Does Bariatric Surgery Affect the Incidence of Breast Cancer Development? A Systematic Review

Abstract

We reviewed the evidence for bariatric surgery reducing the risk of breast cancer. Data was extracted from multiple libraries, including PubMed, EMBASE, and Medline, to perform a systematic review. Abstracts were reviewed by two independent reviewers. Thirty-eight full-text articles were identified from 1171 abstracts. Four studies were included for meta-analysis; 114 of 10,533 (1.1%) patients receiving bariatric surgery versus 516 of 20,130 (2.6%) controls developed breast cancer, odds ratio 0.564 (95% CI 0.453 to 0.702) using a fixed effects model (P < 0.001) and odds ratio 0.585 (95% CI 0.247 to 1.386) using a random effects model (P 0.223). Bariatric surgery may reduce the risk of breast cancer. More research is required due to heterogeneity of studies, difficulty in identifying accurate controls, and limited follow-up.

The impact of bariatric surgery on qualitative and quantitative breast density

“…Morbidly obese women experienced significant increases in VBD following bariatric surgery at our institution, primarily related to substantial reductions in adipose volume. However, small yet significant reductions in FGV were also detected, suggesting that the decrease in FGV could be conveying the anticancer benefit previously described following bariatric surgery . This is in line with Shepard et al, which identified both FGV and percent FGV as stronger and more accurate predictors of breast cancer risk as compared to VBD …”

“…Resolution and improvement of obesity‐related comorbidities, including diabetes mellitus and metabolic syndrome—two additional cancer risk factors—are also seen with surgical weight loss . Notably, multiple observational studies have additionally reported reductions in the incidence of several malignancies, including breast cancer, following bariatric surgery, possibly related to the decreased circulating estrogen levels seen with reductions in body fat . The impact of bariatric surgery on breast density as a potential modulator of cancer risk, however, remains poorly understood.…”

“…10,32 Notably, multiple observational studies have additionally reported reductions in the incidence of several malignancies, including breast cancer, following bariatric surgery, possibly related to the decreased circulating estrogen levels seen with reductions in body fat. [11][12][13]33,34 The impact of bariatric surgery on breast density as a potential modulator of cancer risk, however, remains poorly understood.…”

“…Bariatric surgery is an effective treatment for obesity, consistently resulting in more substantial weight loss and comorbidity amelioration compared with medical management alone . Multiple population‐based studies have also suggested that the postsurgical reductions in BMI positively modify subsequent cancer risk for various malignancies, including breast cancer . Conceptually, the significant decrease in BMI might be expected to result in increased breast density related to an overall reduction in total body fat.…”

“…9,10 Multiple populationbased studies have also suggested that the postsurgical reductions in BMI positively modify subsequent cancer risk for various malignancies, including breast cancer. [11][12][13] Conceptually, the significant decrease in BMI might be expected to result in increased breast density related to an overall reduction in total body fat. This is antithetical to the decrease in breast cancer incidence seen following bariatric surgery, suggesting a more complex interplay between BMI and breast density.…”