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Overall and Estrogen Receptor–Positive Breast Cancer Incidences Are Decreased Following Bariatric Surgery

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Abstract

Introduction

Bariatric surgery treats morbid obesity resulting in long-lasting weight loss. Elevated body mass index (BMI) increases breast cancer risk. We hypothesized that patients undergoing bariatric surgery would have decreased overall and estrogen receptor (ER)-positive breast cancer incidences compared to a propensity-matched non-surgical cohort.

Methods

The bariatric population included all female patients who underwent weight loss surgery at a single institution from 1985 to 2015. Patients from all outpatient visits were propensity score matched 1:1 with bariatric patients using BMI, comorbidities, demographics, and insurance status. The primary outcome was breast cancer incidence. Univariate analyses compared the groups.

Results

A total of 4860 patients were included, with 2430 in both groups. Median follow-up time from date of surgery or morbid obesity diagnosis was 5.7 years. There were no differences in age or comorbidities aside from gastroesophageal reflux disease. Seventeen (0.7%) patients in the surgery group were subsequently diagnosed with breast cancer versus 32 (1.3%) in the non-surgery group (p = 0.03). The non-surgery group had more ER-positive tumors [4 (36.4%) vs. 22 (71.0%); p = 0.04].

Conclusion

Female patients who underwent bariatric surgery were less frequently diagnosed with any breast cancer and ER-positive breast cancer versus a propensity-matched cohort suggesting a possible oncologic benefit to weight loss surgery.

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Funding

This work was financially supported by the National Institutes of Health [grant numbers T32HL007849 and T32CA163177].

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Authors and Affiliations

  1. Department of Surgery, University of Virginia Health System, P.O. Box 800709, Charlottesville, VA, 22903, USA

    Taryn E. Hassinger, J. Hunter Mehaffey, Robert B. Hawkins, Bruce D. Schirmer, Peter T. Hallowell, Anneke T. Schroen & Shayna L. Showalter

Authors
  1. Taryn E. Hassinger
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  2. J. Hunter Mehaffey
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  3. Robert B. Hawkins
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  4. Bruce D. Schirmer
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  6. Anneke T. Schroen
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  7. Shayna L. Showalter
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Corresponding author

Correspondence to Shayna L. Showalter.

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The authors declare that they have no conflict of interest.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Research reported in this publication was supported by the National Institutes of Health under Award Numbers T32HL007849 and T32CA163177.

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Hassinger, T.E., Mehaffey, J.H., Hawkins, R.B. et al. Overall and Estrogen Receptor–Positive Breast Cancer Incidences Are Decreased Following Bariatric Surgery. OBES SURG 29, 776–781 (2019). https://doi.org/10.1007/s11695-018-3598-9

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