Obesity disrupts the dynamic role of the adipocyte in energyhomeostasis, resulting in inflammation and alteration of adipokinesignaling [10]. In addition, obesity causes secondary changes thatare related to insulin signaling and lipid deregulation [10]. Thesemetabolic changes related to obesity might in turn affect breastcancer development [11]. Body fat distribution and related mark-ers might be more closely related to breast cancer developmentthan obesity [10]. Intra-abdominal visceral fat is metabolically dis-tinct from subcutaneous fat. It is associated with metabolic changes,including hyperinsulinemia and insulin resistance, increased levelsof free fatty acids, lower levels of sex-hormone-binding glob-ulin, and increased bioavailability of estradiol [10]. These datasuggest that body fat distribution may define distinct obesity sub-phenotypes with specific metabolic biomarkers, which, ultimately,may differentially affect breast cancer risk.The association between obesity and breast cancer risk may be,at least in part, dependent on tumor type. For example, waist andhip circumferences and waist-to-hip ratio were significantly associ-ated with increased risk for estrogen receptor negative (ER−) breasttumors in pre-menopausal women in the Nurses’ Health Study II[12]. Also, high (≥35 kg/m2) BMI was associated with increased riskof ER− and PR+ tumors among postmenopausal African-Americanwomen compared to normal to low BMI (