The effect of bariatric surgery on breast cancer incidence and characteristics: A meta-analysis and systematic review

O Lovrics; J Butt; Y Lee; P Lovrics; V Boudreau; M Anvari; D Hong; A G Doumouras

doi:10.1016/j.amjsurg.2021.03.016

The effect of bariatric surgery on breast cancer incidence and characteristics: A meta-analysis and systematic review

Am J Surg. 2021 Oct;222(4):715-722. doi: 10.1016/j.amjsurg.2021.03.016. Epub 2021 Mar 18.

Authors

O Lovrics¹, J Butt¹, Y Lee², P Lovrics², V Boudreau³, M Anvari³, D Hong³, A G Doumouras⁴

Affiliations

¹ Faculty of Medicine, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada.
² Division of General Surgery, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada.
³ Division of General Surgery, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada; Centre for Minimal Access Surgery (CMAS), St. Joseph's Healthcare Hamilton, 50 Charlton Ave. E., Hamilton, Ontario, Canada.
⁴ Division of General Surgery, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada; Centre for Minimal Access Surgery (CMAS), St. Joseph's Healthcare Hamilton, 50 Charlton Ave. E., Hamilton, Ontario, Canada. Electronic address: aristithes.doumouras@medportal.ca.

PMID: 33771341
DOI: 10.1016/j.amjsurg.2021.03.016

Abstract

Background: Obesity is a major risk factor for breast cancer. This study examines whether bariatric surgery affects breast cancer incidence in women with obesity compared to BMI-matched controls.

Methods: EMBASE, MEDLINE, Web of Science, and CINAHL were searched. Primary studies on female breast cancer incidence after bariatric surgery were eligible.

Results: 11 studies were included (n = 1,106,939). The rate of cancer diagnosis was lower in the surgical group (0.54%) compared to control (0.84%; risk ratio (RR) 0.50, 95%CI 0.37-0.67, I² = 88%). The results were robust to sensitivity analyses for patient age and study size. Bariatric surgery was associated with increased risk of stage I cancer (RR 1.23, 95%CI 1.06-1.44) and reduced risk of stage III or IV cancer (RR 0.50, 95%CI 0.28-0.88). Hormone receptor characteristics were not affected.

Conclusions: Bariatric surgery is associated with reduced incidence and earlier stage at diagnosis of breast cancer in women with obesity compared to BMI-matched controls.

Keywords: Bariatric surgery; Breast cancer; Obesity-related cancer; Risk reduction.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Bariatric Surgery*
Breast Neoplasms / epidemiology*
Female
Humans
Incidence
Obesity / complications*
Obesity / surgery*