Background

Recent studies emphasize the benefits of bariatric surgery in reducing breast cancer risk. This study aims to assess the impact of overweight, obesity and history of severe obesity on the incidence of breast cancer-related surgeries.

Methods

Data from the Nation Inpatient Sample collected from January 2010 to September 2015 were examined for female patients admitted for breast cancer-related surgery as an indirect measure of resectable breast cancer incidence. Univariate and multivariate logistic regression assessed the risk of breast cancer-related surgery based on age, comorbidities, family history of breast cancer, smoking, BMI and history of obesity.

Results

Analysis included 1,435,398 female patients, among whom 0.25% (n=3,555) underwent breast cancer-related surgery (breast preserving, n=765, mastectomy or radical mastectomy, n=2,859, both procedures n=69). The incidence of breast cancer-related surgery was 0.1% for normal weight, 0.18% after bariatric surgery, and 0.28%, 0.39% and 0.29% for overweight, obesity class I and II or more, respectively. Multivariate analysis revealed that obesity was a significant risk factor for breast cancer-related surgery [Overweight: OR:2.99, p<0.0001), Class I: OR:4.29 p<0.0001), Class II and more: OR:3.29, p<0.0001)]. History of severe obesity was associated with a persistent risk of resectable breast cancer, (OR:1.74, p<0.0001) with lower odds ratio than individual with obesity.

Conclusions

Despite significant and rapid weight loss after metabolic and bariatric surgery, individuals with a history of severe obesity had a higher incidence of resectable breast cancer when compared to non-obese cohort. This suggests a potential influence of the duration of untreated obesity on breast cancer risk.