Bariatric Surgery May Reduce Breast Cancer Risk
By Brittany Mancuso Roper
New study findings show that weight loss surgery lowers the risk of developing obesity-related cancers – including colon, uterine, and breast cancer – by more than 40%.
Obesity is a risk factor for breast cancer in people with diabetes. Along with lifestyle changes, there are treatment options for obesity – like medications and bariatric surgery (weight loss surgery) – that may reduce the risk of developing breast cancer.
Recent research found that bariatric surgery lowered the risk of getting any type of cancer by 25%. In women who underwent weight loss surgery, the procedure reduced the chances of developing obesity-related cancers like ovarian, colon, and breast cancer by 41%.
For people with diabetes, this can potentially be lifesaving news given that 62% of those with type 1 diabetes and 86% with type 2 diabetes have excess weight or obesity.
What’s the link between obesity and breast cancer?
Obesity is a risk factor for many cancers, including breast cancer. In the U.S. population, postmenopausal women with overweight or obesity are up to 1.4 times as likely to develop breast cancer.
This can be due to several factors, including excess estrogen levels. In those who are postmenopausal, estrogen is produced in fat or adipose tissue. More fat tissue results in more estrogen, which contributes to the risk of developing breast cancer.
Many people with obesity also have other chronic conditions like diabetes. Women with diabetes have a 20-27% higher risk of developing breast cancer than those without diabetes. Some studies attribute this link to insulin resistance; excess insulin essentially feeds cancer cells, promoting tumor growth and leading to higher incidences of breast cancer and all-cause mortality.
While correlation doesn't equal causation, obesity increases the risk of breast cancer in those with diabetes. And unlike risk factors that you can’t change – like age, menopausal status, family history, or race – treatments for obesity like medication and weight loss surgery may reduce breast cancer risk.
How medications may help
Significant weight loss can be achieved with some of the newer weight loss medications like semaglutide (Ozempic) and tirzepatide (Mounjaro).
Semaglutide has been approved for weight loss regardless of diabetes status. Tirzepatide is already approved for people with type 2 diabetes, and FDA approval for weight loss without diabetes is expected in the next 12 months.
How bariatric surgery may help
Bariatric surgery contributes to significant weight loss, resulting in easier management or remission of multiple health conditions, including type 2 diabetes and metabolic syndrome.
A 2023 study found that bariatric surgery also was associated with a lower risk of developing obesity-related cancers among female patients. Researchers reviewed the long-term cancer outcomes of 22,000 women who underwent bariatric surgery between 1982 and 2018 and compared them by age, sex, and body mass index (BMI) with a group that did not have weight loss surgery.
Weight loss surgery was associated with a 25% reduction in cancer incidence and a 41% reduction in cancer risk for obesity-related cancers, including breast, colon, and ovarian cancer. Additionally, surgery was associated with a 43% lower all-cancer mortality.
The authors suggest that their findings have clinical significance in relation to breast cancer, suggesting that “weight loss in females with severe obesity may beneficially lower incidence for both postmenopausal and premenopausal breast cancer.”
“These findings would suggest a possible hormonal mechanism driving cancer risk reduction with bariatric surgery,” said Dr. Ted Adams, lead researcher and professor at the University of Utah.
He added that his team’s most recent study isn’t the only one highlighting how beneficial bariatric surgery can be for certain populations. In 2017, the same researchers found that type 2 diabetes remission rates increased among those who underwent gastric bypass surgery.
“Bariatric surgery is appropriate for patients who have a high body mass index and have been diagnosed with type 2 diabetes,” said Adams. “In fact, having type 2 diabetes and having severe obesity helps to qualify a patient for having bariatric surgery.”
The positive long-term outcomes across multiple studies, including those conducted by Adams and his team, show that bariatric surgery may help certain patients with diabetes reduce their breast cancer risk factors and induce diabetes remission.
“Following bariatric surgery, diabetes medication is often significantly reduced or eliminated as the surgery results in a significant improvement in the patient's diabetes status and treatment,” he added.
If you’re considering bariatric surgery, Adams recommended speaking with a healthcare provider and bariatric surgeon about your health status.
Tips for breast cancer prevention
While you can’t modify some breast cancer risk factors like age or race, you can reduce your breast cancer risk by:
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Undergoing regular breast cancer screenings: Follow your healthcare provider’s guidelines regarding annual or bi-annual mammograms. Additionally, perform monthly breast self-exams and talk to a healthcare professional if any changes in breast tissue arise.
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Eating a balanced diet: Focus on eating fewer calories with foods rich in antioxidants, vitamins, and minerals. Include fruits (in moderation), vegetables, lean proteins, whole grains, and healthy fats.
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Engaging in regular exercise: Physical activity is not only great for managing your diabetes, but it also reduces your risk for breast cancer. The American Cancer Society recommends getting at least 150 minutes of moderate physical activity (like brisk walking or biking) weekly.
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Maintaining a healthy weight: It is estimated that obesity is the cause of 4-8% of all cancers. Maintaining a healthy weight can lower your cancer risk and your risk of cancer-specific mortality.
Other lifestyle factors that may help reduce your breast cancer risk include avoiding or limiting alcohol and certain forms of hormonal medication that contain estrogen.
The bottom line
Women with diabetes have a higher chance of developing breast cancer than women without diabetes. For those with obesity and diabetes, medication and weight loss surgery have been shown to increase diabetes remission rates. Weight loss will decrease the risk of developing obesity-related breast cancer.
You may qualify for weight loss surgery if you have a body mass index at or over 35. If you don’t qualify other treatment options, including weight loss medications and lifestyle changes, can help you reach a healthy weight and lower your overall cancer risk.
Learn more about diabetes and weight loss here:
