Bariatric Surgery for Breast Cancer Risk Reduction—Benefit May Not Be One Size Fits All
Menée à partir de données 2010-2016 portant sur 69 260 femmes ayant souffert d'obésité (âge moyen : 45,1 ans), cette étude analyse le risque résiduel de cancer du sein 1 à 5 ans après une perte de poids liée à une chirurgie bariatrique
Résumé en anglais
In this issue of JAMA Surgery, Doumouras et al add to the growing body of literature demonstrating the association of bariatric surgery with a reduced risk of cancer. This population-based study, focused specifically on the risk of incident breast cancer, is unique compared with prior work because it focused on evaluating the “residual” risk of breast cancer in individuals with obesity after bariatric surgery. In other words, because most patients undergoing bariatric surgery do not reach a normal body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), the goal of this study was to compare patients after bariatric surgery with patients without obesity (BMI <25) to determine whether they have residual cancer risk. The study found that there was no difference in risk of incident breast cancer for patients after bariatric surgery compared with those with BMI less than 25, thus implying there is no residual risk for obesity in this group. Unfortunately, the study is limited by a lack of data on weight loss after surgery, so the BMIs of patients after bariatric surgery are unknown. Nonetheless, because there are data on weight loss after bariatric surgery from many other studies (few patients reach a normal BMI), the conclusions of the study are reasonable. These results imply that there is likely something about weight loss, or caloric restriction, independent of BMI that reduces cancer risk beyond what we would expect from matched BMI nonsurgical controls. A future study that had postsurgical BMI data to match and compare those risks would allow this result to be studied in more detail and would build nicely on the findings of the present work.
