BIRC5 and obesity due to melanocortin 4 receptor deficiency: Recent findings have shown a strong relationship between adipocyte-derived leptin and breast cancer.44 Notwithstanding the fact that leptin might act centrally to trigger apoptosis in WAT resulting in adipocyte depletion,45, 46, 47 several studies suggest that the molecular effects of leptin on carcinogenesis are mediated by suppression of apoptosis through survivin-dependent mechanisms.14, 15 Chronically high levels of leptin in obesity can lead to leptin resistance,48 which results not only in loss of appetite control but also in resistance to adipocyte apoptosis.