens are not equal to each other.”

The author argues that clinical studies of GLP-1 drugs in women with ER+ breast cancer who have obesity are a logical next step.

Slingerland said: “The GLP-1 drugs have revolutionised weight loss.

“Because of oestrone’s powerful inflammatory effects in fat, there’s real potential that, by inducing weight loss, GLP-1 drugs can pump the brakes on oestrone’s cancer-fuelling behaviour.”

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Women shouldering hidden burden of navigating healthcare system – study

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Women face a hidden burden navigating healthcare, with many repeatedly retelling their medical history, a national study suggests.

The findings indicate that Canadian women are taking on cognitive, emotional and administrative work alongside managing their health, including coordinating providers and advocating for care.

More than half of women surveyed, 53 per cent, reported a past or current chronic condition, while 64 per cent said there were health topics they struggled to raise with their doctor.

Sarah Hoffman, president and CEO of Pacific Blue Cross, said: “These findings challenge us to think differently about women’s healthcare and highlight the hidden work required to navigate the system.

“For many women, managing their health has also come to mean managing the healthcare system itself.

“They are acting as project managers of their own care, shouldering the invisible labour of coordinating between providers, retelling their medical history and advocating to be heard.

 “The gap between men and women is meaningful and raises important questions about why younger women report lower levels of confidence and support.

“It also challenges us to consider whether we are actually making progress in women’s care, and whether the next generation is being equipped with the confidence and voice to advocate for their health.”

Overall, 71 per cent of Canadians described their doctors as supportive and 88 per cent expected their appointments to go well.

Among women living with chronic conditions, 71 per cent reported having to repeat their complete health history multiple times a year.

Younger women were particularly likely to report difficulties discussing their health. The study found 81 per cent of Gen Z women aged 18 to 30 and 73 per cent of Millennial women aged 31 to 45 had health topics they struggled to raise with their doctor.

Among Gen Z women with chronic illness, 92 per cent reported having to repeat their complete health history.

The study also found differences between young women and men. While 95 per cent of Gen Z men expected a doctor’s appointment to go well, the figure was 82 per cent among Gen Z women.

Similarly, 82 per cent of Gen Z men said they felt supported by their family doctor, compared with 66 per cent of Gen Z women.

Reasons for holding back health concerns varied between generations.

Among Gen Z women, 30 per cent cited fear of dismissal and 29 per cent fear of judgement.

Embarrassment was the most common barrier among Millennial, Gen X and Boomer women, reported by 29 per cent, 27 per cent and 35 per cent respectively.

Women who felt they needed to prove themselves to be taken seriously said they adapted how they approached appointments.

Strategies included researching medical information, repeatedly describing or justifying symptoms, bringing written notes or documentation, tracking symptom timelines, making repeat visits and emphasising how symptoms affected their daily lives.

The study also found an association between feeling supported by a doctor and expecting appointments to go well.

Canadians who described their physician as supportive were nearly four times more likely to expect appointments to go well than those who felt unsupported, at 98 per cent compared with 25 per cent.

Overall, 66 per cent of Canadians said they described their symptoms accurately. This fell to 48 per cent among those who said they felt unsupported by their doctor.

The 2026 Blue Cross Women’s Health Study surveyed 2,045 adult Canadians online in March 2026 through independent research company Research + Knowledge = Insights.

The survey had a reported margin of error of plus or minus 2 per cent, 19 times out of 20.

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Court recognises radiation as factor in flight attendant’s breast cancer

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A French court has linked cosmic radiation to a former flight attendant’s breast cancer for the first time.

Sophie Lainault, 59, had sought to have her cancer recognised as an occupational disease linked to her working conditions.

The court in Bayonne ruled that cosmic radiation was one of three carcinogenic, or cancer-causing, hazards arising from her profession, alongside passive smoking and prolonged night work.

Smoking was authorised on Air France flights until 2000.

The ruling means Lainault, who is in remission, can take early retirement and have any further treatment fully reimbursed by the French health system.

Lawyers said the decision has also cleared the way for similar claims by recognising breast cancer as an occupational risk for flight crews.

Lainault said: “My dearest wish is that the decision encourages other women who up until now have not had the courage to take this step.”

Lainault worked as a stewardess and later a purser on Air France aircraft, recording 12,600 flight hours between 1989 and 2019. More than half of those hours were at night.

Many of her long-distance, high-altitude flights from Paris would have taken her near the North Pole, where exposure to cosmic radiation is most intense.

Cosmic radiation consists of particles originating from the sun and other stars.

A study this month at Harvard Medical School in the US involving more than 500 professions found that flight attendants and pilots had the highest proportions of radiation-related cancer deaths.

About 6.9 per cent of deaths among flight attendants and 6.7 per cent among pilots were from radiation-related cancers, according to the analysis.

The proportions were higher than in other professions, including nuclear technologists, who are routinely exposed to radiation from non-cosmic sources and ranked 12th in the analysis.

It has long been known that high-altitude air travel exposes people to cosmic radiation, although the dose received by most travellers is regarded as statistically insignificant. Exposure is higher at the poles because elsewhere the Earth’s magnetic field acts as a shield.

Lainault’s lawyer Elisabeth Leroux said: “In France the link between breast cancer and certain hazards has been established for a number of professions, such as nurses … but this is the first time for an air-hostess.”

Air France said it had not been involved in Lainault’s legal case and had not seen the reasoning behind the court’s decision.

“The health and security of our staff is an absolute imperative,” the airline said. “Every employee has a medical accompaniment that goes well beyond the regulatory minimum.”

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Study to tackle years-long delays in endometriosis diagnosis

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A study is examining where delays occur in diagnosing endometriosis  – a condition that can take seven to twelve years to diagnose.

Endometriosis affects an estimated 1.5 million women and people in the UK, but there is currently no consistent way of measuring where and why diagnostic delays happen.

The research aims to develop the first standardised framework for understanding the diagnostic journey and identifying points where interventions could improve care.

The international project involves researchers from the University of Sheffield, University of Liverpool, University of Oxford, Aarhus University in Denmark and the University of Edinburgh, alongside Endometriosis UK.

Dr Rebecca Mawson, NIHR clinical lecturer in primary care at the University of Sheffield, is part of the research team.

She said: “Our project asks: where exactly are people getting lost or let down on their journey to diagnosis, and how can we map those points in a systematic way to identify where interventions could make a real difference.”

The project is led by Dr Babu Karavadra, NIHR academic clinical fellow in general practice at the University of Liverpool, who has been awarded a World Endometriosis Society Early Career Investigator Award as lead principal investigator at the University of Liverpool.

Researchers will review existing evidence, gather experiences from people living with endometriosis and bring together an international panel to map the diagnostic pathway and agree common definitions for key points along the journey.

The work will focus particularly on people whose experiences are often missing from research, including Black women, people living in rural or deprived areas, LGBTQ+ communities and disabled people.

Primary care will also be central to the research because it is often where people first seek help with symptoms.

Mawson said: “Primary care needs to be at the heart of this work. Primary care is often where people first seek help with their symptoms, so it has a crucial role in understanding diagnostic delay.

“If we only look at what happens once someone reaches specialist gynaecology, we risk missing some of the barriers that shape the journey long before that point.”

Unlike cancer research, where internationally recognised standards exist for studying diagnostic delays, endometriosis research has been more fragmented, with studies measuring different parts of the diagnostic journey in different ways.

The researchers hope to create an ‘Endometriosis Diagnostic Pathway Framework’ to help identify where people are falling through the gaps and where healthcare could be improved.

They will also develop a ‘Snakes and Ladders’ style visual representation showing how systemic barriers, chance and individual experiences can influence whether someone reaches a diagnosis.

The project forms part of the PEARL network, Primary care Endometriosis and Adenomyosis Research and Learning, an international collaboration of primary care and community researchers and clinicians.

Mawson said: “Endometriosis diagnostic delay isn’t inevitable. If we can understand where and why people are experiencing barriers, we have a much better chance of designing interventions that actually make a difference.

“The scale of the problem demands that we look at the whole journey, listen to the people experiencing it and build an evidence base that can lead to real change.”

The framework could provide the foundations for future research, clinical guideline development, healthcare professional training and NHS service improvements, with potential applications to related conditions such as adenomyosis and chronic pelvic pain.

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