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<p>Obesity is associated with breast cancer risk, and metabolic bariatric surgery (MBS) may reduce obesity-related cancer incidence. Prior reviews suggest lower breast cancer incidence after MBS, but uncertainty remains across design, menopausal status, procedure type, and confounding control. We conducted a PROSPERO-registered systematic review (CRD420261384078), meta-analysis, and network meta-analysis according to PRISMA. PubMed, Embase/MEDLINE, and Scopus were searched for comparative studies of breast cancer incidence after MBS versus control. Risk of bias was assessed using ROBINS-I and certainty using GRADE. Seventeen studies including 343,531 surgical patients and 1,587,413 controls were included. MBS was associated with lower breast cancer incidence in the primary hazard-ratio analysis (HR 0.75, 95% CI 0.70–0.81; I<sup>2</sup> = 0%) and women-only cohorts (HR 0.74, 95% CI 0.67–0.81). Propensity-score-matched analyses showed a larger but heterogeneous association (RR 0.56, 95% CI 0.31–0.99; I<sup>2</sup> = 91%). Premenopausal estimates favoured MBS (HR 0.74, 95% CI 0.60–0.91), whereas postmenopausal estimates were not significant (HR 0.73, 95% CI 0.50–1.07). Network estimates favoured sleeve gastrectomy and Roux-en-Y gastric bypass versus control, but no procedure was superior. Certainty ranged very low-to-moderate overall. MBS may be associated with lower breast cancer incidence, but evidence remains observational; future work must clarify causality, patient selection, and procedure effects.</p>

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An updated systematic review, meta-analysis, and network meta-analysis of breast cancer incidence after metabolic and bariatric surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • Sebastian Mitchell,
  • Ryan Gidda,
  • James Lucocq,
  • Georgios Geropoulos,
  • Danielle Clyde,
  • Mohamed H. Zidan,
  • Ross Dolan,
  • Dimitri Pournaras,
  • Mohamed Hany,
  • Omar M. Ghanem,
  • Andrew G. Robertson

摘要

Obesity is associated with breast cancer risk, and metabolic bariatric surgery (MBS) may reduce obesity-related cancer incidence. Prior reviews suggest lower breast cancer incidence after MBS, but uncertainty remains across design, menopausal status, procedure type, and confounding control. We conducted a PROSPERO-registered systematic review (CRD420261384078), meta-analysis, and network meta-analysis according to PRISMA. PubMed, Embase/MEDLINE, and Scopus were searched for comparative studies of breast cancer incidence after MBS versus control. Risk of bias was assessed using ROBINS-I and certainty using GRADE. Seventeen studies including 343,531 surgical patients and 1,587,413 controls were included. MBS was associated with lower breast cancer incidence in the primary hazard-ratio analysis (HR 0.75, 95% CI 0.70–0.81; I2 = 0%) and women-only cohorts (HR 0.74, 95% CI 0.67–0.81). Propensity-score-matched analyses showed a larger but heterogeneous association (RR 0.56, 95% CI 0.31–0.99; I2 = 91%). Premenopausal estimates favoured MBS (HR 0.74, 95% CI 0.60–0.91), whereas postmenopausal estimates were not significant (HR 0.73, 95% CI 0.50–1.07). Network estimates favoured sleeve gastrectomy and Roux-en-Y gastric bypass versus control, but no procedure was superior. Certainty ranged very low-to-moderate overall. MBS may be associated with lower breast cancer incidence, but evidence remains observational; future work must clarify causality, patient selection, and procedure effects.