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Cancer Risk Reduction After Breast Reduction Surgery: Evidence from 220,645 Women
Robert D. Sampson, MD, MBA1, Wenchu Pan, MS
2, Lu Wang, PhD
2, Kevin C. Chung, MD, MS
1.
1University of Michigan Medical School, Ann Arbor, MI, USA,
2University of Michigan School of Public Health, Ann Arbor, MI, USA.
PURPOSE:Breast cancer affects 1in 8 women in the United States. Although over 110,000 women annually undergobreast reduction, the procedure lacks indication for cancer risk reduction andinsurers routinely deny coverage. We examined whether breast reductiondecreases cancer risk using the largest cohort studied to date.
METHODS: Using MarketScandatabases (2009-2023), we identified 55,582 women undergoing bilateral breastreduction, matched 1:3 to controls by age/year (n=220,645). Inverseprobability-weighted Cox models adjusted for Elixhauser comorbidity index,family history, benign breast disease, mammography frequency, and healthcareutilization.
RESULTS: Breast cancer developedin 878 reduction patients (1.58%) versus 4,553 controls (2.76%), demonstrating37% risk reduction (HR 0.63; 95% CI: 0.58-0.68; p<0.001). Risk reduction was40% in those ≥40 years (HR 0.60; 95% CI: 0.56-0.65; p<0.001) versus 21% inthose <40 years (HR 0.79; 95% CI: 0.63-0.98; p=0.035). Women with benignbreast disease achieved 75% reduction (HR 0.25; 95% CI: 0.21-0.29; p<0.001),those with family history achieved 62% reduction (HR 0.38; 95% CI: 0.29-0.48;p<0.001).
CONCLUSION:Breast reduction wasassociated with substantial cancer risk reduction, particularly among thosewith benign breast disease or family history. These findings challenge currentpractice that limits breast reduction to symptomatic relief. Such risk reductionsupports incorporating cancer benefits into preoperative discussions andreconsidering policies restricting access to this procedure.
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