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

Lovrics, Olivia; Butt, Julia; Lee, Y.; Lovrics, Peter; Boudreau, Vanessa; Anvari, Mehran; Hong, Dennis; Doumouras, Aristithes G.

doi:10.1016/j.amjsurg.2021.03.016

Cited by 36 publications

(27 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lovrics et al pooled results from a total of 11 studies, including 1,106,939 patients, and found a 50% reduced risk of breast cancer following bariatric surgery (RR 0.50, 95% CI: 0.37‐0.67) (104). Interestingly, the risk reduction was predominately in higher stage groups (III to IV), and bariatric surgery patients had higher risk of stage I disease (RR 1.23, 95% CI: 1.06‐1.44), suggesting a tendency for diagnosis at an earlier stage in the surgical group (104). Earlier stage disease in the surgical group could suggest that women in bariatric surgery programs may receive more preventive health screening.…”

Section: Bariatric Surgery and Breast Cancer Riskmentioning

confidence: 99%

“…Systematic reviews and meta‐analyses evaluating the risk of breast cancer after bariatric surgery have reported similar findings. Lovrics et al pooled results from a total of 11 studies, including 1,106,939 patients, and found a 50% reduced risk of breast cancer following bariatric surgery (RR 0.50, 95% CI: 0.37‐0.67) (104). Interestingly, the risk reduction was predominately in higher stage groups (III to IV), and bariatric surgery patients had higher risk of stage I disease (RR 1.23, 95% CI: 1.06‐1.44), suggesting a tendency for diagnosis at an earlier stage in the surgical group (104).…”

Section: Bariatric Surgery and Breast Cancer Riskmentioning

confidence: 99%

See 1 more Smart Citation

Obesity and breast cancer: Preventive and therapeutic possibilities for bariatric surgery

Crafts

Tonneson

Wolfe

et al. 2022

Obesity

View full text Add to dashboard Cite

Breast cancer is the most common and second deadliest malignancy in women. With rising obesity rates and building evidence for a strong association with obesity, the incidence of breast cancer can be expected to increase. Weight loss reduces breast cancer risk, the mechanisms of which are still poorly understood. As an effective therapy for obesity, bariatric surgery may be a powerful tool in breast cancer prevention and treatment. This review details the potential physiologic mechanisms that may underlie this association, as well as recently published studies that reinforce the link between bariatric surgery and a reduction in incident breast cancer. The use of bariatric surgery as an adjunct therapy in endometrial cancer also raises the potential for similar use in select breast cancer patients. Despite the expanding potential applications of bariatric surgery in this field, publications to date have been strictly observational, highlighting a need for future clinical trials.

show abstract

Section: Bariatric Surgery and Breast Cancer Riskmentioning

confidence: 99%

Section: Bariatric Surgery and Breast Cancer Riskmentioning

confidence: 99%

Obesity and breast cancer: Preventive and therapeutic possibilities for bariatric surgery

Crafts

Tonneson

Wolfe

et al. 2022

Obesity

View full text Add to dashboard Cite

show abstract

“… Feigelson et al, 2020 described the greatest benefit in pre-menopausal estrogen receptor negative cancer in patients after bariatric surgery. A meta-analysis of 11 studies with over 1 million bariatric surgery patients demonstrated a significant 54% reduction in breast cancer incidence compared to BMI-matched controls, regardless of patient age ( Bruno and Berger, 2020 ; Schauer et al, 2017 ; Lovrics et al, 2021 ). While there are no specific recommendations for weight loss nor bariatric surgery in patients as a routine cancer prevention approach, the reduction in breast cancer risk associated with weight loss should be further examined using a controlled model system to better understand mechanisms impacting cancer progression and therapeutic efficacy.…”

Section: Introductionmentioning

confidence: 99%

Response to immune checkpoint blockade improved in pre-clinical model of breast cancer after bariatric surgery

Sipe

Chaib

Korba

et al. 2022

eLife

View full text Add to dashboard Cite

Bariatric surgery is becoming more prevalent as a sustainable weight loss approach, with vertical sleeve gastrectomy (VSG) being the first line of surgical intervention. We and others have shown that obesity exacerbates tumor growth while diet-induced weight loss impairs obesity-driven progression. It remains unknown how bariatric surgery-induced weight loss impacts cancer progression or alters responses to therapy. Using a pre-clinical model of diet induced obesity followed by VSG or diet-induced weight loss, breast cancer progression and immune checkpoint blockade therapy was investigated. Weight loss by bariatric surgery or weight matched dietary intervention before tumor engraftment protected against obesity-exacerbated tumor progression. However, VSG was not as effective as dietary intervention in reducing tumor burden despite achieving a similar extent of weight and adiposity loss. Circulating leptin did not associate with changes in tumor burden, however circulating IL-6 was elevated in mice after VSG. Uniquely, tumors in mice that received VSG displayed elevated inflammation and immune checkpoint ligand PD-L1+ myeloid and non-immune cells. Further, mice that received VSG had reduced tumor T lymphocytes and markers of cytolysis suggesting an ineffective anti-tumor microenvironment. VSG-associated elevation of PD-L1 prompted us to next investigate the efficacy of immune checkpoint blockade in lean, obese, and formerly obese mice that lost weight by VSG or weight matched controls. While obese mice were resistant to immune checkpoint blockade, anti-PD-L1 potently impaired tumor progression after VSG through improved anti-tumor immunity. Thus, in formerly obese mice, surgical weight loss followed by immunotherapy reduced breast cancer burden. Last, we compared transcriptomic changes in adipose tissue after bariatric surgery from both patients and mouse models that revealed a conserved bariatric surgery associated weight loss signature (BSAS). Importantly, BSAS significantly associated with decreased tumor volume. Our findings demonstrate conserved impacts of obesity and bariatric surgery-induced weight loss pathways associated with breast cancer progression.

show abstract

“…More uncertain are the consequences of BS on hospital admissions and healthcare resource use. Many studies reported lower hospital admissions after BS [ 11 , 12 , 13 , 14 , 15 ], suggesting beneficial effects on the chronic conditions characterizing individuals with obesity, such as type 2 diabetes mellitus, cardiovascular risk factors and diseases, chronic sub-clinic inflammation, and some types of cancer [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Other authors reported an increased request for inpatient and nonprimary outpatient care during the first 6-year period, but not thereafter in post-BS patients when compared to controls [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

et al. 2021

View full text Add to dashboard Cite

Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ³ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95%CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

show abstract

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

Cited by 36 publications

References 42 publications

Obesity and breast cancer: Preventive and therapeutic possibilities for bariatric surgery

Obesity and breast cancer: Preventive and therapeutic possibilities for bariatric surgery

Response to immune checkpoint blockade improved in pre-clinical model of breast cancer after bariatric surgery

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Contact Info

Product

Resources

About