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. 2022 Jul 20:12:925596.
doi: 10.3389/fonc.2022.925596. eCollection 2022.

Prior Tonsillectomy and the Risk of Breast Cancer in Females: A Systematic Review and Meta-analysis

Salah Eddine O Kacimi  1 , Anas Elgenidy  2 , Huzaifa Ahmad Cheema  3 , Mounir Ould Setti  4   5 , Atulya Aman Khosla  6 , Amira Yasmine Benmelouka  7 , Mohammad Aloulou  8 , Kawthar Djebabria  9 , Laila Salah Shamseldin  10 , Omar Riffi  1 , Nabil Smain Mesli  1   11 , Hanane Z Sekkal  1 , Ahmed M Afifi  12 , Jaffer Shah  13 , Sherief Ghozy  14   15
Affiliations

Prior Tonsillectomy and the Risk of Breast Cancer in Females: A Systematic Review and Meta-analysis

Salah Eddine O Kacimi et al. Front Oncol. .

Abstract

Background: Exposure to recurrent infections in childhood was linked to an increased risk of cancer in adulthood. There is also evidence that a history of tonsillectomy, a procedure often performed in children with recurrent infections, is linked to an increased risk of leukemia and Hodgkin lymphoma. Tonsillectomy could be directly associated with cancer risk, or it could be a proxy for another risk factor such as recurrent infections and chronic inflammation. Nevertheless, the role of recurrent childhood infections and tonsillectomy on the one hand, and the risk of breast cancer (BC) in adulthood remain understudied. Our study aims to verify whether a history of tonsillectomy increases the risk of BC in women.

Methods: A systematic review was performed using PubMed, Google Scholar, Scopus, Embase, and Web of Science databases from inception to January 25, 2022, to identify the studies which assessed the association between the history of tonsillectomy and BC in females. Odds ratio (OR) was calculated using the random/fixed-effects models to synthesize the associations between tonsillectomy and BC risk based on heterogeneity.

Results: Eight studies included 2252 patients with breast cancer of which 1151 underwent tonsillectomy and 5314 controls of which 1725 had their tonsils removed. Patients with a history of tonsillectomy showed a higher subsequent risk of developing BC (OR, 1.24; 95% CI: 1.11-1.39) as compared to patients without a history of tonsillectomy. Influence analyses showed that no single study had a significant effect on the overall estimate or the heterogeneity.

Conclusions: Our study revealed that a history of tonsillectomy is associated with an increased risk of breast cancer. These findings underscore the need for frequent follow-ups and screening of tonsillectomy patients to assess for the risk of BC.

Keywords: breast; meta-analysis; oral infection; risk; tonsillectomy.

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Conflict of interest statement

Author MO was employed by IQVIA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The Prisma flow diagram of the study.
Figure 2
Figure 2
The forest plots of (A) All studies included (Unadjusted analysis) (B) Only high-quality studies included based on NOS (Unadjusted analysis) (C) Adjusted analysis.
Figure 3
Figure 3
Influence (leave-one out sensitivity) analysis; (A) Sorted by effect size (B) Sorted by I2.
See this image and copyright information in PMC

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