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Obesity Surgery

, Volume 29, Issue 4, pp 1092–1098 | Cite as

Association of Bariatric Surgery Status with Reduced HER2+ Breast Cancers: a Retrospective Cohort Study

  • Keyvan Heshmati
  • David A. Harris
  • Bernard Rosner
  • Elisha Pranckevicius
  • Ali Ardestani
  • Nancy Cho
  • Mehra Golshan
  • Winnie T. Ng
  • Jennifer Ligibel
  • Ali Tavakkoli
  • Eric SheuEmail author
Original Contributions
  • 243 Downloads

Abstract

Background

Bariatric surgery is associated with a reduced risk of developing certain malignancies, particularly in women. However, the impact of bariatric surgery on tumor characteristics, cancer treatment, and oncologic outcomes is unknown.

Method

In a retrospective cohort study, 42 subjects diagnosed with breast cancer after bariatric surgery (1989–2014) were matched to 84 subjects with breast cancer (1984–2012) who did not undergo bariatric surgery, based on age, body mass index (BMI), and menopausal status at the time of breast cancer diagnosis, as well as the date of cancer diagnosis. Medical records were reviewed for cancer and bariatric endpoints. Statistical analysis was performed using mixed effects regression models, generalized estimating equation, conditional logistic regression, and Fisher’s exact tests.

Results

Women who developed breast cancer after bariatric surgery presented at an earlier stage compared to non-operated, obese controls. In the bariatric surgery group, there were fewer tumors with human epidermal growth factor receptor 2 overexpression (HER2+) (OR 0.16 (0.03–0.76); p = 0.02), with no significant differences seen in estrogen and progesterone receptor positivity. No HER2+ cancers were found in patients who underwent Roux-en-Y gastric bypass (OR 0.00 (0.00–0.43); p = 0.002). On multivariate analysis, bariatric surgery status remained associated with reduced HER2+ breast cancers (OR 0.18 (0.03–0.99); p < 0.05). At a mean follow-up of 5 years, bariatric surgery was associated with trends toward reduced cancer-specific and all-cause mortality.

Conclusions

Bariatric surgery is associated with reduced HER2+ breast cancers, suggesting that bariatric surgery can influence breast cancer characteristics and, potentially, tumor biology.

Keywords

Bariatric surgery Breast cancer Roux-en-Y gastric bypass HER2 overexpression 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11695_2018_3701_MOESM1_ESM.docx (18 kb)
Data S1 (DOCX 14 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Keyvan Heshmati
    • 1
  • David A. Harris
    • 1
  • Bernard Rosner
    • 2
  • Elisha Pranckevicius
    • 1
  • Ali Ardestani
    • 1
  • Nancy Cho
    • 1
  • Mehra Golshan
    • 1
  • Winnie T. Ng
    • 3
  • Jennifer Ligibel
    • 3
  • Ali Tavakkoli
    • 1
  • Eric Sheu
    • 1
    Email author
  1. 1.Department of SurgeryBrigham and Women’s Hospital, Harvard Medical SchoolBostonUnited States
  2. 2.Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonUSA
  3. 3.Breast Oncology Program, Dana-Farber Cancer InstituteHarvard Medical SchoolBostonUSA

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