On a molecular level, it has been hypothesized that elevated leptin expression in epithelial mammary cells may promote tumorigenesis via mechanisms including cell proliferation (aromatase, MAPK, STAT3, and cyclin D1), angiogenesis (VEGF), apoptosis (p53 and caspase 9), cell-cycle regulation (p21), and cell survival (Akt) in breast cancer cell lines [64]. This evidence concerns the gene CYP19A1 and breast cancer.