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15-year Cardiovascular And Pulmonary Outcomes After Breast Reduction: A Propensity Score-matched Analysis
Charlotte Thomas, BS, Manuela Neira, MD, Agustin Posso, MD, Tricia Raquepo, BA, Sanjana Challa, BS, Alynah J. Adams, BS, Fatima Z. Arif, MD, MSc, Samuel J. Lin, MD, MBA, Sarah J. Karinja, MD, Bernard T. Lee, MD, MPH, MBA.
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
PURPOSE:Breast reduction surgery provides durable improvements in pain, function, and quality of life, but its broader health effects remain unclear. Whether increased activity and improved sleep translate to reduced cardiopulmonary disease risk has not been well studied. This study evaluated long-term health outcomes following breast reduction.
METHODS:Using the TriNetX database, we identified patients with macromastia who underwent breast reduction within six months of diagnosis, and propensity-score matched controls who did not. Matching was applied for age, demographics, diabetes, hypertension, smoking, GLP-1s, LDL cholesterol, and BMI. New diagnoses of obstructive sleep apnea (OSA), stroke, myocardial infarction (MI), unstable angina (UA), and heart failure (HF), were assessed beginning one year after diagnosis at 5-, 10-, and 15-year timepoints. Subgroup analyses by BMI were performed.
RESULTS:After matching, 47,426 patients were included per cohort. At 5 years, breast reduction was associated with lower risk of OSA (p=0.0002), stroke (p<0.0001), MI (p<0.0001), and HF (p<0.0001). These protective effects persisted through 15 years. Effects were strongest in patients with BMI ≥ 30, and limited to OSA and HF in BMI 25-30; no benefit was observed in BMI < 25.
CONCLUSION:Breast reduction was associated with sustained reductions in cardiovascular and pulmonary disease risk, most pronounced in women with obesity. To our knowledge, this represents the first large-scale evidence of systemic health benefits of breast reduction.
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