减肥手术对乳腺癌发病率及特征的影响：一项荟萃分析与系统评价

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

作者信息

Lovrics O, Butt J, Lee Y, Lovrics P, Boudreau V, Anvari M, Hong D, Doumouras A G

机构信息

Faculty of Medicine, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada.

Division of General Surgery, McMaster University, 1280 Main St. W, Hamilton, Ontario, Canada.

出版信息

Am J Surg. 2021 Oct;222(4):715-722. doi: 10.1016/j.amjsurg.2021.03.016. Epub 2021 Mar 18.

DOI:10.1016/j.amjsurg.2021.03.016

PMID:33771341

Abstract

BACKGROUND

Obesity is a major risk factor for breast cancer. This study examines whether bariatric surgery affects breast cancer incidence in women with obesity compared to BMI-matched controls.

METHODS

EMBASE, MEDLINE, Web of Science, and CINAHL were searched. Primary studies on female breast cancer incidence after bariatric surgery were eligible.

RESULTS

11 studies were included (n = 1,106,939). The rate of cancer diagnosis was lower in the surgical group (0.54%) compared to control (0.84%; risk ratio (RR) 0.50, 95%CI 0.37-0.67, I = 88%). The results were robust to sensitivity analyses for patient age and study size. Bariatric surgery was associated with increased risk of stage I cancer (RR 1.23, 95%CI 1.06-1.44) and reduced risk of stage III or IV cancer (RR 0.50, 95%CI 0.28-0.88). Hormone receptor characteristics were not affected.

CONCLUSIONS

Bariatric surgery is associated with reduced incidence and earlier stage at diagnosis of breast cancer in women with obesity compared to BMI-matched controls.

摘要

背景

肥胖是乳腺癌的主要危险因素。本研究旨在探讨与体重指数（BMI）匹配的对照组相比，减肥手术是否会影响肥胖女性的乳腺癌发病率。

方法

检索了EMBASE、MEDLINE、科学网和护理学与健康领域数据库（CINAHL）。纳入关于减肥手术后女性乳腺癌发病率的原始研究。

结果

共纳入11项研究（n = 1,106,939）。手术组的癌症诊断率（0.54%）低于对照组（0.84%；风险比（RR）0.50，95%置信区间（CI）0.37 - 0.67，I² = 88%）。对患者年龄和研究规模进行敏感性分析后，结果依然稳健。减肥手术与I期癌症风险增加（RR 1.23，95%CI 1.06 - 1.44）以及III期或IV期癌症风险降低（RR 0.50，95%CI 0.28 - 0.88）相关。激素受体特征未受影响。