A nationwide epidemiologic study of breast cancer incidence following breast reduction surgery in a large cohort of Swedish women

  • Jon P. Fryzek
  • Weimin Ye
  • Olof Nyrén
  • Robert E. Tarone
  • Loren Lipworth
  • Joseph  K. McLaughlin
Epidemiology

Summary

While it has been demonstrated that prophylactic mastectomy reduces breast cancer incidence among women at high risk, many women often consider this disfiguring surgery unacceptable. One alternative approach may be breast reduction surgery. In order to evaluate the long-term incidence of breast cancer following surgical removal of breast tissue, we have extended by 9 years the follow-up period of our earlier retrospective cohort study of Swedish women electing cosmetic breast reduction surgery (n=30,444) between 1965 and 1993, yielding an average of nearly 16 years of follow-up. Cancer incidence through 2002 was ascertained via the Swedish Cancer Registry. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated comparing women who underwent breast reduction surgery with women in the general Swedish population. Breast cancer was observed in 443 women versus 624 expected for a statistically significant reduced SIR of 0.71 (95% CI=0.65–0.78). Analyses by age at surgery, time since surgery or calendar year of surgery revealed similar reductions in risk. Our study of over 30,000 women with long-term follow-up offers further evidence that women undergoing breast reduction surgery have reduced breast cancer risk. As the evidence from large-scale cohort studies accumulates, direct testing of this reduction in risk through clinical trials should be considered.

Keywords

breast cancer breast reduction surgery cohort epidemiology 

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Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Jon P. Fryzek
    • 1
    • 4
  • Weimin Ye
    • 3
  • Olof Nyrén
    • 3
  • Robert E. Tarone
    • 1
  • Loren Lipworth
    • 1
    • 2
  • Joseph  K. McLaughlin
    • 1
  1. 1.Department of Medicine, International Epidemiology Institute, Rockville, MDVanderbilt University Medical Center, Vanderbilt-Ingram Cancer CenterNashvilleUSA
  2. 2.Department of Preventive MedicineVanderbilt University Medical Center, Vanderbilt-Ingram Cancer CenterNashvilleUSA
  3. 3.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  4. 4.International Epidemiology InstituteRockvilleUSA

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